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Spontaneous foetal losses in women using different contraceptives around the time of conception.

Spontaneous losses between the 5th and 27th weeks of pregnancy were measured in a prospective study of 32 123 women whose contraceptive history around the time of conception was known. Diaphragm use prior to conception was associated with a significant reduction in second-trimester losses, after taking into account the effects of age, parity, race, marital status, alcohol use, and previous spontaneous or induced abortions. Women who used oral contraceptives and stopped them more than one month prior to their LMP experienced a deficit of first-trimester losses but conceptions occurring immediately after stopping the pill were followed by a small but nonsignificant increase in spontaneous abortions. After oral contraceptive failures there was an increase in first-trimester losses, but no change in the incidence of second-trimester ones. IUD failures were followed by a significant two-fold increase in the risk of both first and second-trimester losses: no differences were detected between the different brands.

Abortion, Spontaneous↗

Frequency of non-hormonal contraception around conception and association with congenital malformations in offspring.

A case-control study using data on deliveries in the mid-1970s at five Connecticut hospitals (cases, n = 1427; controls, n = 3001) found little relationship between delivery of a malformed infant and use by the mother of nonhormonal contraceptive methods at conception. Of particular interest was the lack of an association with use of the rhythm method (odds ratio (OR) = 1.02, 95% confidence limits (CL) = 0.73, 1.42), spermicides (OR = 1.26, 95% CL = 0.85, 1.85) at conception and a modest association for the intrauterine device (IUD) one week before conception (OR = 1.99, 95% CL = 0.98, 4.04). Continued use of the IUD after conception may further increase the risk for malformations but this observation was statistically unreliable in the present study. Mothers of newborns with cleft lip and palate (OR = 2.91) and congenital hydrocele (OR = 4.64) were more frequent rhythm users at conception, and mothers of newborns with multiple anomalies had more recent IUD exposure (OR = 9.87), but these and all other specific congenital malformation groups were not significantly related to any non-hormonal contraceptive after adjustment for multiple observations. Potentially confounding maternal risk factors were controlled.

Adult↗

Epidemiological studies of natural family planning.

The prevalence of the use of natural family planning (NFP) can be estimated from sample surveys of married women in the reproductive ages (MWRA). Surveys in developed and developing countries during the past decade indicate that the prevalence of NFP use varies from 0 to 11%. In addition, if one considers NFP use in relation to other contraceptive methods, the percentage of all current contraceptors who use NFP varies from 1 to 35%. This suggests that NFP is an important method in certain countries. Pregnancy rates for NFP vary widely, but most reliable studies report 1-year life-table pregnancy rates between 10 and 25/100 woman-years. The Billings ovulation method consistently has higher pregnancy rates than the sympto-thermal method and NFP users generally have among the highest pregnancy rates compared to other methods. The major safety issue concerning NFP is the risk of adverse pregnancy outcomes associated with aged gametes. There are suggestions from a number of investigations that conceptions distant from ovulation have a higher risk of spontaneous abortion and a higher proportion of male births. The findings with respect to birth defects or multiple pregnancies are less consistent, although some studies have reported an increased risk of chromosomal anomalies.

Abortion, Spontaneous↗

What nurses should know about natural family planning.

Two common natural family planning (NFP) methods are the ovulation method based on characteristics of cervical mucus and the symptothermal method based on changes in cervical mucus, basal body temperature, and the cervix. Both methods are effective when used correctly. Nurses should understand the principles of NFP and introduce these methods in discussions of family planning options. Interested clients should be referred to a certified NFP instructor for education and supervision.

Body Temperature↗

Combination of the ovulation method with diaphragm.

A marked increase in acceptance of the ovulation method of contraception, together with promising method and user failure rates, were revealed in this study of women to whom a system of combining the ovulation method with the optional use of a diaphragm, advisedly as a menstrual seal, was offered.

Contraception↗

Type and time of insemination within the menstrual cycle and the human sex ratio at birth.

Data that strongly suggest that the timing of insemination affects the human sex ratio at birth are presented. Two studies conducted by the author, including a total of 1,318 pregnancies, in which timing of insemination was related to the shift in basal body temperature are discussed, and previous literature is reviewed. The differential effect of type of insemination-natural versus artificial-is noted. The further question why timing and type of insemination affects the human sex ratio is also explored.

Animals↗