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At least 361 records · Page 20Linked to original sources
PubMed1984

Women's health groups: alternatives to the health care system.

This article describes an empirical study of 28 alternative women's health organizations. These organizations were formed by women who rejected the existing institutions of health care, especially the nature and quality of reproductive health services. The study examined their philosophy of health care, the range of services provided and the characteristics of women who use them, their internal organization in terms of the distribution of power and authority, and the problems and challenges involved in their existence. Implications and impacts resulting from their continuing existence into the 1980s on the delivery of health care for women are addressed.

Community Health Services↗
PubMed2000

Support for nurses directly involved with women who chose to terminate a pregnancy.

Research conducted by Poggenpoel, Myburgh and Gmeiner (1998:2-8) on "One voice regarding the legalization of abortion: Nurses who experience discomfort" indicated that the nurses were in favour of the fact that nurses should volunteer to participate in terminating a pregnancy of a woman. From our observations in clinics where nurses voluntarily participate in providing reproductive health services, including termination of pregnancy, it became clear that supporting these nurses may be essential. To be able to provide support, it is necessary to identify, explore and describe nurses' experience of being directly involved with women who terminate their pregnancy. To enable us to address the identified problems, a qualitative research strategy was implemented in which respondents were included in the sample through purposive sampling. Phenomenological interviews were conducted individually. Data was analyzed by means of Tesch's descriptive approach. Thereafter, guidelines for operationalization were inferred from the results and a literature control completed to verify and enrich guidelines. Measures to ensure trustworthiness have been applied in the research and ethical measures have been strictly adhered to regarding this sensitive issue.

Abortion, Induced↗
PubMed2001

Female sterilisation through mini-laparotomy at Gondar College of Medical Sciences.

OBJECTIVES: To describe the socio-demographic characteristics and clinical course and follow up of clients who have undergone voluntary surgical contraception (VSC) through minilaparotomy (mini-lap) under local anaesthesia (LA). Also, to evaluate the safety and method satisfaction, so as to forward recommendations for method utilisation in the Ethiopian context. DESIGN: A case series design where pre- and post-operative conditions of clients coming for voluntary surgical contraception via mini-laparotomy were systematically analysed. SETTING: Department of Obstetrics and Gynaecology, Gondar College of Medical Sciences, Gondar, Ethiopia. SUBJECTS AND METHODS: Eighty two clients (median age of 33 years, range 25-40) who decided to use tubal sterilisation method of contraception from April 1993 to May 1995 were included in the study. A format prepared and distributed to VSC providing sites in Ethiopia by the Family Guidance Association of Ethiopia (FGAE) was used in collecting the necessary information, including informed consent of every client. MAIN OUTCOME MEASURES: Previous knowledge of contraceptive methods, decision making for tubal sterilisation, size of incision, advantages of use of local anaesthesia in the local setting, duration of hospital stay, conditions on follow up. RESULTS: Eighty two (55.4%) women underwent tubal sterilisation through mini-lap. The mean number of the live children per client was 6.2 +/- 1.7, with parity ranging from two to eleven children. Mothers with five or more children were 70 (85.4%). Among 69 mothers (84.1%), the last pregnancy outcome were live births. The average length of the time since making a decision not to have any more children was 2.5 +/- 2 years (median of one year). The rationales given were economic, ill health and completed family size. Regarding the pattern of decision making, in 77 (91.9%) clients both the couples were involved in decision making. All except two underwent the procedure under LA and no complication was encountered during surgery. Follow-up attendance was 100% in one-year period and nothing serious was reported. All reported to be satisfied with the method. CONCLUSION: The study showed that early decision making by involving both couples other than proper case selection minimises regrets. The authors believe that tubal sterilisation through mini-lap under LA is an ideal method in developing countries where access to family planning and other reproductive health services are not widely available and where there is population explosion, less than 10% contraceptive prevalence rate and high maternal mortality.

Adult↗
PubMed2004

Induced abortion among women attending antenatal clinics in Yaounde, Cameroon.

