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Improving birth control service utilization by offering services prerelease vs postincarceration.

OBJECTIVES: We examined whether incarcerated women would substantially increase birth control initiation if contraceptive services were available within the prison compared with after their release back into the community. METHODS: During phase 1 of the study, a nurse educator met with women at the Rhode Island Adult Correctional Institute and offered them referrals for contraceptive services at a community health clinic after their release. During phase 2, contraceptive services were offered to women during their incarceration. RESULTS: The majority of the participants (77.5%) reported a desire to initiate use of birth control methods. Within 4 weeks of their release, 4.4% of phase 1 participants initiated use of a contraceptive method, compared with 39.1% of phase 2 participants (odds ratio [OR]=14.6; 95% confidence interval [CI]=5.5, 38.8). CONCLUSIONS: Provision of contraceptive services to women during their incarceration is feasible and greatly increases birth control initiation compared to providing services only in the community.

Adult↗

Marvellous secrets: birth control in European short fiction, 1150-1650.

Medieval and Renaissance tales are remarkable for their frank discussion of sexual practices, including birth control. Italian and French writings are the most explicit. Contraception and abortions are often treated as 'secrets', esoteric practices acquired from experts. The concealment of pregnancy is presented as an alternative form of birth control, often used after the others have failed. In the narratives, the use of birth control is mostly confined to premarital relations, although contraception by married women appears at the end of the period in a few French examples.

Contraception↗

Functional and immunological relevance of the COOH-terminal extension of human chorionic gonadotropin beta: implications for the WHO birth control vaccine.

The World Health Organisation (WHO) Task Force on Birth Control Vaccines has selected the pregnancy hormone human chorionic gonadotropin (hCG) as a target molecule for a contraceptive vaccine. A synthetic peptide antigen corresponding to the amino acid sequence 109-145 of the carboxyl-terminal portion of the hCG beta-subunit (hCG beta CTP), which is supposed to elicit hCG-immunoneutralizing antibodies, has been submitted to clinical trials. Recent findings suggest that hCG beta CTP does not play a role in the biological activity of hCG. This raises the question concerning the assumed mechanism of action of the hCG beta CTP-based birth control vaccine. We therefore investigated the immunoneutralizing capacity of antibodies directed against hCG beta CTP. Although it is possible to generate specific monoclonal and polyclonal antibodies for hCG by using hCG beta CTP as an immunogen, it appeared that the biological response to hCG was not affected by such antibodies. The reason for this is that the hCG-antibody-complex is still able to bind to target cell receptors and therefore the intended contraceptive effect should not occur. In addition there is a risk of hazardous possible side effects such as an autoimmune reaction against the ovary because we found that at least one epitope is still accessible for antibody binding on receptor-bound hCG. We conclude from our results that both the efficacy and safety of the WHO vaccine are not yet ensured.

Animals↗

Birth control failure among patients with unwanted pregnancies: 1982-1984.

Three hundred twenty-three patients who underwent abortion counseling between 1982 and 1984 were interviewed to determine the cause of birth control failure. Twenty-three percent employed no birth control and 27 percent used diaphragms, the majority either inconsistently or incorrectly. Twenty-two percent of the pregnancies were due to oral contraceptive-related failures; and the remainder were due to spermicide, condom, rhythm method, multiple method, and intrauterine device failures. Overall, fewer than one quarter of unwanted pregnancies among the predominantly white, middle-class population studied resulted from failure to obtain contraception, and only 19 percent represented technical failure despite correct and consistent use. The majority (51 percent) occurred because of human error, ie, either incorrect or inconsistent use of available contraceptive modalities. These findings contrast sharply with those of a similar study performed between 1969 and 1974. At that time failure to obtain contraception accounted for more than one half of the failures. Whereas the development and distribution of contraceptive technology was the challenge of the 1960s and the 1970s, reducing the number of birth control failures through anticipatory patient counseling is the challenge of the current decade.

