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At least 19 recordsLinked to original sources
PubMed2004

Abortion as a backup method for contraceptive failure in China.

Contraceptive failure rates for modern methods including sterilization are reported to be high in China, but little is known about the consequence of contraceptive failure and characteristics of women who decide to have an abortion if a contraceptive failure occurs. Using 6225 contraceptive failures from the 1988 Chinese Two-per-Thousand Fertility Survey, this study examines the resolution of contraceptive failure and assesses the impact of some women's sociodemographic characteristics on the decision to terminate contraceptive failure in abortion. This study has three important findings: (1) The abortion rate was 50.1%, 75.3% and 80.2% for IUD, condom and pill failures, respectively; (2) The abortion rates differed by contraceptive method and women's social and demographic characteristics. In particular, a woman with just one child was most likely to have the contraceptive failure aborted; (3) Some women experienced repeated abortions because of contraceptive failure. The results suggest that abortion was a backup method if contraception failed in China and the correlates of aborting an unwanted pregnancy reflect the strong impact of the Chinese family planning programme.

Abortion, Induced↗
PubMed1995

The impact on fertility of contraceptive failure in China in the 1980s.

Contraceptive failure was an important determinant of fertility in China in the 1980s. Based on the data from the China Two-per-Thousand Fertility Survey, this study shows that about 7% of the general fertility rate of currently married women aged 15-49 for a 12-month period is attributed to contraceptive failure, mainly due to the high failure rate associated with IUD use. A number of demographic characteristics are associated with contraceptive use, and with contraceptive failure and its outcome. Relevant socioeconomic differentials are also identified.

Adolescent↗
PubMed2002

Contraceptive failure--results from a study conducted among women with accepted and unaccepted pregnancies in Denmark.

Most studies focusing on contraceptive failure in relation to pregnancy have focused on contraceptive failure among women having induced abortions, thereby neglecting those women who, despite contraceptive failure, accept the pregnancy and intend to carry the fetus to term. To get a more complete picture of the problem of contraceptive failure, this study focuses on contraceptive failure among women with diverse pregnancy outcomes. In all, 3520 pregnant women attending Odense University Hospital were included: 373 had induced abortions, 435 had spontaneous abortions, 97 had ectopic pregnancies, and 2614 received antenatal care. The variables studied comprise age, partner relationship, number of births, occupational and economical situation, and contraceptive use.Contraceptive failure, defined as contraceptive use (condom, diaphragm, IUD, oral contraception, or another modern method) at the intercourse where conception most likely occurred, were reported by 315 women, 52% of these women had induced abortions, 10% had spontaneous abortions, 3% had ectopic pregnancies, and 36% received antenatal care. Women aged 15-24 years were more likely to have experienced contraceptive failure in relation to use of condom and oral contraception than women aged 25-34 years. In addition, contraceptive failure was found to be associated with being single, a student, and having given birth twice or more previously. Regarding pregnancy acceptance, being 25-34 years of age was positively associated, whereas being single and a student was negatively associated with pregnancy acceptance.

Abortion, Induced↗
PubMed1999

Interactions between oral contraceptives and antifungals/antibacterials. Is contraceptive failure the result?

The effectiveness of oral contraceptives may be impaired by concomitant treatment with antimicrobials. This may occur because of reductions in plasma concentrations of ethinylestradiol by the induction of hepatic metabolism, as for rifampicin (rifampin) and possibly griseofulvin, or in a small percentage of women because of interference with enterohepatic recirculation. There are no scientific data to support the anecdotal evidence that the concomitant use of combined oral contraceptives and antimicrobials reduces contraceptive efficacy in the majority of women. It has been postulated that there is a subset of women in whom the enterohepatic recirculation of ethinylestradiol plays an important role. In these women the action of an antimicrobial may reduce the efficacy of oral contraceptives by interfering with this mechanism. Studies that have quantitatively examined these effects may have failed to include women from this subset because of the small numbers involved in the studies. On the other hand, there are no good prospective studies comparing contraceptive failure rates between compliant women who use combined oral contraceptives with and without antimicrobials. All women using combined oral contraceptives should be informed of the very low level of risk of interactions with antimicrobials (probably about 1%) and that it is not possible to identify who may be at risk. Women concerned about this low level of risk should be given information about the use of barrier methods or avoidance of intercourse during the first 7 days of concomitant antimicrobial therapy and for 7 subsequent days. Women who have had previous contraceptive failures or developed breakthrough bleeding during concomitant antimicrobial use should be strongly advised to follow these precautions, as they may be part of the subset of women at higher risk of contraceptive failure.

Animals↗
PubMed2002

Contraceptive failure in China.

This study examines patterns and differentials of contraceptive failure rates by method and characteristics of users, using the Chinese Two-per-Thousand Fertility Survey data. The results show that contraceptive failure rates for modern methods including sterilization are some of the highest in the world. The first year failure rates are 4.2% for male sterilization, 0.7% for female sterilization, 10.3% for IUD, 14.5% for pill, and 19.0% for condom. There are also some differentials in contraceptive failure rates by users' sociodemographic and fertility characteristics. Contraceptive failure rate declines with women's age for all reversible methods. Rural women have higher sterilization, IUD, and condom contraceptive failure rates than urban women. Women with two or more children have a higher failure rate for sterilization methods but have lower failure rates for other methods.

