Search

The efficacy and availability of contraception have changed in the last several decades; however, unintended pregnancies continue to be an issue in Australia. This study aimed to describe trends in contraception in women attending a sexual health service over 9 years. Repeated cross-sectional study. Women aged 16–49 years attending Melbourne Sexual Health Centre between 2011 and 2020 were included. Women were asked what methods of contraception they currently use. Contraception were categorised into long-acting reversible contraception (LARC; e.g. intrauterine devices and implants classified as highly effective), moderately effective contraception (e.g. oral contraception pill), less effective contraception (e.g. condom and withdrawal) and no contraception, as defined by US Centers for Disease Control and Prevention guidelines. Multivariable logistic regression was used to examine the factors associated with the use of moderate-high-efficacy contraception. A total of 38,288 women were included with a median age of 25 (interquartile range: 22–29). Between 2011 and 2020, there was a decreasing trend in condom (63.3%–56.1%; P trend <0.001) and oral contraception (27.2%–20.5%; P trend <0.001) use, whilst there was an increasing trend in the use of LARCs: implant (4.6%–6.0%; P trend = 0.002) and intrauterine device (2.8%–11.8%; P trend <0.001). Increasing age was associated with decreased odds of using moderate-high-efficacy contraception (P trend <0.001). Compared with Oceanian-born women, Asian (adjusted odds ratios [aOR] = 0.63, 95% confidence interval [CI]: 0.56–0.72) and Middle Eastern-born women (aOR = 0.60, 95% CI: 0.48–0.74) had lower odds of using moderate-high-efficacy contraception, whilst European (aOR = 1.23, 95% CI:1.07–1.41) and North American-born women (aOR = 1.51, 95% CI: 1.22–1.87) had higher odds of using moderate-high-efficacy contraception. Between 2011 and 2020, LARC use has increased, whilst less effective contraceptives, such as condom and oral contraception, have decreased among women at Melbourne Sexual Health Centre. Further research is required to understand age and ethnic disparities in contraception methods for future family planning programmes. [ABSTRACT FROM AUTHOR]

The study investigated the determinants of family planning choices and barriers among women attending private fertility clinics in Delta State. A stratified sampling technique was used in selecting three (3) private fertility clinics in Delta State while a simple random sampling technique was employed in selecting 156 participants out of a total population of 1,560 women that are registered with the private fertility clinics. A self-structured, pre-validated questionnaire was designed by the researchers as the instrument for data collection. The questionnaires were administered to the participants and 140 were successfully retrieved for data analysis. Simple percentages and frequency count was adopted as statistical tools for analyzing the obtained data while chi-square technique was used in testing the five (5) formulated hypotheses. Results findings obtained from the analysis revealed that family planning choices and barriers among women attending private fertility clinics in the study area are determined by; health, economic, social, religion, and cultural factors. Hence, the need for the government of Delta State to provide quality, subsidized, and comprehensive family planning services capable of substituting the prevalent traditional family planning methods while considering health, economy, social, religion and culture as necessary factors that might pose as barriers to the choices of these women towards sustainable family planning choices. [ABSTRACT FROM AUTHOR]