Abortion Applicants↗

Men and women together: the impact of birth control technology on male-female relationships.

The authors argue that "birth control technologies have fundamentally altered the nature of male-female relationships.... New sequences of love, intimacy, sex, and marriage in male-female relationships emerged. The expanded number of choices for individuals has simultaneously created new freedom and opportunity, as well as uncertainty and confusion in male-female relationships. New norms for cross-sex interactions and the new post-birth control morality are still evolving." The geographic focus is on developed countries.

Attitude↗

Development of a decision aid for women choosing a method of birth control.

The choice of a contraceptive method is complex and difficult. This study identifies issues for concern for women in selecting a birth control method, examines the accuracy of a self-administered questionnaire based upon these outcomes in predicting actual use, and in a preliminary fashion evaluates the usefulness of such an instrument as a decision aid. A questionnaire was designed to assess women's perceptions of the likelihood of each issue of concern for four birth control methods--oral contraceptives, intrauterine device (IUD), diaphragm, and foam or condoms--as well as the relative value of each issue. It was then tested among a convenience sample of 106 women. A weighted score was constructed by combining likelihood and value estimates for each contraceptive method. The method with the highest score was compared with actual contraceptive use and the intention to use such methods in the future. Positive predictive values were highest for pill use (83 percent) and lowest for IUD use (40 percent). While 65 percent of the sample were satisfied with their current method, 60 percent also found the questionnaire helpful. This attitude was most prevalent among younger, unmarried women. A decision aid for contraceptive decision making appears to be reasonably predictive of actual contraceptive use and helpful in thinking about the choice of a birth control method.

Adolescent↗

Women's satisfaction with birth control.

BACKGROUND: Contraception is a major component of preventive health care for women. There are indications that women are not satisfied with the methods of birth control currently available. Dissatisfaction with contraceptive methods may lead to unplanned pregnancies. METHODS: Adult women visiting the family health center over a 1-year period were invited to participate in a research interview. Questions were asked about demographic variables and the women's use of, and their satisfaction with, contraceptive methods. RESULTS: Many women were displeased with the present methods of birth control. This is reflected in the numerous methods used by each woman, and by frequent use of permanent sterilization as a contraceptive method. Women were as dissatisfied with oral contraceptives as they were with the less efficacious methods such as condoms, foams, gels, and rhythm. The only methods that had a greater than 70% satisfaction rate were tubal ligations and partner's vasectomies. CONCLUSIONS: There is significant dissatisfaction with the methods of contraception currently available. Increased patient-physician discussion and education may improve satisfaction with birth control methods now used. New methods of contraception may be needed to prevent unplanned pregnancies.

Adolescent↗

Birth control practice in Khartoum.

The results presented here are based on a fertility survey carried out in Khartoum in 1978. It was shown that the knowledge of family planning is widespread in the city and that the level of ever-use of birth control is becoming significant. The popularity of the different methods of birth control is investigated, revealing that the pill is used by nearly all ever-users. IUDs, rhythm, and withdrawal are also relatively popular. A great degree of consistency was found to exist between reports given by husbands and their wives in this respect. The purpose of using birth control is not yet clear. The significant ever-use, noted before the 3rd live birth, indicates that these methods are used for the purpose of spacing births rather than limiting the number of children.

Africa↗

Birth control pills and nonprofessional voice: acoustic analyses.

