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PubMed1989

Contraceptive method change among rural Sri Lankan women.

Patterns of contraceptive method change and their association with reproductive motivation and contraceptive failure are examined using data from a 1986 survey of family planning behaviour of rural Sinhalese married women aged 15-44 in seventeen districts of Sri Lanka. A notable degree of rationality in contraceptive method changes occurs with family formation. The attempt to control unwanted fertility leads to more efficacious use of contraception, including traditional methods. Some methodological improvements to the analysis of contraceptive switching are indicated. Implications of the findings for programmatic emphasis on permanent versus non-permanent modern methods are discussed.

Adolescent↗
PubMed1989

[Use and knowledge of contraceptive methods in female students of children education].

An inquire about contraception use and knowledge was applied to 292 female students. (Average of age = 21.3 years) An 88.4% of the woman with sexual activity had used contraceptive methods at least once. Principal reason for not going on using them, was not having sexual intercourse. In single women, the use of contraceptive methods was related with age, while the type selected was related with sexual intercourse's frequency. The most used contraceptive methods were rhythm and pill, which were not the best known ones.

Adult↗
PubMed2003

[Unwanted adolescent pregnancy and post-partum utilization of contraceptive methods].

OBJECTIVE: To describe the proportion of unwanted pregnancies among all pregnant adolescents, its association with sociodemographic characteristics, and the use of post-partum contraceptive methods. MATERIAL AND METHODS: A cross-sectional study was conducted among 220 women between 13 and 19 years of age, in two semi-urban municipalities of the State of Morelos, Mexico, interviewed between 1992 and 1994. Women were interviewed at home, six to twelve weeks after their delivery date. Women were asked whether they had wanted their last pregnancy, and about knowledge and use of contraceptive methods after delivery. RESULTS: Adolescent pregnancies accounted for 17% of all births registered in these two municipalities. Among all adolescent mother 22.73% reported that their pregnancy had not been wanted. A positive association was found between the lack of access to health services provided by public medical insurance systems (Instituto Mexicano del Seguro Social IMSS and Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado ISSSTE) and unwanted pregnancy (adjusted OR = 3.03, 95% CI (1.31, 7.) An association was also found between living in an urban community (adjusted OR = 2.16, 95% CI (1.08, 4.33) and an unwanted pregnancy. Among all adolescent mothers, 91.3% were familiar with "the pill" as a contraceptive method; 84.72% knew about the IUD, and 63.68% knew about the condom. However, only 35% of them were actually using an effective contraceptive method six weeks after delivery. No difference in frequency of contraceptive use was found among the adolescent mothers, according to whether they wanted their last pregnancy. Only 43.39% of mothers who delivered at hospitals or health centers were using an effective contraceptive method. CONCLUSIONS: These findings suggest that there is a great potential for family planning programs to target adolescents, and that the use of contraceptive methods after delivery should be promoted among adolescent mothers, especially those lacking access to public medical insurance and those living in semi-urban settings. It is also recommended to conduct studies on family planning education programs that can be introduced earlier in the school system in Mexico.

Adolescent↗
PubMed1999

Intrauterine devices. The optimal long-term contraceptive method?

OBJECTIVE: To review selected data on the effectiveness, safety, cost and technical ease of intrauterine device (IUD) use compared with Norplant and surgical sterilization. STUDY DESIGN: Literature review. RESULTS: IUDs are highly effective, safe and relatively inexpensive methods of contraception that may offer advantages for some women over other long-term methods, such as sterilization and Norplant. IUDs provide protection against pregnancy comparable to that provided by female sterilization, and they may be more effective than Norplant. IUDs have a long duration of effectiveness: the copper T 380A (TCu380A) is effective for at least 10 years, and the levonorgestrel (LNg) IUD appears to be effective for at least 7. Norplant is effective for only five years. Both types of IUD can disrupt menstrual bleeding patterns, although the patterns of bleeding are different. Copper IUDs often increase blood loss, whereas the LNg IUD, like Norplant, substantially reduces menstrual bleeding. The most important adverse outcome associated with IUD use is higher rates of pelvic inflammatory disease; careful attention to proper insertion techniques can reduce this risk substantially, and LNg IUDs may cause no increase in risk. IUDs, like both sterilization and Norplant, provide no protection against sexually transmitted disease. The TCu380A IUD is extremely cost-effective. There is as yet no public sector price for the LNg IUD, which has not been approved by the U.S. Food and Drug Administration and is not provided by family planning donor organizations. If it can be made available to the public sector at a price substantially less than its present market price, the LNg IUD would be a useful addition to the contraceptive armamentarium for developing countries. CONCLUSION: Providers, consumers and family planning program managers should begin to see IUDs as potential substitutes for both surgical sterilization and Norplant.