OBJECTIVES: Unsafe abortion is a public health concern because of its impact on maternal morbidity and mortality. The objective of this study was to document on induced abortion in Yaounde, Cameroon. DESIGN: Cross-sectional study. SETTING: Six antenatal clinics in Yaounde, Cameroon. METHODS: Women attending antenatal clinics between October and December 1998 were included in the study and interviewed. Nulliparous were women with no previous delivery and multiparous were defined as women who had at least one previous delivery. RESULTS: Out of the 1532 women, five hundred seventy-two were nulliparous and 960 were multiparous. Of the nulliparous women 17% reported a previous abortion ever; this proportion exceeded 35% in those over 24 years. For multiparous women, the proportion who reported an abortion (between the last birth and present pregnancy) was 22%. In multivariate analysis on the group of nulliparous women, older age, having used modern contraception and having spent more than two years in the city were significantly associated with induced abortion. In the multiparous group, older age, having a full time job and antenatal clinic were significantly associated with induced abortion. CONCLUSIONS: This study shows that induced abortion is a common practice in urban Cameroon. Because of restrictive laws, a substantial proportion of these abortions are likely to be unsafe, with the risk of associated complications. There is a need for expanded comprehensive sexual and reproductive health services.

Abortion, Illegal↗
PubMedDate not supplied

Awareness, attitude and practice of contraception among secondary school girls in Calabar, Nigeria.

BACKGROUND: Adolescents are disposed to unprotected sexual activity and as a consequence, there is an increasing incidence of unwanted pregnancy among adolescent school girls in Nigeria. This study was carried out to assess the awareness, attitude and use of contraceptives among secondary school girls in Calabar, Nigeria and to determine how attitude affects its use. METHODS: Data was obtained using self administered semi-structured questionnaires distributed to 480 secondary school girls out of which 450 were properly filled and returned. These were analysed using percentages and chi-square was used to test for significance. RESULTS: The study revealed that contraceptive awareness was high. The main sources of contraceptive information were books/magazines (37%) and friends (26%). Three hundred and thirty-three (74%) girls had a negative attitude (misconceptions) towards contraceptives, while 117 (26%) girls said contraceptives were essential/useful. Sixty-six girls (14.7%) admitted that they were currently sexually active and 42 (9.3%) of them used contraceptives. There was a statistically significant association between positive attitude/beliefs and use of contraceptives (P < 0.05). CONCLUSION: We recommend the provision of accurate contraceptive information to dispel these misconceptions and the establishment of adolescent reproductive health services which should be strictly confidential to encourage acceptability and optimum utilization.

Adolescent↗
PubMed1989

Will Webster redefine Roe v. Wade? The Supreme Court could use a Missouri case to begin limiting abortion rights.

The U.S. Supreme Court's decision to review Webster v. Reproductive Health Services, a Missouri case that challenges the validity of legislative direction of public policy as outlined in Roe v. Wade, has fueled speculation that the Court will use the case to reconsider, and perhaps reverse, Roe. When the Supreme Court in Roe v. Wade opened the door to legalized abortion, it guaranteed only a woman's right to choose to terminate or continue a pregnancy without undue interference by the state--citing legitimate grounds for "due" interference by the state. In 1986 the Missouri legislature passed a statute that regulated medical practices related to abortion, including broad restrictions on the expenditure of state funds. Further, the state attempted to protect viable fetuses and directed physicians to perform certain tests to ascertain the baby's gestational age. It also contained a legislative finding that "life begins at conception." A challenge was filed almost immediately. In its application for Supreme Court review, Missouri questioned whether the Roe "trimester approach for selecting the test for which state regulation of abortion services is reviewed should be reconsidered and discarded in favor of a rational basis test." It further argued that if Missouri's statutory provisions are unconstitutional under Roe, then "Roe v. Wade should itself be reconsidered." Under current jurisprudence, it is debatable whether this formulation of the case will invite direct review of Roe. For the foreseeable future, the law will likely protect the notion that an abortion decision implicates a fundamental liberty interest.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Legal↗
PubMed1999

Perceived gynecological morbidity among young ever-married women living in squatter settlements of Karachi, Pakistan.

