Birth Control Research Articles

Clinical strategy study on prenatal screening and diagnostic model for Down syndrome

Exploring efficient and easily implementable prenatal screening strategies aims at birth defect prevention and control. However, there have been limited economic evaluations of non-invasive prenatal screening (NIPS) strategies in China. Furthermore, these studies were predominantly confined to local or geographically proximate provinces and lacked universality and representativeness. This study assesses the health economics of current prenatal screening strategies and NIPS as first-line screening programs, analyzing their efficacy to determine an optimal strategy. From the perspective of health economics, cost-effectiveness, cost-benefit, and single-factor sensitivity were conducted for five different screening strategies using a decision tree model. Among pregnant women aged < 35 years who underwent only one screening for foetal Down syndrome (DS), the detection rate, false positive rate and positive predictive value of NIPS for foetuses with DS were superior to those of the other four serological screening methods. Although applying NIPS as first-line screening method yields the highest efficacy and benefits, it currently lacks cost-effectiveness when compared to serological screening and sequential NIPS screening strategies.

Socio-Economic and Health Literacy Inequalities as Determinants of Women's Knowledge about Their Reproductive System: A Cross-Sectional Study.

To support women's informed decisions and reproductive self-care, confident reproductive health-related knowledge is needed, supported by adequate health literacy (HL). No corresponding survey has been carried out in Hungary on inequalities to provide information addressing education. In the current cross-sectional online survey, 301 women of reproductive age (27.16 ± 0.36 years) were asked with the Hungarian versions of validated and standardised questionnaires about reproductive knowledge on hormones, ovulation, menstrual cycle, pregnancy signs and birth control (Knowledge of Female Body Scale-KFB), and HL (Brief Health Literacy Screening Tool-BRIEF). Spearman correlation and multivariable linear regression analyses were utilised, with a significance level set at p < 0.05. IBM SPSS version 28.0 (IBM SPSS, Armonk, NY, USA: IBM Corp.) and G*Power (version 3.1.9.7; Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany) software. The STROBE checklist was followed. The Clinical Trial Registry Nr. is NCT06146673. The KFB composite score was high (20.01 ± 2.33); 86.374% had "high knowledge". Still, lacking information was identified for the mechanisms of certain contraceptive methods and early physical signs of pregnancy. A significant difference was also found in the KFB scores in the case of higher age (p = 0.019), higher education level (p = 0.018) and previous live birth (p = 0.028). A positive correlation was found between KFB and HL (p < 0.001), education (p = 0.005), and age (p = 0.021). A multiple regression analysis (R2 = 0.087, p < 0.001) indicated that both HL (p < 0.001) and age (p = 0.003) are potential positive predictors of adequate reproductive knowledge, whereas induced abortion (p = 0.013) might serve as an inverse predictor. Inequalities in women's knowledge about their reproductive system and HL were found, and it was significantly the lowest in their highest conception probability age. Therefore, in addition to targeted education, HL also needs improvement.

Polish medical students’ awareness about reproductive physiology

Introduction: Falling fertility rates and prevalence of infertility become serious problems of public health that affect families all over the world. Both men and women are delaying parenthood for several reasons, such as undertaking further education, pursuing careers, travelling, finding a partner later in life and facing the challenges of establishing secure finances and housing. Unfortunately their fertility declines with age and this awareness may influence the prioritization of life plans. Medical students are specially dedicated to promote health literacy in their future practice as well as in they private life. Aim of the study and methodology: Aim of this study was to examine polish medical students’ awareness about the basic reproductive physiology. It was based on on-line authors’ own questionnaire among 445 female and 97 male medical students of a mean age 22.3 years from 13 polish medical universities. Results It showed that awareness of basic fertility physiology is on relatively high level what can be promising. Students who plan to start a family in the future have the highest overall mean score of correct answers (83%). Statistically lower levels of knowledge about fertility is presented by the students that have no decision about the future family or do not want to raise a family (80% and 72% respectively). The results seem to be similar irrespective of the participants’ gender, year of study, sexual activity and potential pregnancy prevention method. Conclusions It is still essential to introduce modern knowledge about fertility care and prophylaxis issue among future medical staff, so that they will properly take care of their health and educate their patients.

