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PubMed1987

Family planning needs and behavior of Mexican American women: a study of health care professionals and their clientele.

"A random sample of Mexican American women and a sample of family planning health care professionals, both from two major southwestern cities in the United States, were compared in terms of their reports of birth control methods used, problems in obtaining family planning services, and values involved in making fertility-related decisions, within the Mexican American population.... While there were points of agreement between the two samples, discrepancies were found in reports of problems in obtaining family planning services, fertility-related values, and in the acceptability of female sterilization as a birth control method. It was concluded that family planning professionals in these service areas tend to stereotype Mexican American women, and may not yet realize that the family planning attitudes and behavior of these women are probably changing in significant ways." (SUMMARY IN SPA)

Americas↗
PubMed1988

Epidermal growth factor in urine of nonpregnant women and pregnant women throughout pregnancy and at delivery.

Human epidermal growth factor (EGF) concentrations were measured by a specific solid phase RIA in random urine samples collected throughout the menstrual cycle of normal menstruating women (n = 8), women with tubal sterilization (n = 6), women taking a low dose oral contraceptive (n = 5), and women throughout pregnancy (n = 52) and delivery (n = 35). There were no differences in EGF concentrations between the proliferative and secretory phases of the menstrual cycle (P greater than 0.05). Normal menstruating women had higher urinary EGF concentrations [mean +/- SE, 37.2 +/- 6.0 micrograms/g creatinine (4.23 +/- 0.68 ng/mumol)] than women with tubal sterilization [32.7 +/- 4.0 (3.71 +/- 0.45)] or women taking a low dose oral contraceptive [19.5 +/- 6.0 (2.21 +/- 0.68)], but the differences were not significant (P greater than 0.05). During pregnancy, urinary EGF concentrations increased linearly from 6-20 weeks gestation (r = 0.76; P less than 0.001), then declined toward term (r = -0.71; P less than 0.001). EGF concentrations in early pregnancy (less than 12 weeks) or at term did not differ significantly from those in normal menstruating women (P greater than 0.05). For women delivering normal, appropriate for gestational age (AGA) infants, there was no correlation between urinary EGF concentrations and fetal weight or sex (P greater than 0.05). Urinary EGF concentrations in women delivering normal AGA infants [52.7 +/- 2.5 (5.98 +/- 0.28); n = 16] did not differ significantly (P greater than 0.05) from those in women with class A/B diabetes [41.9 +/- 2.8 (4.76 +/- 0.31); n = 6] or women delivering twins [45.6 +/- 2.6 (5.18 +/- 0.29); n = 8] with a greater fetoplacental mass. However, women delivering an intrauterine growth-retarded fetus with decreased fetoplacental mass had lower urinary EGF concentrations (24.9 +/- 2.2 (2.83 +/- 0.25); n = 5] than women with normal AGA infants (P less than 0.01). The significance of the rise in the urinary EGF concentration late in the second trimester and lower urinary EGF concentrations in women delivering intrauterine growth-retarded infants is not known, but may reflect an important physiological role for EGF in fetal-maternal hormonal interaction and development.

Adolescent↗
PubMed1995

Barriers to condom use and barrier method preferences among low-income African-American women.

Low-income African-American women (N = 178) entering health clinics completed surveys assessing perceived barriers to condom use for themselves personally and for African-American women generally. Following the survey, each woman received a demonstration of five barrier contraceptive methods and then rated her preference among those methods. The women perceived relatively few personal barriers to use of the male condom but perceived significantly greater barriers for other African-American women (all p < .0001). The male condom was first choice of the largest percentage of women (45%) and last choice of the smallest percentage of women (11%). The male condom was preferred for its convenience, availability, and safety, although the necessity for active cooperation by the male partner was considered a hindrance to using the method. Only 23% of women ranked the female condom as first choice and 35% ranked the female condom as last choice. Reasons for selecting the female condom included preference for a female-controlled method, safety, and protection. However, the female condom was perceived to be uncomfortable, to require the partner's acquiescence, and to interfere with sexual experience. Differences in the women's perceptions of barriers to condom use for themselves and for other African-American women are consistent with Weinstein's theory of optimistic bias. Preferences among barrier methods indicate that further research and product development are needed to develop barrier methods that are female-controlled, do not require the awareness of the male partner, and are safe, comfortable, and convenient.

Adolescent↗
PubMed1998

Women's choice between indigenous and Western contraception in urban Mozambique.

Research on women's reproductive behavior and family planning in developing countries is usually focused on western contraceptive methods and rarely addresses indigenous contraception, such as herbs, amulets, and charms that are believed to prevent pregnancy. However, the available data demonstrate that indigenous contraception is widely known, and its prevalence often rivals that of western methods. Based on qualitative data collected in Greater Maputo, Mozambique, in 1993, this study explores and analyzes women's choice between western methods-mainly oral contraceptives, intra-uterine devices and injectables-available from state-run family planning clinics, and indigenous contraception, a combination of herbal and magical medicine, provided by traditional healers. The study demonstrates that women's choice between the two types of methods is determined by their sociodemographic characteristics and cultural background, access to these methods, perceptions of the effectiveness and undesirable side-effects of these methods, and by restrictions imposed by the providers. Although indigenous methods may not compete with western contraception in the long run, their present-day persistence warrants the attention of scholars and policymakers who intend to integrate women's concerns and constraints in the design of family planning systems.