Adolescent↗
PubMed2002

Contraception failure and wrongful birth claims.

Case histories are based on actual medical negligence claims, however, certain facts have been omitted or changed by the author to ensure the anonymity of the parties involved. Medical negligence claims involving an allegation or 'wrongful birth' can arise from a negligent failure of contraception. In these wrongful birth claims, the patient sues the medical practitioner who failed to prevent her conception and subsequent pregnancy. This article outlines some risk management strategies for general practitioners to minimise the possibility of a claim arising from a failure of contraception involving the use of the long acting contraceptive implant, Implanon.

Adult↗
PubMed1997

Correlates of contraceptive failure among clients attending an antenatal clinical in Nairobi.

This paper presents a study analysing 100 cases of contraceptive failure and an equal number of controls in Nairobi. The study population included all the patients who attended the antenatal clinic at Kenyatta National Hospital, during a ten-week study period and who had conceived while on a contraceptive method. The controls were patients who were carrying a planned pregnancy. The objective of the study was to determine the sociodemographic patterns, level of counselling and attitudes of patients who presented to antenatal clinic after contraceptive failure and to formulate recommendation on how to manage these patients. User failure was more common than method failure. High parity and a high number of living children were associated with increased risk of contraceptive failure (OR 3.7 and 4.6, respectively). Other factors found to be associated with increased risk of contraceptive failure were: inadequate counselling at contraceptive initiation (OR 4.0), poor knowledge of different contraceptive methods (OR 1.9), short duration of contraceptive use (OR 3.3), and non-compliance, with 40% of the cases having been non-compliant. Thirty per cent of the patients who had contraceptive failure were unhappy about the pregnancy. This paper finds that better counselling on contraceptive use and compliance would reduce contraceptive failure and diminish the negative programme effects of failed contraception. Counselling would also enhance acceptance of the pregnancy and minimise the chances of negative psychological sequelae.

Adult↗
PubMedDate not supplied

Contraceptive failure, method-related discontinuation and resumption of use: results from the 1995 National Survey of Family Growth.

CONTEXT: Half of all pregnancies in the United States are unintended. Of these, half occur to women who were practicing contraception in the month they conceived, and others occur when couples stop use because they find their method difficult or inconvenient to use. METHODS: Data from the 1995 National Survey of Family Growth were used to compute life-table probabilities of contraceptive failure for reversible methods of contraception, discontinuation of use for a method-related reason and resumption of contraceptive use. RESULTS: Within one year of starting to use a reversible method of contraception, 9% of women experience a contraceptive failure--7% of those using the pill, 9% of those relying on the male condom and 19% of those practicing withdrawal. During a lifetime of use of reversible methods, the typical woman will experience 1.8 contraceptive failures. Overall, 31% of women discontinue use of a reversible contraceptive for a method-related reason within six months of starting use, and 44% do so within 12 months; however, 68% resume use of a method within one month and 76% do so within three months. Multivariate analyses show that the risk of contraceptive failure is elevated among low-income women and Hispanic women. Low-income women are also less likely than other women to resume contraceptive use after discontinuation. CONCLUSIONS: The risks of pregnancy during typical use of reversible methods of contraception are considerably higher than risks of failure during clinical trials, reflecting imperfect use of these methods rather than lack of inherent efficacy. High rates of method-related discontinuation probably reflect dissatisfaction with available methods.

Adult↗
PubMed1996

The impact of postpartum redundant use of contraception on contraceptive failure rates.

Redundant use of contraception occurs when periods of contraceptive use overlap with periods of reduced fecundity, and will downwardly bias estimates of contraceptive failure rates. This paper investigates this bias using calendar data from the Demographic and Health Surveys. The paper presents unadjusted and adjusted 12-month failure rates for each of nine countries. The impact of redundant use on failure rates is generally modest. It tends to be greater in Indonesia, however, where both the incidence and the duration of overlap are relatively large.

Adolescent↗
PubMed1991

Methodological pitfalls in the analysis of contraceptive failure.

Although the literature on contraceptive failure is vast and is expanding rapidly, our understanding of the relative efficacy of methods is quite limited because of defects in the research design and in the analytical tools used by investigators. Errors in the literature range from simple arithmetical mistakes to outright fraud. In many studies the proportion of the original sample lost to follow-up is so large that the published results have little meaning. Investigators do not routinely use life table techniques to control for duration of exposure; many employ the Pearl index, which suffers from the same problem as does the crude death rate as a measure of mortality. Investigators routinely calculate 'method' failure rates by eliminating 'user' failures from the numerator (pregnancies) but fail to eliminate 'imperfect' use from the denominator (exposure); as a consequence, these 'method' rates are biased downward. This paper explores these and other common biases that snare investigators and establishes methodological guidelines for future research.

Contraception↗
PubMed2004

Reproductive consequences of contraceptive failure in 19 developing countries.