Copyright of Revue d'Histoire Moderne & Contemporaine is the property of Societe d'Histoire Moderne et Contemporaine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Use of HIV PrEP (pre-exposure prophylaxis) is a strategic tool in the effort to end the HIV epidemic. 20% of new HIV infections in the US are among cis-gender women, yet they comprise only 5% of all PrEP users. Black women disproportionately bear the burden of new HIV acquisition and accounted for almost 60% of new HIV diagnoses among women in 2018. Increasing understanding and uptake of PrEP among women at risk of HIV acquisition in alignment with their reproductive values and preferences is key to increasing PrEP uptake and decreasing HIV burden in this population. Objective: This study examines how experiences with contraception among women of color shape their perceptions and preferences regarding HIV PrEP to inform counseling that aligns with their reproductive values. Methods: Women aged 18–45 who self-identified as Black or Latina were recruited at an academic medical center in the Bronx from June 2018 to July 2019. We enrolled 30 participants seeking family planning care (10), prenatal care (10), or care for sexually transmitted infections (10). Participants completed a brief written survey assessing their risk of HIV acquisition. Semi-structured, face-to-face interviews were then audio-recorded, transcribed, and entered into Dedoose. Grounded theory and constant comparison approaches were used to analyze the data. Results: Twenty-one participants (70%) screened positive for HIV acquisition risk. Four had received information on PrEP from a medical provider prior to the interview. Three themes emerged from the qualitative analysis: (1) Similar to oral contraception, women conceptualized PrEP as a "daily pill" to support their reproductive health; (2) Women perceived PrEP as a tool to support autonomy and pleasure in their sexual health; (3) Like birth control, women desired multiple delivery options for HIV prophylaxis. Conclusions: Contraception may serve as a frame of reference when counseling about PrEP among cis-women at risk of acquiring HIV. Our study suggests that this approach re-contextualizes counseling on PrEP within a sex-positive framework that prioritizes pleasure, safety, and autonomy as integral to sexual and reproductive wellness. Consideration of historically marginalized women's experiences with contraception and reproductive values may facilitate their use of PrEP. Plain Language Summary: PrEP (pre-exposure prophylaxis) is a medicine taken daily by people at risk of getting HIV from sex or injection drug use. Although PrEP is a safe and effective medication for women, the use of PrEP remains exceedingly low among cis-gender women at risk of HIV in the US. This study examines how experiences with contraception among women of color, who disproportionately bear the burden of HIV acquisition, shape their perceptions and preferences regarding PrEP. We interviewed 30 women who self-identified as Black or Latina at an academic medical center in the Bronx. Similar to oral contraception, women in this study conceptualized PrEP as a "daily pill" to support their reproductive health. This report details how women's experiences with contraception may serve as the foundation to re-contextualize conversations on PrEP within a sex-positive framework that prioritizes pleasure, safety, and autonomy as integral to sexual and reproductive wellness. [ABSTRACT FROM AUTHOR]

After dropping rapidly and steadily over two decades, fertility in Iran stabilized between 2001 and 2011 at around 1.9 to 2 children per woman, before starting to rise slightly between 2012 and 2016, then falling fairly quickly. This coincided with the implementation of the Islamic Republic's new population policy, with its aggressive and coercive measures, one of whose goals was to reverse the downwards trend in fertility. Given changes in proximate and remote determinants of fertility in Iran, and the decline in fertility since 2016, it is assumed that this new population policy triggered a reduction in intervals between births between 2012 and 2015, leading to a slight rise in the fertility of already married couples. The other latent objective of the Islamic Republic's new population policy is to drive Iran's population up to 150 million inhabitants in the near future. This is utopian given Iran's demographic dynamics, but it conceals the political and ideological goal of asserting Iran's demographic and geopolitical significance within the region, by drawing on a novel immigration policy to make up for its low fertility. [ABSTRACT FROM AUTHOR]

