[Current status of and prospects for contraceptive methods].
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Data from a street survey conducted among 717 women aged 17-35 in two inner-city Baltimore communities in 1991-1992 indicate that 17% of the entire sample, 38% of women using the pill and 11% of users of methods other than the pill used a condom in addition to another method the last time they had intercourse. Although adolescents reported the highest rate of combined condom and pill use (22% of 17-19-year-olds), condom use was significantly associated with pill use among adult women (odds ratio of 1.57) but not among adolescents (odds ratio of 1.03). Condom use was negatively associated with use of methods such as the diaphragm, the IUD, the implant and the sponge (odds ratio of 0.21) among both adolescents and adults. Logistic regression analyses show that positive attitudes toward safer sex, ever having refused sex without a condom and believing in condom efficacy all significantly predicted use of the condom with another method. Having ever been tested for HIV was negatively related to combined use, while behavioral risk factors showed no association.
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In the present study Norplant(R) and IUD acceptors who attended the same counseling sessions have been compared on their perception of the information received at the family planning clinic. The study covered 100 acceptors of each method quota matched by parity and years of schooling. Data were obtained through home interviews. The two groups presented no significant differences when selected socio-demographic characteristics were analyzed. Norplant users recalled more information on this method than did IUD acceptors, and the content of what they remembered was different. This included concepts as important as risk of pregnancy, menstrual and health effects, and method of removal. The results suggest that the intrinsic qualities of the new method and the presence of a group of women motivated to use one with its general characteristics, are not sufficient conditions for its acceptance.
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Research was conducted to determine the patterns of contraceptive choice in four developing countries and to investigate the association between method selection and demographic/socioeconomic variables, future family planning intentions, and users' perceptions of methods and preference for personnel. After listening to a balanced presentation of information on the methods, each woman indicated her choice and was then interviewed to determine her reasons for selecting that method. The pattern of contraceptive selection differed from the previous pattern of contraceptive use in each clinic, and this suggests that the presentation of balanced information combined with the provision of a free choice of methods is a useful approach to the assessment of the demand.
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In Japan, most couples use traditional methods, with about 80% relying on the condom and a further significant proportion on the rhythm method. In fact a combination of both methods is common among married couples. The oral contraceptives have the following advantages: Reversibility, simple and easy to use, coitally independent, no skill or knowledge required for its use, high acceptability, no pain or discomfort at use, self-administration, while they have the following disadvantages: Inadequate during lactation, sustained motivation in the female side required, clinical contraindication exists, possible side-effects such as nausea, vomiting, breast tenderness, weight gain, questionable possibility of serious side effects such as hypertension, thromboembolic diseases etc., medical supervision and follow up required, expensive cost. The use of the steroidal preparations for contraceptive purpose in Japan awaits official approval. Under present regulations, it is not illegal for the physicians to prescribe the pill, and currently six preparations are available and all contain 50 microgram of estrogen. The reduction in the estrogen and progestogen content of the pill did not appreciably compromise contraceptive potential while untoward effects were considerably lowered. The development and use of the new progestogen also contributed to minimize the possible side effects. Efforts are now being directed at a pill which minimizes metabolic change, decreases the incidence of breakthrough bleeding or spotting, without compromising efficacy. It is with these goals in mind that the multi-phasic pills have been developed in the belief that many of the undesirable side-effects can be circumvented while maintaining almost 100% conception control.(ABSTRACT TRUNCATED AT 250 WORDS)
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A study is made on some significant aspects of the obstetric history and contraceptive practice in an urban health area by means of a random sample that selected 352 women of reproductive potential. They were interviewed by means of a questionnaire designed for that purpose. Most women in all age groups had a male partner, except for the 15-19 age group, and it seems that often marriage duration is not low. Pregnancy average per woman was high (3.04) and high rates for induced abortion per live birth (0.99) and of induced abortion per woman (1.44) were found, which is indicative of inappropriate contraceptive practice. The contraceptives most commonly used were intrauterine devices (74%) and oral tablets (51%); much less frequent is the use of condoms (5.8%), diaphragms (2.9%), periodic abstinence (2.5%) and breast feeding (2.5%). Results indicate an abuse of abortion as a family planning method, as well as a poor contraceptive practice.
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