OBJECTIVE: To ascertain the contribution of contraceptive failure to unintended births and fetal loss in developing countries. METHODS: Nationally representative survey data from married women in 19 developing countries were analyzed. All surveys contained retrospective monthly calendars of contraceptive use and pregnancies for a 5-year period preceding each survey. Information on the intendedness of live births, ascertained earlier in the interview, were linked to the calendar data. Single-decrement life table analysis was applied to episodes of use to estimate failure probabilities. The reproductive consequences of failure were established by simple tabulation. Logistic regression was used to explore the determinants of fetal loss. RESULTS: Reported contraceptive failure rates were similar to those derived from studies conducted mainly in the United States. About three fourths of pregnancies resulting from contraceptive failure were carried to term, and all but 16% of those were classified by the mother as unwanted or mistimed. Just over one tenth ended in fetal loss, either induced or spontaneous. Analysis of determinants of fetal loss suggested that a large proportion were induced. The median contribution of failure to all unintended births for all 19 surveys was about 15%, and the contribution to fetal loss was 12%. CONCLUSION: The contribution of contraceptive failure in developing countries is much lower than the estimate of 50% in the United States. Despite the substantial increases in contraceptive practice that have occurred in Asia, Latin America, the Middle East, and to a lesser extent, Africa, the level of use is still below the 75% mark achieved in most industrialized countries. Nonuse of contraception remains the dominant direct cause of unintended births, and family planning promotion should remain a public health priority.

Contraception↗
PubMed2006

Contraceptive failures and determinants of emergency contraception use.

OBJECTIVES: Two years after emergency contraceptive pills (ECPs) were made available without prescription in France, we investigated the determinants of ECP use in a representative sample of women at risk for unintended pregnancy. STUDY DESIGN: This study is based on data collected from a population-based cohort exploring contraceptive practices and abortion (N=2863). RESULTS: Among the 706 women at risk for unintended pregnancy during the first year of follow-up (2001), only 11.1% used ECPs. Women in stable relationships or using the same contraceptive method during the year were less likely to use ECPs than other women. The study also demonstrates that detailed knowledge of ECPs increases the probability of its subsequent use. CONCLUSIONS: Given the low frequency of ECP use in cases of unintended pregnancy risk, these results suggest that information campaigns should be targeted not only at women with irregular contraceptive practices but also at women who experience errors in the use of their regular contraceptive method.

Adolescent↗
PubMedDate not supplied

Are all contraceptive failures unintended pregnancies? Evidence from the 1995 National Survey of Family Growth.

CONTEXT: The incidence of unintended pregnancy has long been used as a primary indicator of the state of reproductive health. However, the definition--and therefore the measurement--of this indicator has been elusive. METHODS: Data from the 1995 National Survey of Family Growth (NSFG) were used to compare levels of unintended pregnancy among contraceptive users based on two definitions--the standard definition based on women's reports of contraceptive failure, and the NSFG definition based on pregnancy timing (wanted then, wanted later, or not wanted then or in the future). An attitudinal scale was used to examine women's feelings about their unintended pregnancy. RESULTS: Of pregnancies classified as contraceptive failures under the standard definition, only 68% were unintended pregnancies--94% of those ending in abortion and 60% of those ending in birth. Just 59% of women with a contraceptive failure classified as an unintended pregnancy reported feeling unhappy or very unhappy about their pregnancy, while 90% of those with a failure classified as an intended pregnancy reported being happy or very happy. CONCLUSIONS: Measures of wantedness based on women's feelings about their pregnancy may correlate more closely with important pregnancy outcomes than do traditional measures of intendedness.

Adult↗
PubMed1992

[A study of contraceptive-failure pregnancy and induced abortion in Korea].

The author reviews South Korea's family planning program since its inception in 1962. The focus is on pregnancy due to contraceptive failure and the use of induced abortion as a remedy. It is found that "according to a logistic regression analysis, major factors which affect the outcome of pregnancy due to contraceptive failure were residence area, number of boys, educational level, duration of marriage, women's age and number of children." (SUMMARY IN ENG)

Abortion, Induced↗
PubMed1983

Apparent oral contraceptive failure associated with antibiotic administration.

The concomitant use of antibiotics and oral contraceptives should be included in the assessment of contraceptive failure. A case of unwanted adolescent pregnancy during the use of a semisynthetic penicillin and an oral contraceptive is presented and discussed. Advising a different contraceptive method or an additional contraceptive modality may be indicated in adolescents taking long-term antibiotic medication.

Adolescent↗
PubMed2004

Contraceptive failure in the United States.

This review provides an update of previous estimates of first-year probabilities of contraceptive failure for all methods of contraception available in the United States. Estimates are provided of probabilities of failure during typical use (which includes both incorrect and inconsistent use) and during perfect use (correct and consistent use). The difference between these two probabilities reveals the consequences of imperfect use; it depends both on how unforgiving of imperfect use a method is and on how hard it is to use that method perfectly. These revisions reflect new research on contraceptive failure both during perfect use and during typical use.

Amenorrhea↗