Copyright of Historia y Comunicación Social is the property of Universidad Complutense de Madrid and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Provision of contraception to women in the immediate postnatal period has been endorsed by professional bodies, to reduce the incidence of short inter-pregnancy intervals. This study examined the views of postnatal women and practising midwives regarding provision of contraceptive advice and contraceptive methods by midwives, in a region of the United Kingdom.Methods: A mixed-method approach using qualitative interviews with midwives, and a postnatal survey followed by qualitative interviews with postnatal women, in five hospitals in the East of England. Twenty-one practising midwives and ten women were interviewed. Two hundred and twenty-seven women returned a survey. Survey data was analysed descriptively, augmented by Student's t-tests and Chi-squared tests to examine associations within the data. Interviews were recorded, transcribed and analysed guided by the phases of thematic analysis.Results: Midwives and women supported the concept of increased midwifery provision of contraceptive advice, and provision of contraceptive methods in the postnatal period. Convenience and an established trusting relationship were reasons for preferring midwifery provision over visiting a doctor for contraception. The best time for detailed discussion was reported to be antenatal and community visits. The Progesterone-only-pill (POP) was the method, in which women indicated most interest postnatally. Concerns for midwives included the need for increased education on contraceptive methods and training in supplying these. Structural barriers to such provision were time pressures, low prioritisation of contraceptive training and disputes over funding.Conclusions: Women reported interest in midwives supplying contraceptive methods and expressed the view that this would be convenient and highly acceptable. Midwives are supportive of the concept of providing enhanced contraceptive advice and methods to women in their care, and believe that it would be advantageous for women. Institutional support is required to overcome structural barriers such as poor access to continuous professional development, and to allow contraceptive provision to be fully recognised as integral to the midwifery role, rather than a marginalised addition. [ABSTRACT FROM AUTHOR]

In this retrospective analysis of the 2015-2017 and 2017-2019 National Survey of Family Growth female respondent files, women younger than 30 years of age were more likely to experience sterilization regret compared to women older than 30 years of age. As women got older, sterilization regret decreased, and no other demographic or clinical factors, including race, parity, educational attainment, or medical reasons for sterilization, were associated with regret. [ABSTRACT FROM AUTHOR]

The paper discusses the changing position of women in the socialist society and its partial, but not complete emancipation. Special attention has been given to gender relations in the conditions of socialist modernization, weakening of social restrains and patriarchal believes, the awakening of sexuality and the consequences that followed these major social changes. The sources from the Archives of Yugoslavia, as well as relevant periodicals and literature, were used. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 177 016: Srpsko društvo u jugoslovenskoj državi u 20. veku: između demokratije i diktature]

Objective: Effective contraception prevents unintended pregnancy which disproportionately affects women in the criminal justice system. This study examined selected variables associated with contraceptive use by women on probation and parole living on the United States–Mexico border. Design: This quantitative correlational study examined individual and interpersonal variables—age, parity, ethnicity, prior contraception, self‐efficacy, pregnancy attitudes, and reproductive autonomy—that may influence contraception among 52 women under community supervision. Measures: Variable were examined with bivariate, multivariate analyses, and hierarchical logistic regression. Data were collected from a demographic and contraceptive use survey, and validated scales measuring reproductive autonomy and pregnancy attitudes. Results: Contraceptive methods were used by 89% of the women; 65% used effective methods, but this decreased to 35% among those released within the past year. Reproductive autonomy was associated with effective contraceptive use. Prior contraception and contraceptive self‐efficacy were significant, but wide confidence intervals suggested instability. The remaining variables were insignificant. Conclusion: No known studies have examined contraception use among women on probation and parole on the border. More women used some form of contraception than might be predicted. Collaborative efforts between correctional facilities and the community are needed to expand access to contraception. [ABSTRACT FROM AUTHOR]

The childcare burden is one of the main reasons behind the lower employment rate of women in Turkey, and the opportunity cost of childbearing is high for employed women (especially for those in higher-paid jobs). Since using an effective birth control method allows women to control the timing of reproduction, there may be differences in contraception behavior between employed women and women not working for pay. This study analyzes the impact of employment status of women with young children on their contraception behavior using data from the 2013 Turkey Demographic and Health Survey (TDHS). Results show that employed women, including family workers, are more likely to choose a modern method over a traditional one, particularly those working as government employees. Results also indicate that the likelihood of employment can be enhanced by increasing the share of public provision of childcare and preschool services. [ABSTRACT FROM AUTHOR]