PURPOSE: Two studies are presented here. Study 1 was aimed at evaluating whether the voice characteristics of women who use birth control pills that contain different progestins differ from the voice characteristics of a control group. Study 2 presents a meta-analysis that combined the results of Study 1 with those from 3 recent studies that compared voices of women who use and do not use birth control pills. METHOD: In Study 1, voice samples from 30 women with no history of voice training, who use pills with different progestins (drospirenone, desogestrel, gestodene), and 10 women who do not use the pill were recorded at specific time points across the menstrual cycle and were analyzed acoustically. In Study 2, results from Study 1 were analyzed jointly with results from three recent studies, which used similar methodologies. RESULTS: Results of Study 1 did not reveal acoustic differences in sustained phonation of vowels across the pill groups and controls. Results of the meta-analysis performed in Study 2 indicated that pill users exhibited lower jitter and shimmer values on sustained vowels, whereas no difference of fundamental frequency was observed among women who use the pill. CONCLUSIONS: These results support findings from previous studies, which suggested that no adverse effect on voice was detected among nonprofessional speakers who use new-generation monophasic birth control pills, for the measures studied. Furthermore, results of the meta-analysis suggested that some acoustic properties of the voice, which are reflected in perturbation measures in sustained vowels, may be improved among women who use the pill.

Adult↗

[National meeting on birth control techniques ends].

210 million contraceptive operations, which include vasoligation, tubal ligation, and implanting of IUDs, were carried out in China in the 9 years from 1971-1979, according to sources from a national working conference on birth control techniques which closed here yesterday. The conference was called to help implement China's birth control policy with stress on the rural areas. The goal is to limit the country's population to 1200 million by the turn of the century. The Ministry of Public Health has issued regulations on dispensing of the various methods of contraception, the conference said. Health workers are instructed to popularize all methods and increase their proficiency. At the conference, proposals were raised on how to spread knowledge of birth control, promote research, production and supply of contraceptive drugs and devices and introduce safe and simple methods and highly-efficient contraceptive pills. At present, a network of technical guidance teams, stations, research institutions, and operation service groups have been set up in all provinces, municipalities and autonomous regions across the country. Great efforts are being made to train technically proficient medical workers in all counties, the conference said.

Asia↗

Motivations for the use of birth control: evidence from West Africa.

A conventional assumption in the family planning literature is that birth control in developing countries is first adopted by high parity women who wish to cease childbearing. The empirical support for this belief has mainly been drawn from interview surveys on the motivations for, and the timing of, the inception of birth control among married women in areas where there is no cultural precedent for birth spacing by traditional means. This study, on the other hand, is based on data drawn from an area sample of 6,606 women, married or single, aged 15-59, in Ibadan, Nigeria, where there is a tradition for the practice of abstinence after a birth for the purpose of birth spacing. The Nigerian pattern revealed in the data presented here is indeed distinctive in many respects: (a) although premarital sex is prevalent, levels of premarital contraception are high; and (b) within marriage, spacing is the most prominent motivation for contraceptive practice, more important than the limitation of family size.

Adolescent↗

Relationship of African Americans' sociodemographic characteristics to belief in conspiracies about HIV/AIDS and birth control.

Although prior research shows that substantial proportions of African Americans hold conspiracy beliefs, little is known about the subgroups of African Americans most likely to endorse such beliefs. We examined the relationship of African Americans' sociodemographic characteristics to their conspiracy beliefs about HIV/AIDS and birth control. Anonymous telephone surveys were conducted with a targeted random-digit-dial sample of 500 African Americans (15-44 years) in the contiguous United States. Respondents reported agreement with statements capturing beliefs in HIV/AIDS conspiracies (one scale) and birth control conspiracies (two scales). Sociodemographic variables included gender, age, education, employment, income, number of people income supports, number of living children, marital/cohabitation status, religiosity and black identity. Multivariate analyses indicated that stronger HIV/AIDS conspiracy beliefs were significantly associated with male gender, black identity and lower income. Male gender and lower education were significantly related to black genocide conspiracy beliefs, and male gender and high religiosity were significantly related to contraceptive safety conspiracy beliefs. The set of sociodemographic characteristics explained a moderately small amount of the variance in conspiracy beliefs regarding HIV/AIDS (R2 range=0.07-0.12) and birth control (R2 range=0.05-0.09). Findings suggest that conspiracy beliefs are not isolated to specific segments of the African-American population.