Contraceptive Agents, Female↗
PubMedDate not supplied

Iron status in 268 Danish women aged 18-30 years: influence of menstruation, contraceptive method, and iron supplementation.

The aim of the present study was to evaluate the influence of menstruation, method of contraception, and iron supplementation on iron status in young Danish women, and to assess whether iron deficiency could be predicted from the pattern of menstruation. Iron status was examined by measuring serum (S-) ferritin and hemoglobin (Hb) in 268 randomly selected, healthy, menstruating, nonpregnant Danish women aged 18-30 years. Iron deficiency (S-ferritin <16 microg/l) was observed in 9.7%, of the women, iron deficiency anemia (S-ferritin < 13 microg/l and Hb < 121 g/l) in 2.2%. Iron supplementation, predominantly as vitamin-mineral tablets containing 14-20 mg of ferrous iron was used by 35.1%. The median serum ferritin was similar in non-iron users and in iron users, whereas the prevalence of iron deficiency was 12.6% in nonusers vs. 4.3% in users, the prevalence of iron deficiency anemia 3.4% in nonusers vs. 0%, in users (p=0.17) In non-iron-supplemented women, S-ferritin levels were inversely correlated with the duration of menstrual bleeding (rs= -0.25, p<0.001) and with the women's assessment of the intensity of menstrual bleeding (r(s)= -0.27, p<0.001), whereas no such correlations were found in iron-supplemented women. The results demonstrate that even moderate daily doses of ferrous iron can influence iron status in women with small iron stores. Women using hormonal contraceptives had menstrual bleeding of significantly shorter duration than those using intrauterine devices (IUD) or other methods. There was a high prevalence of small and absent body iron stores in young women, suggesting that preventive measures should be focused on those women whose menstruation lasts 5 days or longer, who have menstrual bleeding of strong intensity, who use an IUD without gestagen, and who are blood donors.

Adolescent↗
PubMed1998

Sex education and contraceptive methods: knowledge and sources of information among the Estonian population.

A survey on sex education and contraceptive methods was carried out within a monthly EMOR Omnibus Survey. By using a questionnaire, knowledge and attitudes, as well as the main sources of information on contraceptive methods and sex education, among the Estonian adult population (n = 618) was investigated. Of the respondents, 68% were female and 32% were males: the mean age was 34 years. Almost all respondents expressed the opinion that sex education should start at school and that education on contraceptive methods would reduce the number of abortions. The majority of the respondents believed that it would be more convenient to visit a family doctor than a gynecologist for family planning. Main sources of information on contraception were: literature, doctors and journals, as rated by females; and literature, partners and television, as rated by males. The roles of the school nurse, father and siblings were rated as comparatively small. The level of respondents' knowledge of contraceptive methods was not too high. It is concluded that the prerequisites for changing sexual behavior and knowledge over a short time are wider use of mass media and better sex education at schools. Also, it is necessary to prepare family doctors to offer family planning services to their patients.

Adult↗
PubMedDate not supplied

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↗
PubMed2006

Unplanned pregnancy: does past experience influence the use of a contraceptive method?

OBJECTIVE: To investigate whether women between the ages of 14 and 25 years with a past unplanned pregnancy were more likely to use a contraceptive method compared with women without a history of unplanned pregnancy. METHODS: We analyzed baseline data of 424 nonpregnant women between the ages of 14 and 25 years enrolled in a randomized trial to prevent sexually transmitted diseases and unplanned pregnancy (Project PROTECT). Women at high risk for sexually transmitted diseases or unplanned pregnancy were included. Participants completed a demographic, substance use, and reproductive health questionnaire. We compared women with and without a history of unplanned pregnancy using bivariate analysis and log binomial regression. RESULTS: The prevalence of past unplanned pregnancy in this sample was 43%. Women reporting an unplanned pregnancy were older, and had less education, and were more likely to be nonwhite race or ethnicity. History of an unplanned pregnancy was not associated with usage of a contraceptive method (relative risk 1.01, 95% confidence interval 0.87-1.16) in bivariate analysis or when potential confounders were accounted for in the analysis (adjusted relative risk 1.10, 95% confidence interval 0.95-1.28). CONCLUSION: Several factors were associated with both unplanned pregnancy and overall contraceptive method use in this population. However, a past unplanned pregnancy was not associated with overall contraceptive method usage. Future studies are necessary to investigate the complex relationship between unplanned pregnancy and contraceptive method use. LEVEL OF EVIDENCE: II-2.

Adolescent↗
PubMed1999

Forearm bone density in users of Depo-Provera as a contraceptive method.