BACKGROUND: Community-based information on obstetric and gynecological morbidity in developing countries is meager and nearly non-existent in Pakistan. OBJECTIVES: To estimate the prevalence of specific gynecological morbidities and investigate the predictors of pelvic inflammatory disease. METHODS: Users [404] and non-users [313] of modern contraceptives were identified from eight squatter settlements of Karachi, Pakistan and detailed information on basic demographics, contraceptive use, female mobility, decision-making and gynecological morbidities were elicited. RESULTS: The perceived prevalence of menstrual disorders were 45.3%, uterine prolapse 19.1%, pelvic inflammatory disease 12.8% and urinary tract infection 5.4%. The magnitude of gynecological morbidity was high with about 55% of women reporting at least one gynecological morbidity though fewer [20%] reported at least two gynecological morbidities. Significant predictors of pelvic inflammatory disease were intrauterine contraceptive device users (OR = 3.1; 95% CI 1.7-5.6), age < or = 20 years (OR = 2.3; 95% CI 1.1-4.8) and urban life style (OR = 2.1; 95% CI 1.0-4.6). CONCLUSION: There is an immense burden of reproductive ill-health and a significant association between ever users of intrauterine contraceptive device and pelvic inflammatory disease. We therefore suggest improvement in the quality of reproductive health services generally, but specifically for family planning services.

Adolescent↗
PubMed2001

Adolescent girls' attitudes toward pregnancy: the importance of asking what the boyfriend wants.

OBJECTIVE: We evaluated the factors associated with attitudes toward pregnancy among girls presenting to an adolescent health clinic to better predict which girls are at the highest risk of pregnancy. STUDY DESIGN: We used a cross-sectional provider-administered survey design. POPULATION: A total 202 girls aged 13 to 18 years presenting consecutively for reproductive health services to an adolescent care clinic were interviewed about their desire for pregnancy. Girls found to be already pregnant at the initial visit (n=54) were removed from analysis. OUTCOMES: measured The main outcome measured was desire for pregnancy. Subjects were grouped by those desiring pregnancy (n=16), those desiring to avoid pregnancy (n=107), and those ambivalent about pregnancy (n=25). RESULTS: The girls who were ambivalent about pregnancy were not significantly different from the girls desiring pregnancy. In unadjusted analysis, girls desiring pregnancy or who were ambivalent about it were more likely to be Hispanic, unemployed, to not attend school, to live with neither natural parent, and to have lived away from home for more than 2 weeks. In adjusted analysis, the reported attitude of the boyfriend toward having a child was the only significant predictor of adolescent girls&rsquo attitude toward pregnancy. CONCLUSIONS: The best predictor of an adolescent girl&rsquos attitude toward pregnancy is her perception of her boyfriends&rsquo desire for a baby. Primary care providers should include boyfriends in any efforts to delay pregnancy in at-risk adolescent girls. Teenagers who are ambivalent about whether they want to be pregnant do not differ significantly from those desiring pregnancy, and should be considered just as high risk.

Adolescent↗
PubMed2001

Contraceptive use and family planning after labor in the European part of the Russian Federation: 2-year monitoring.

OBJECTIVES: To explore the main determinants of the reproductive behavior of nursing mothers, all inhabitants of the central part of the European region of the Russian Federation, their use of modern contraceptive methods and their attitude to future family planning. METHODS: Open cohort multicenter study of 1200 nursing mothers aged 16-42 years interviewed at 3-5 days' postpartum, with subsequent longitudinal monitoring ofthe majority in the local family planning centers during the 2 years after labor. RESULTS: The main determinants of the reproductive behavior of this cohort of women are an early debut of sexual activity, several partners in their reproductive history, relatively early marriage with a motivation to have one child in their family and the tendency to use induced abortion as one of the methods of birth regulation. Our experience of postpartum counselling demonstrated positive changes in the women's attitudes to modern contraceptive methods. The data reveal that the induced abortion rate among 639 mothers regularly followed-up during the first year postpartum was 4.4%, and among 606 during the second year was 5.1%. The corresponding rates among 129 women who did not visit the family planning centers and who were only interviewed 2 years after labor were 9.3% and 8.5%, respectively. CONCLUSIONS: Our data show that the unmet needs are remarkably concentrated among women who have given birth within the last year or two, and who need augmented attention from the family planning and reproductive health services.