Adolescent↗

Choice of contraceptive method for birth control and attitudes toward abortion in Swedish women ages 23-29.

In Sweden, contraceptive methods for birth control are readily available, but one in four pregnancies was legally terminated during the period from 1975 to 1990. Our purpose in conducting the present study was to describe young women's choices and use of contraceptive methods and their attitudes to abortion. The participants were 305 Swedish women ages 23-29 years. Eighty-eight percent of the women were using some contraceptive method. The most common method was hormonal (43%), followed by a barrier method (22%). The women considered that abortion should not be used as a method of birth control and that the fact that a pregnancy is unintended is not a sufficient reason for terminating it. An acceptable reason, they thought, for a woman to have an abortion is the woman's present situation, in particular her social situation. The women were aware that the use of contraceptive methods gives them the chance to choose if and when they wish to have children.

Abortion, Legal↗

Use of birth control pills, condoms, and withdrawal among U.S. high school students.

PURPOSE: To examine the use of contraception at last sexual intercourse among currently sexually active adolescents. METHODS: We analyzed data from national school-based Youth Risk Behavior Surveys (YRBS) conducted in 1991, 1993, 1995, and 1997. The YRBS is a self-administered, anonymous survey which uses a national probability sample of U.S. students in public and private schools from grades 9 through 12. RESULTS: From 1991 to 1997, condom use significantly increased (from 46% to 57%), birth control pill use decreased (from 21% to 17%), and use of withdrawal significantly decreased (from 18% to 13%). In 1997, although more students were using condoms, 13% reported using withdrawal and 15% reported using no method to prevent pregnancy at last sexual intercourse. In 1997, condom use among females was significantly lower in the 9th grade than in the 12th grade (p <.001), whereas birth control pill use was higher (p <.001) and use of withdrawal remained stable. Among males, condom use and withdrawal use remained stable from 9th to 12th grade, whereas birth control pill use by their partner increased (p <.001). CONCLUSIONS: Inadequate contraceptive use among sexually active adolescents continues to be a major public health problem in the United States. For young people who will not remain sexually abstinent, families, health care providers, schools, and other influential societal institutions should promote the correct and continued use of condoms as essential protection against sexually transmitted diseases and human immunodeficiency virus infection.

Adolescent↗

Sexual experience and responses to a birth control film.

The objective of this research was to examine the relationship between sexual experience and sexual and contraceptive attitudinal responses to a birth control film. A questionnaire was administered immediately before and after showing a birth control film to 103 college females. Subjects were classified into three groups according to their sexual and contraceptive experience. With perceived change measures, it was found that the film reinforced sexual and contraceptive beliefs. Significant group differences were found regarding reinforcement of sexual attitudes but not for contraceptive attitudes.

Evaluation Studies as Topic↗

Birth control discontinuance as a diffusion process.

This paper applies the diffusion of innovations model to the study of the birth control discontinuance of first-time users in the Dominican Republic. Two sets of factors are examined: social characteristics of the adopters are used to test Rogers's and Shoemaker's contention that discontinuers have more traditional values than continuers; and the adoption decision process is analyzed to identify the relationship of communication factors to discontinuance. Although number of children and experience of method problems were the major determinants of discontinuance, unfavorable information from friends and other birth control users was a significant factor. Rumor was found to have little effect on a women's decision to continue or discontinue.

Adult↗

Associations of parity, breast-feeding, and birth control pills with lumbar spine and femoral neck bone densities.

The relationships between parity, breast-feeding, and the use of birth control pills and the bone densities of the lumbar spine and the femoral neck, measured by dual-photon densitometry, were studied in normal women. Femoral neck density was found to decrease by 1.1% per live-birth, whereas lumbar spine density showed no significant association with parity. Breast-feeding was found to increase lumbar spine density by 1.5% per breast-fed child, whereas femoral neck density was not significantly correlated. No significant relationships between the use of birth control pills and the bone densities were found.

Adult↗