OBJECTIVE: To determine the influence of depot medroxyprogesterone acetate (MPA) on bone mineral density when used as a contraceptive method. DESIGN: Cross-sectional study. SETTING: Academic tertiary-care hospital. PATIENT(S): Fifty premenopausal women who had used depot MPA as a contraceptive method for > or =1 year and 50 women who had never used hormonal contraceptive methods. INTERVENTION(S): Bone mineral density was evaluated at the midshaft and at the distal radius of the nondominant forearm using single x-ray absorptiometry. MAIN OUTCOME MEASURE(S): Bone mineral density. RESULT(S): Bone mineral density at the midshaft of the forearm was lower in depot MPA users than in women who had never used hormonal contraceptive methods, but the difference was not statistically significant. At the distal portion, bone mineral density was significantly lower in the study group. The duration of depot MPA use was not related to bone mineral density. CONCLUSION(S): Women > or =35 years of age presented with a lower bone mineral density only at the distal portion of the forearm after the use of depot MPA for > or =1 year. However, this decrease was not related to the duration of depot MPA use. It is not possible to conclude that women who use depot MPA are at risk of osteoporosis.

Adult↗
PubMed2006

On the use of contraceptive methods among married women in Turkey.

OBJECTIVE: To identify factors affecting use and choice of contraceptive methods of married women in Turkey. METHODS: The study is based on data from the 1998 Turkish Demographic and Health Survey, held by the Hacettepe Institute of Population Studies. To analyse the data set, a multinomial logistic regression model has been used. RESULTS: The most influential variable for traditional method use versus non-use is 'region', while that for modern method use versus non-use is a 'woman's attitudes towards family planning methods'. Moreover, modern method use versus traditional method use is more common in middle-aged women, living in urban areas, approving of family planning methods and with higher education. CONCLUSION: Women's behaviours on contraceptive method use and choice are associated with women's attitude towards family planning and level of education as well as region and place of residence; that is, ease of access to the methods. To increase success of family planning programmes, it should be ensured that the methods are easily accessed and women receive information about contraceptive methods. In addition, family planning providers must strive to increase women's level of education.

Adolescent↗
PubMed2004

The condom in relation to prevention of sexually transmitted infections and as a contraceptive method in Sweden.

OBJECTIVE: To analyze in detail the latest Swedish population survey regarding condom use in order to gain a deeper knowledge of the characteristics of women and men using or not using condoms at a time when the number of sexually transmitted infections (STIs) had started to increase. METHODS: From a population-based survey of sexual life in Sweden among men and women aged between 18 and 74 years (n = 2810), we investigated the use of condoms in relation to social demographic, lifestyle, sexual and behavioral characteristics. RESULTS: In the age group 18-49 years, every third person had experience of a legal abortion and every fourth had had an STI. Overall, use of condoms was 12% in the whole population and 15% in the age group 18-49 years. Using a condom as a method of contraception, as opposed to other methods, was found to be less frequent in six subgroups: when coitus was less frequent, age above 25 years, among those who had had many partners and those with earlier experience of abortion or STI, as well as having a risky behavior. Using a condom as a preventive against contracting an STI occurred less often in women and men older than 25 years and among those having coitus more frequently. CONCLUSION: Even with good information and easy accessibility to condoms, there are still obstacles to their use. To achieve the aim of safer sexual practice, it is a challenge for the couple as well as for counselors to reason about the advantages and disadvantages of not using a condom. Discussions about attitudes, behavior and gender differences must be continued and emphasized in coming generations, both on the individual and on a societal level, in order to achieve safer sexual practice.

Adolescent↗
PubMedDate not supplied

Contraceptive method switching in the United States.

CONTEXT: Switching among contraceptive method types is the primary determinant of the prevalence of use of specific contraceptive methods, and it has direct implications for women's ability to avoid unintended pregnancies. Yet, method switching among U.S. women has received little attention from researchers. METHODS: Data from the 1995 National Survey of Family Growth were used to construct multiple-decrement life tables to explore the gross switching rates of married and unmarried women. Within each group, discrete-time hazard models were estimated to determine how women's characteristics affect their switching behavior. RESULTS: Overall rates of method switching are high among both married and unmarried women (40% and 61%, respectively). Married women's two-year switching rates vary from 30% among women who use the implant, injectable, IUD or other reversible methods to 43% among nonusers, while unmarried women's rates vary from 33% among women who use the implant, injectable or IUD to 70% among nonusers. Multivariate analyses of method switching according to women's characteristics indicate that among married women, women without children are less likely than other women to adopt sterilization or a long-term reversible contraceptive (the implant, injectable or IUD). Older married women have a higher rate than their younger counterparts of switching to sterilization, but are also more likely to continue using no method. Among unmarried women, younger and more highly educated women have high rates of switching to the condom and to dual methods. CONCLUSIONS: Women's method switching decisions may be driven primarily by concerns related to level and duration of contraceptive effectiveness, health risks associated with contraceptive use and, among single women, sexually transmitted disease prevention.