Abortion, Induced↗
PubMed2001

Adolescent pregnancy trends and demographics.

In the United States today, 9% of women aged 15 to 19 years become pregnant each year: 5% give birth, 3% have induced abortions, and 1% have miscarriages or stillbirths--rates much higher than those in other developed countries. Rates are highest among those who are older, from disadvantaged backgrounds, black or Hispanic, married, have much older male partners, and live in southern states. Teen pregnancies are overwhelmingly unintended, reflecting substantial gaps in contraceptive use, and difficulties using reversible methods effectively. Teen pregnancy, birth, and abortion levels have decreased in recent years, primarily because of more effective contraceptive use (responsible for about 75% of the decline), and because of fewer adolescents having sexual intercourse (about 25%). Much work remains to improve the conditions in which young people grow up, provide them with information and education regarding sexuality and relationships, and improve access to sexual and reproductive health services.

Abortion, Induced↗
PubMed2002

Prevalence, patterns and correlates of domestic violence in selected Igbo communities of Imo State, Nigeria.

Three hundred and eight Igbo women were randomly selected to respond to a number of questions on experiences, patterns and attitudes to domestic violence. Data was collected using structured questionnaires that were complemented with focus group discussions. The results show that 78.8% of the women have ever been battered by their male counterparts, out of which 58.9% reported battery during pregnancy, while 21.3% reported having been forced to have sexual intercourse. The study further revealed that the practice of female circumcision is still common among this Igbo population, and 52.6% were of the view that it should be continued. Multivariate logistic regression identified the correlates of these forms of violence such as age, place of residence, age at first marriage, type of marital union, level of income of women, and level of education of husband against women in Imo State. While wife battery is more pronounced in the urban area, forced sexual relationship and female genital mutilation are more pronounced in the rural areas. We recommend education of women and integration of services in reproductive health care service delivery as appropriate measures to eradicate these practice.

Adolescent↗
PubMedDate not supplied

Chronically homeless women's perceived deterrents to contraception.

CONTEXT: Despite the growing number of homeless women of reproductive age, little is known about their reproductive health and contraceptive use. METHODS: A representative sample of 974 currently homeless women surveyed in Los Angeles County in 1997 included 229 who were chronically homeless and at risk for unintended pregnancy. The relationships between perceived deterrents among these women and their frequency of contraceptive use were evaluated using chi-square tests. Logistic regression analyses were performed to identify independent predictors of contraceptive deterrents. RESULTS: The most commonly cited deterrents to contraceptive use were side effects, fear of potential health risks, partner's dislike of contraception and cost (20-27%). Women who reported substantial deterrents were significantly less likely than others to use contraceptives consistently. Perceived deterrents differed by women's characteristics: Hispanic women were more likely than whites to view not knowing how to use contraceptives or which method to use as a deterrent (odds ratios, 9.6-9.8); black women were more likely than whites to cite not knowing which method to use (4.0), lack of storage (5.5), health risks (6.0) and discomfort (3.3). Women with a history of drug abuse had elevated odds of citing not knowing how to use contraceptives, uncertainty about which method to use and cost as deterrents (5.2-7.7). CONCLUSION: Homeless women report substantial deterrents that reduce their contraceptive use. The multiplicity and heterogeneity of their perceived deterrents suggest a need for reproductive health services that are more integrated and culturally competent than those currently offered.

Adolescent↗
PubMed2003

High pregnancy rates and reproductive health indicators among female injection-drug users in Vancouver, Canada.