Choice Behavior↗
PubMed1994

Choice of contraceptive modality by women in Norway.

STUDY OBJECTIVE: To investigate the use of contraception in a representative sample of Norwegian women. OUTCOME MEASURES: Frequency distribution of contraceptive methods by age, marital status and partly strata. MATERIAL: A sample of 4,933 women were selected at random from the Central Population Register as participants in the second Norwegian fertility study (1988). The response rate was 81% (n = 4,019) and personal interviews of contraceptive use were carried out among 2,782 women who were fecund, sexually active and not pregnant. These women comprise the study population. RESULTS: 2,782 women were sexually active during the last month prior to the interview and thus in potential need of contraception. More than 50% of the women used either oral contraceptives (21%) or IUDs (30%). The use of oral contraceptives decreased linearly with age from a user rate of 60% among women 20-24 years old to 1.5% among women 40-44 years of age. The use of IUDs increased from 6% in the youngest age group to nearly 40% among women aged 30-39 years of age. Oral contraceptives were preferentially used by childless women or those with only one child, while IUDs were most often used by women with two or more children. The sterilisation rate increased by age and in the 40-44 age group one out of every three women was sterilised. Non-use was most frequent among the subgroups of women who planned children in the future. Use of condoms and other coitus-dependent contraceptives varied less with age, marital status and parity than did the use of OC, IUDs or sterilisation. CONCLUSION: The user pattern concerning different contraceptive methods reflects the general guidelines for contraceptives in Norway. The fact that nearly 70% of the women were in one of the three categories--OC or IUD users, or one of the partners was sterilised--reveals that the awareness and knowledge of modern contraception is high in Norwegian society.

Adult↗
PubMed1995

Reasons for pregnancy termination: negligence or failure of contraception?

BACKGROUND: The aim of the study was to analyze the reasons for the failure of contraception and the reasons for not using any contraception among women seeking a legal abortion on social grounds. The women were also asked about their knowledge of contraception methods, including postcoital contraception. METHODS: We interviewed 200 women applying for a legal abortion within the first trimester of pregnancy about contraception, the contraceptive methods used, and the possible reasons for failure of contraception. RESULTS: Of all the women interviewed, 93% claimed to have adequate knowledge of contraception. At the time of conception 11.5% used safe methods (OCs 8%, IUDs 3.5%), 63% used less safe methods, and 26% were without contraception. Only 25% of the pill users had no explanation for the failure. 76.7% of the condom users reported that the condom was broken, had slipped off or its use had been irregular. The concern about side effects was the most common reason for not using safe contraceptives (25%). CONCLUSIONS: The women claimed to have enough information about contraceptives, and postcoital contraception was also familiar, but the knowledge on how to use them in practice was inadequate. Irregular use and breaks in contraception were common. Despite the data based on Pearl indices, pills failed twice as often as IUDs. Counseling about the proper use of contraceptives is important, although the concern about the side effects appeared to be a big, unsolved problem.

Abortion Applicants↗
PubMed1993

Trends in population and contraception.

There has been an explosion in contraceptive use in the past 30 years. In 1960-65, the level of contraceptive use in the developing countries of Asia, Latin America and Africa represented about 9% of married couples of reproductive age. In the 1990s use of contraception in developing countries comprises over 50% of couples and contraceptive prevalence is increasing each year. Total fertility rates for the developing world have already fallen from over 6, where they were in 1960 to about 4, halfway toward the replacement level of 2.1. The United Nations projects that during this decade, over 90 million people will be added each year to world population. If this projection is not to be exceeded, prodigious supplies of contraceptives will have to be available at affordable cost to the people of developing countries, where 94% of this population increase will occur. New technology alone will not guarantee this success, but it would help ensure that people are able to meet their fertility objectives.

Contraception↗
PubMedDate not supplied

Contraceptive failure rates: new estimates from the 1995 National Survey of Family Growth.