Objective: To determine the current risks of infertility and impaired fecundity as well as the live birth/pregnancy ratio among women with epilepsy (WWE) in the USA and whether antiepileptic drug (AED) use is a factor. Methods: These retrospective survey data come from the 2010‐2014 Epilepsy Birth Control Registry (EBCR) Web‐based survey of 1000 WWE in the USA, aged 18‐47 years, who provided demographic, epilepsy, AED, reproductive, and contraceptive data. We report risks of infertility and impaired fecundity, live birth/pregnancy ratio, and whether outcomes differ by AED use or category versus No AED. Results: A total of 978 of the 1000 USA WWE reported reproductive data; 373 WWE had 724 pregnancies and 445 births. An additional 38 WWE (9.2%, 95% confidence interval [CI] = 6.7‐12.4%) tried to conceive but were infertile. A total of 72.5% had a live birth outcome for their first pregnancy, 89.0% had at least one live birth for their first two pregnancies, and 61.6% had two live births for their first two pregnancies. Eighty‐four of 406 WWE (20.7%, 95% CI = 17.0‐2.9%) had impaired fecundity. The risk of impaired fecundity trended higher on AED polytherapy than on No AED (risk ratio [RR] = 1.79, 95% CI = 0.94‐3.11, P = .08). The ratio of live birth/unaborted pregnancy (445/594, 74.9%) was similar among WWE on No AED (71.3%), AED monotherapy (71.8%), and polytherapy (69.7%). None of the AED categories differed significantly from No AED. Note that glucuronidated AED (lamotrigine), which had the highest ratio of live birth/pregnancy (89.1%), compared favorably to enzyme‐inhibiting AED (valproate), which had the lowest (63.3%; RR = 1.41, 95% CI = 1.05‐1.88, P = .02). Significance: The EBCR finds 9.2% infertility risk and 20.7% impaired fecundity risk among WWE in the USA. Impaired fecundity trended higher on AED polytherapy than on No AED. Live birth/pregnancy ratio was higher with the use of lamotrigine than valproate. These findings may provide WWE a more objective basis for pregnancy planning. [ABSTRACT FROM AUTHOR]

Condoms are one of the most effective methods of birth control and sexually transmitted illness (STI) prevention. A great deal is known about condom knowledge, attitudes, and use in different countries in the current literature, but not much comparative data exist. This study seeks to explore the cross-cultural differences in condom knowledge, attitudes, and use, as well as the relationships among these variables, for young, educated women--an important yet often overlooked target audience for prevention campaigns. We surveyed approximately 300 18- to 30- year-old women each from China, India, the United Kingdom, and the United States (n = 1,099) using online survey services. Results showed that American and British women reported better condom knowledge and more favorable condom attitudes than Chinese and Indian women; however, Chinese women reported significantly higher condom use than others. Multi-group structural equation modeling (SEM) revealed that condom negotiation was the most important explanatory factor of condom attitudes among all four groups. Embarrassment during condom purchase and lack of accessibility for purchase were important in determining condom attitudes of Indian women. Moreover, condom use was more strongly associated with condom attitudes among Chinese and Indian women than American and British women. Condom knowledge was not positively associated with condom use in any of the groups. Theoretical contributions to the literature and practical implications for condom promotion, sex education, and health campaigns are presented. [ABSTRACT FROM AUTHOR]