OBJECTIVE: To determine the incidence of pregnancy among active injection-drug users and to identify factors associated with becoming pregnant. METHODS: The Vancouver Injection Drug User Study (VIDUS) is a prospective cohort study that began in 1996. Women who had completed a baseline and at least one follow-up questionnaire between June 1996 and January 2002 were included in the study. Parametric and non-parametric methods were used to compare characteristics of women who reported pregnancy over the study period with those who did not over the same time period. RESULTS: A total of 104 women reported a primary pregnancy over the study period. The incidence of pregnancy over the follow-up period was 6.46 (95% confidence interval (CI) 5.24-7.87) per 100 person-years. The average age of women who reported pregnancy was younger than that of women who did not report pregnancy (27 vs. 32 years, p < 0.001). Women of Aboriginal ethnicity were more likely to report pregnancy (odds ratio 1.6, 95% CI 1.0-2.5). Comparison of drug use showed no significant differences in pregnancy rate with respect to the use of heroin, cocaine or crack (p > 0.05). In examining sexual behavior, women who reported having had a regular partner in the previous 6 months were three times more likely to have reported pregnancy. Despite the fact that 67% of women in this study reported using some form of contraception, the use of reliable birth control was low. Only 5% of women in our study reported the use of hormonal contraceptives. CONCLUSION: There were a high number of pregnancies among high-risk women in this cohort. This corresponded with very low uptake of reliable contraception. Innovative strategies to provide reproductive health services to at-risk women who are injecting drugs is a public health priority.

Adult↗
PubMedDate not supplied

[The evolution of health care in the areas of reproductive and sexual health--Brazil, 20th Century].

Technical and practical works on the reproduction and sexuality processes conducted in Brazil, in the last century, are the subject of this article. Therefore, authors review the history and emphasize three moments: the first one, until the 1950's, when the basis of public responsibility is defined specially regarding maternity and medical interventions are carried out in order to moralize the sexuality field; second, between the 1950's and 1970's, when the clinical and educative health care is consolidated and directed to women reproductive process and complications on men and women sexual apparatus; third, when broader political bases are built regarding health care, reproduction and sexuality.

Brazil↗
PubMed2004

Natural family planning revisited.

The article focuses on the role of natural family planning NFP as a component of reproductive health. It distinguishes NFP from the concept of fertility awareness method. Furthermore, the effectiveness of NFP as determined by previous studies is presented and the advantages and disadvantages of NFP are highlighted. Additionally, factors that influence the use of NFP methods are examined. Finally, delivery strategies and options for mainstreaming NFP into reproductive health services are identified and discussed.

Cervix Mucus↗
PubMed2005

Reproductive surgery.

The aim of this review is to try and answer the following questions. What is the importance of reproductive surgery? What does the field encompass? What are the deleterious effects of postoperative adhesions in reproductive age women? Is there a relationship between the mode of surgical access, laparoscopy versus laparotomy, and the degree of postoperative adhesions? What is microsurgery and what is its place in reproductive surgery? Does training in microsurgery provide benefits to the gynecologist and his/her patients? At present, when assisted reproductive techniques have recorded enormous progress and the technology has been industrialized, what is the place of reconstructive tubal surgery in the treatment of tubal infertility?

Embryo Transfer↗
PubMed2005

Births to teens in Wisconsin: targeting high-risk populations.

BACKGROUND: Adolescents giving birth represents an important public health issue with social, economic, and health-related consequences. OBJECTIVE: Compare birth rates and trends in birth rates among adolescents age 15-19 years in Wisconsin and the United States by race/ethnicity. METHODS: Teen birth rates from 1998-2002, and trends in birth rates from 1995-2002 for Wisconsin and the United States were compared by race/ethnicity using data from the Wisconsin Interactive Statistics on Health and data from the Centers for Disease Control and Prevention. RESULTS: The general statewide birth rates and birth rates for Wisconsin white teens were lower than national rates, while birth rates for black, Hispanic, and American Indian teens were well above national rates from 1998-2002. Disparities between births to minority adolescents and white adolescents were higher in Wisconsin than in the United States. Although teen birth rates in general have declined nationally and in Wisconsin, rates among Hispanics in Wisconsin have increased during the 1995-2002 period. DISCUSSION: Racial disparities in teen birth rates in Wisconsin far exceed national disparities. These disparities result from far-ranging, long-term social and environmental differences in underlying determinants of health that relate to ethnic and cultural beliefs, variation in access to health care that provides family planning and reproductive health services, decreased availability of school-based clinics, lack of role models, education, and variations in income and social status. Wisconsin should focus its teen pregnancy prevention activities on the groups at highest risk.

Adolescent↗