CONTEXT: Unintended pregnancy remains a major public health concern in the United States. Information on pregnancy rates among contraceptive users is needed to guide medical professionals' recommendations and individuals' choices of contraceptive methods. METHODS: Data were taken from the 1995 National Survey of Family Growth (NSFG) and the 1994-1995 Abortion Patient Survey (APS). Hazards models were used to estimate method-specific contraceptive failure rates during the first six months and during the first year of contraceptive use for all U.S. women. In addition, rates were corrected to take into account the underreporting of induced abortion in the NSFG. Corrected 12-month failure rates were also estimated for subgroups of women by age, union status, poverty level, race or ethnicity, and religion. RESULTS: When contraceptive methods are ranked by effectiveness over the first 12 months of use (corrected for abortion underreporting), the implant and injectables have the lowest failure rates (2-3%), followed by the pill (8%), the diaphragm and the cervical cap (12%), the male condom (14%), periodic abstinence (21%), withdrawal (24%) and spermicides (26%). In general, failure rates are highest among cohabiting and other unmarried women, among those with an annual family income below 200% of the federal poverty level, among black and Hispanic women, among adolescents and among women in their 20s. For example, adolescent women who are not married but are cohabiting experience a failure rate of about 31% in the first year of contraceptive use, while the 12-month failure rate among married women aged 30 and older is only 7%. Black women have a contraceptive failure rate of about 19%, and this rate does not vary by family income; in contrast, overall 12-month rates are lower among Hispanic women (15%) and white women (10%), but vary by income, with poorer women having substantially greater failure rates than more affluent women. CONCLUSIONS: Levels of contraceptive failure vary widely by method, as well as by personal and background characteristics. Income's strong influence on contraceptive failure suggests that access barriers and the general disadvantage associated with poverty seriously impede effective contraceptive practice in the United States.

Abortion, Induced↗
PubMedDate not supplied

Contraceptive characteristics: the perceptions and priorities of men and women.

CONTEXT: Despite the fact that choosing a contraceptive method is often a decision made by couples, little is known about how men and women differ in their perceptions of the characteristics of various method types, and in the importance that they attach to those characteristics when choosing a contraceptive method. METHODS: The data analyzed here are subsets from two companion surveys conducted in 1991--1,189 men aged 20-27 who were surveyed in the National Survey of Men and 740 women aged 20-27 who were surveyed in the National Survey of Women. Multivariate ordered logit analysis is used to examine how gender is related to both the importance that individuals assign to seven specific contraceptive characteristics when choosing a method, and to perceptions about the extent to which five common method types possess each of these characteristics. RESULTS: Women rank pregnancy prevention as the single most important contraceptive characteristic when choosing a method, with 90% citing it as "very important." The health risks associated with particular methods and protection from sexually transmitted diseases (STDs) are rated as the second most important characteristics by women (each mentioned as "very important" by 77%). In contrast, men consider STD prevention for themselves and their partner to be just as important as pregnancy protection (each mentioned as "very important" by 84-86%), and they rank STD prevention as more important than other health risks (by 72%). Women, but not men, rank both ease of use and the need to plan ahead as being more important characteristics than a method's interference with sexual pleasure. Both men and women have an accurate understanding of the strengths and weaknesses of particular methods, but differ enough in their perceptions to alter the relative attractiveness of each method. In particular, women have more favorable perceptions than men about the pill, being somewhat more likely than men to believe that the pill is "very good" at preventing pregnancy (75% vs. 67%) and to say that it is very good at not interfering with sexual pleasure (82% vs. 76%). In contrast, women have generally less favorable perceptions than men about other reversible methods, including the condom: Women were less likely than men to consider the condom very good at pregnancy prevention (29% vs. 46%) or at having no need for advance planning (22% vs. 38%). Gender differences in perceptions about the specific characteristics of contraceptive methods often vary by marital status. CONCLUSIONS: Men and women have somewhat different priorities when choosing a contraceptive method. Despite many similarities between women and men in their perceptions about the characteristics of each method type, numerous differences between them may have an important influence on how couples make their method choices.

Adult↗
PubMedDate not supplied

Contraceptive use in Canada: 1984-1995.

CONTEXT: In every country, contraceptive behavior has important implications for fertility and the prevalence of sexually transmitted diseases (STDs). There has been relatively little attention to contraceptive practices in Canada, however, particularly how patterns of method use may have changed. METHODS: Data on contraceptive use were collected from 5,315 women in the 1984 Canadian Fertility Survey, and from 3,220 women and 3,449 men in the 1995 General Social Survey. RESULTS: Among Canadian women aged 15-49, current contraceptive use declined from 69% to 60% between 1984 and 1995. Pill use dropped from 19% to 17%, and IUD use declined from 6% to 3%. However, during the same period, condom use increased from 6% to 10%; tubal ligation declined from 24% to 17%, while vasectomy increased. In addition, the proportion of women sterilized for reasons other than contraception rose between 1984 and 1995. Men were less likely to rely on sterilization than were women (31 % vs. 40%). Men reported higher levels of condom use (22%), but lower levels of pill use among their partners (9%), than did women (10% and 17%, respectively). CONCLUSIONS: Contraceptive behavior in Canada is unique: The decline in contraceptive use over the last decade has left Canada's overall contraceptive prevalence among the lowest in the industrialized world, and the rate of sterilization among the highest These changes in contraceptive behavior complicate efforts to plan for social and health needs, particularly policy decisions focusing on reducing infections with STDs.

Adolescent↗