Adolescent↗
PubMed2000

Factors affecting the selection of a reversible or an irreversible contraceptive method in a developing country.

OBJECTIVES: To evaluate the factors that may affect the selection of a reversible or an irreversible contraceptive method. METHODS: In an urban area of a developing country, demographic characteristics, educational and income levels, and previously used contraceptive methods were retrospectively reviewed for 3 years from the files of women who had chosen reversible or irreversible contraceptive methods. Student's t test and the chi2 test were used to analyze the data obtained from the two groups of women. RESULTS: Out of a total of 8078 women, 595 (7.4%) selected surgical sterilization, while 7483 (92.6%) preferred reversible methods such as intrauterine devices (38.1%), combined oral contraceptives (13.9%), condoms (40%) and Norplant (0.6%). Compared to those who preferred reversible methods, the women with surgical sterilization had a higher mean age (33.9 +/- 4.2 years versus 29.6 +/- 3.9 years), mean gravidity (3.8 +/- 0.9 versus 2.3 +/- 1.2) and mean number of living children (2.6 +/- 0.8 versus 2.1 +/- 1.1) (p < 0.01). These women had also higher rates of high-school education (37.3% versus 30.1%) and previous modern contraceptive use (78.1% versus 71.2%) (p < 0.01). None of the women with surgical sterilization, but 1770 (33.0%) of those who chose reversible methods, had fewer than two living children. CONCLUSIONS: These data suggest that irreversible contraceptive methods tend to be chosen by older women with higher educational levels, who have decided that their family is complete and who have at least two children.

Adult↗
PubMed2004

Acceptance of long-term contraceptive methods and its related factors among the eligible couples in a selected union.

This study focuses on the acceptance of long-term contraceptive methods and its related factors among the eligible couples in the rural area of Bangladesh. Among the respondents sixty were acceptors and one hundred seventy were non-acceptors of long-term contraceptive methods. Socio-demographic characteristics of the both acceptors and non-acceptors of long-term contraceptive methods were same except their age. Acceptors of long-term contraceptive method were older than the non-acceptors. Regarding the reproductive characteristics acceptors were married for longer time than non-acceptors. There was significant association between acceptance of long-term method and number of male children and desired additional children. Acceptors had more living male children and desired less additional children than non-acceptors. Regarding reasons for acceptance 35% accepted the method because the methods are long-term and safe while 30% accepted because the methods well suited them and 18% because accepted don't need to take daily like pills. Main cause for not accepting long-term methods fear of side-effects (22%) lack of proper knowledge about the methods (21%) followed by husbands objection (12%), desire for more children (10%) and health reasons (8%).

Adult↗
PubMed1986

The postcoital IUD as an effective continuing contraceptive method.

A two-year controlled clinical study of the effectiveness of postcoital IUD as a continuing contraceptive method in 98 women requesting a postcoital contraception is presented. The control group was selected from women requesting an IUD as contraceptive choice. The rates of accidental pregnancy, expulsion and removal for medical reasons did not differ between the two groups. Removal for personal reasons was the only termination event that showed a significant difference at one year. Moreover, the removal for personal reasons of interceptive IUD users mainly occurred in the early months after insertion. Postcoital IUD has proved to be an effective continuing contraceptive method. Special attention and sympathetic counseling should be given to postcoital IUD users before insertion and during the three months following insertion.

Adolescent↗
PubMed1998

Adolescent males' combined use of condoms with partners' use of female contraceptive methods.

OBJECTIVE: Protection from both sexually transmitted diseases and pregnancy is best obtained by the combined use of male condoms and effective female contraceptive methods. This research examines dual contraceptive method use among teenage men. METHOD: Analyzed data from the 1995 National Survey of Adolescent Males, a nationally representative survey of 15 to 19-year-old males. Used bivariate analyses and logistic regression to examine the correlates of combined use of condoms and female methods. RESULTS: At last intercourse, 17% of sexually active males reported use of a condom and a female method of contraception. Condom use, alone and in combination with a female method, was positively associated with talking with the partner about contraception and condoms, believing that males have a responsibility for contraception, and being in an earlier stage of a relationship. Only high levels of worry about sexually transmitted diseases differentially influenced dual method use, increasing the likelihood of using a condom with a female method, but not using condoms alone. CONCLUSIONS: The results suggest that efforts to increase condom use in general should also influence young men's use of condoms when their partner is using a female method. Providing information to young males about the high prevalence and serious consequences of sexually transmitted diseases may increase dual method use among adolescents.

Adolescent↗