Copyright of Bulletin of the Institute of Ethnography of the Serbian Academy of Sciences & Arts / Glasnik Etnografskog Instituta SANU is the property of Institute of Ethnography, SASA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: The Chinese government launched the two-child policy in 2015 to counteract the demographic changes, skewed sex ratio, and decreasing number of labor force. The policy shift has a significant impact on all levels of society and economy. This study aimed to describe how Mainland Chinese women face this new decision-making on their reproduction and family planning and captures factors contributing to the judgment and decision-making. Method: The present qualitative study included a sample of 37 women, with an average age of 29.51 years, and well educated with bachelor degrees from urban areas of Shanghai and Hangzhou cities. The women were interviewed by social science students, using a 26-item interview targeting the women’s decision-making, expectations, and wishes with regard to the two-child policy. Results: The contributors include the status of women, career, benefits, and challenges of two children, one-child generation, governmental support, and restrictions of reproductive freedom. These factors contribute to the women’s prolonged decision-making on whether to have a second child. These factors highlight the impact of the policy on perinatal health, societal, and economic changes. The study illustrates the need to continue understanding the impact of the child policy shift for families and the society of the China on multiple levels. Conclusion: With the outcomes of research on the families’ judgment and decision-making with regard to a second child, support can be targeted where it is needed the most. The acquired knowledge may serve as a prognosis for the child policy’s future development and used to target perinatal care and education of health care specialists, essential to governmental planning and resource allocation. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Preventing HIV and unintended pregnancies are key global health priorities. To inform product rollout and to understand attributes of future multipurpose prevention technologies (MPT) associated with preference and use, we evaluated three placebo delivery forms: daily oral tablets, a monthly vaginal ring, and two monthly intramuscular injections in TRIO, a five‐month study among young Kenyan and South African women. Methods: HIV‐negative, sexually active, non‐pregnant women aged 18 to 30 were enrolled and randomized to use each placebo delivery form for one month (stage 1). Then, participants chose one product to use for two additional months (stage 2). We assessed safety, product ranking, choice, and use. We examined demographic and behavioural correlates of choice and, reciprocally, unwillingness to use in the future with logistic regression models. Results: 277 women enrolled, 249 completed stage 1 and 246 completed stage 2. Median age was 23 years, 49% were Kenyan and 51% were South African. Three participants became pregnant during the study and one participant HIV‐seroconverted. There were 18 product‐related adverse events, six tablets‐related, 11 ring‐related, and one injection‐related. After trying each product, 85% preferred a TRIO product over condoms. Injections were chosen most (64%, 95% confidence interval (CI) 58%, 70%; p < 0.001), and by more South Africans than Kenyans (odds ratio (OR) 2.01, 95% CI: 1.17, 3.43; p = 0.01). There was no significant difference in choosing tablets versus ring (21%, 95% CI: 16%, 26% vs. 15%, 95% CI: 11%, 20%; p = 0.11). Tablet and ring adherence, based on direct observations and self‐reports, improved over time. However, participants’ self‐reported use of tablets did not match objective data from the electronic dose monitoring device. Participants were fully compliant with injections. Conclusion: In this population at risk for HIV and pregnancy, all participants agreed to choose and use a placebo MPT delivery form. A majority of participants preferred TRIO products to male condoms, an existing MPT. Injections were most liked and best used, however, they are years away from reaching the clinics. In the meantime, expanding the availability of tablets and giving access to rings can begin to fulfill the promise of choice for HIV prevention technologies and inform the development of suitable delivery forms as MPT. [ABSTRACT FROM AUTHOR]

Objectives: To compare rates of postpartum care and contraception provided to women with gestational or preconception diabetes mellitus to women with no known diabetes mellitus.Methods: A retrospective cohort study of 199,860 women aged 15-44 years who were continuously enrolled in California's Medicaid program, Medi-Cal, from 43 days prior to 99 days after delivering in 2012. Claims for postpartum clinic visits and contraceptive supplies were compared for 11,494 mothers with preconception diabetes, 17,970 mothers with gestational diabetes, and 170,396 mothers without diabetes. Multivariable logistic regression was used to control for maternal age, race/ethnicity, primary language, residence in a primary care shortage area, state-funded healthcare program and Cesarean delivery, when examining the effects of diabetes on postpartum care and contraception.Results: Although postpartum clinic visits were more common with diabetes (55% preconception, 55% gestational, 48% no diabetes, p=<.0001), almost half did not receive any postpartum care within 99 days of delivery. Women with pregnancies complicated by diabetes were more likely to receive permanent contraception than women without diabetes (preconception diabetes, aOR: 1.39, 95% CI: 1.31-1.47; gestational diabetes, aOR: 1.20, 95% CI: 1.14-1.27). However, among women without permanent contraception, less than half received any reversible contraception within 99 days of delivery (44% preconception, 43% gestational, 43% no diabetes) and less effective, barrier contraceptives were more commonly provided to women with preconception diabetes than women without diabetes (aOR: 1.24, 95% CI:1.16-1.33).Conclusions: Low-income Californian women with pregnancies complicated by diabetes do not consistently receive postpartum care or contraception that may prevent complication of future pregnancies.Implications: Efforts are needed to improve rates of provision of postpartum care and high quality contraceptive services to low income women in California, particularly following pregnancies complicated by diabetes. [ABSTRACT FROM AUTHOR]

Background: Unintended pregnancy can negatively impact women's lives and is associated with poorer health outcomes for women and children. Many women, particularly in low- and middle-income countries, continue to face obstacles in avoiding unintended pregnancy. In the State of Palestine, a survey conducted in 2006 estimated that 38% of pregnancies are unintended. In 2014, unmet need for contraception was highest among young women aged 20-24 years, at 15%. Mobile phones are increasingly being used to deliver health support. Once developed, interventions delivered by mobile phone are often cheaper to deliver than face-to-face support. The London School of Hygiene and Tropical Medicine and the Palestinian Family Planning and Protection Association have partnered to develop and evaluate a contraceptive behavioural intervention for young women in Palestine delivered by mobile phone. The intervention was developed guided by behavioural science and consists of short, mobile phone text messages that contain information about contraception and behaviour change methods delivered over 4 months.Methods: We will evaluate the intervention by conducting a randomised controlled trial. Five hundred and seventy women aged 18-24 years, who do not report using an effective method of contraception, will be allocated with a 1:1 ratio to receive the intervention text messages or control text messages about trial participation. The primary outcome is self-reported acceptability of at least one method of effective contraception at 4 months. Secondary outcomes include the use of effective contraception, acceptability of individual methods, discontinuation, service uptake, unintended pregnancy and abortion. Process outcomes include knowledge, perceived norms, personal agency and intervention dose received. Outcomes at 4 months will be compared between arms using logistic regression.Discussion: This trial will determine the effect of the intervention on young women's attitudes towards the most effective methods of contraception. If the intervention is found to be effective, the intervention will be implemented widely across Palestine. The results could also be used to design a larger trial to establish its effect on unintended pregnancy.Trial Registration: ClinicalTrials.gov, ID: NCT02905461 . Registered on 14 September 2016. [ABSTRACT FROM AUTHOR]

From history to present day, various territories have utilized both socio-political systems and compulsory powers to place restrictions on reproductive information, healthcare, supplies, procedures, and services pertaining to birth control, sterilization, emergency contraception, and abortion. Quintessentially, these restrictions have uniquely impacted African American women, limiting reproduction for some, and mandating it others. This article takes a comparative historical approach and examines reproductive slavery in the United States during the Atlantic Slave Trade (1619–1865), as well as reproductive restrictions implemented over the last fifty years (1970–2022). This article asserts that the events and policies that occurred in the latter era are an extension of colonial reproductive slavery. Further, this article includes a discussion on the critical importance of intersectional feminist perspectives in discussions of reproductive policies, bodily autonomy, and labor markets. [ABSTRACT FROM AUTHOR]

Purpose: This study was conducted to develop a customized birth control program and identify its effects on attitude, subjective norm, behavioral control, intention, and behavior of contraception among immigrant postpartum mothers. Methods: In this experimental study, Vietnamese, Filipino or Cambodian married immigrant postpartum mothers were recruited. They were assigned to the experiment group (n=21) or control group (n=21). The customized birth control program was provided to the experimental group for 4 weeks. Results: The experimental group showed a significant increase in the score of attitude, subjective norm, behavioral control, intention, and behavior of contraception. Conclusion: Findings in this study indicate that the customized postpartum birth control program, a systematic and integrative intervention program composed of customized health education, counseling and telephone monitoring, is able to provide effective planning for postpartum health promotion and birth control behavior practice in married immigrant women. [ABSTRACT FROM AUTHOR]