The Role of Parents in Preventing Teenage Pregnancy in Rural Areas of Banyumas District

Background:One of the factors contributing to Indonesia's high maternal mortality rate is the high incidence of teenage pregnancy in Banyumas. The family, particularly parents, plays a crucial role in influencing teenage pregnancy, as they are expected to act as educators, motivators, supervisors, communicators, and counselors for their teenagers. Objective:The purpose of this study was to identify the factors that influence the role of parents in the prevention of teenage pregnancy. Methods:A cross-sectional study design was employed, focusing on female participants. A cluster random sampling technique was used to obtain a sample size of 150 parents from the study population, using the proportion estimation formula. The validity and reliability of the questionnaire used were tested. Data were analyzed using logistic regression. Results:The univariate analysis revealed that 93.2% of respondents were female, 25.3% were aged between 38 and 42, 61.3% had only completed elementary school, 63.3% were housewives, 58% had incomes below IDR 1.350.000, 52% had monthly family expenses under IDR 1.350.000, and 42.7% had five or more dependents. The bivariate chi-square test showed an association between parental resources, the role of health professionals, knowledge, attitudes, and societal values in the prevention of teenage pregnancy. The multivariate analysis using logistic regression indicated that the value of people and resources significantly impacts the role of parents in this regard. Conclusion:The role of parents in preventing teenage pregnancy is influenced by the value placed on people and resources. Keywords: Maternal mortality; adolescent pregnancy; role of parents; knowledge; attitudes

Nature without Suffering: Herbivorisation of Predator Species for the Compassionate Stewardship of Earth’s Ecosystems

Abstract Predation causes suffering and the premature deaths of prey animals. With innovative technologies on the horizon, humanity could phase it out. We argue that herbivorisation, i.e., turning carnivorous species into herbivorous ones with biotechnologies, is better than other strategies for ending predation, because it is the one most likely to preserve environmental values such as biodiversity and receive democratic support. Pressure on vegetation in herbivorised ecosystems would increase, but fertility control could relieve this pressure. We respond to other objections and conclude that the process should be considered as a future megaproject to reduce naturogenic harms.

Association between female infertility and stroke mortality: evidence from the PLCO cancer screening trial.

While infertility affects about 15% of women during their reproductive years, its long-term impact on stroke mortality after this period remains unclear. This study aims to investigate the association between infertility and stroke mortality in women using data from the Prostate, Lung, Colorectal, and Ovarian (PLCO) cancer screening trial. We analyzed data from 75,778 female participants aged 55-74 years with a median follow-up of 16.84 years. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for stroke mortality, adjusting for potential confounders. Among participants, 14.53% reported infertility. During follow-up, 1,159 women died from stroke. Compared to women without infertility, those with infertility had a higher risk of stroke mortality (HR 1.21, 95% CI 1.04-1.41, p = 0.016). This association remained statistically significant after adjusting for age, race, education level, marital status, smoking status, body mass index, history of hypertension, history of heart attack, history of diabetes mellitus, birth control pill use, hormone replacement therapy, endometriosis, first menstrual period and pregnancy history (HR 1.20, 95% CI 1.02-1.42, p = 0.029). Sensitivity and subgroup analyses yielded consistent results. The findings of this study indicate that infertility is associated with an increased risk of stroke mortality in women. Further research is needed to confirm these findings and elucidate the underlying mechanisms.

Prescribing Information: Elizabeth B. Connell, the Pill, and the (Woman) Patient's Peace of Mind.

Throughout the 1970s and 1980s, commercialized reproductive technologies experienced a reputational crisis as news about the hormonal birth control pill's possible side effects reportedly caused 18-30% of women to stop taking it. While secondary literature has followed patients' and legislatures' actions, few histories have focused on physicians' responses. How did physicians manage this public crisis of confidence? This article contributes to existing literature through a backstage look at the work of Elizabeth B. Connell (1925-2018), whose wide-ranging career in medicine, academia, government, industry consulting, and popular writing embroiled her at the center of these controversies. To counter critique from legislatures and consumer reformers, Connell became a mediator for medicine in the public sphere, dispensing select information and arguing for limits on others - for the patient's sake. If legislative inquiry's primary havoc was unleashing information, Connell would help the profession moderate it. Because Connell was a woman doctor whom health feminists who were her contemporaries denied was a feminist doctor, the existing scholarship has occluded her. This article reconstructs the contributions of this important and flawed doctor, illuminating how she contorted herself to suit her various public messages, constrained by her conflicting, dual identities as woman and doctor.

Male contraceptive acceptability versus male acceptance of contraceptive responsibility.

Despite the projected impact of new male contraceptives, resources and investments directed at their development remain limited in part due to concerns that men would not actually use them. Now, more than 30 studies have been conducted over the last 30 years-regionally and internationally, within clinical trials, and across populations-examining men and women's attitudes towards new male contraceptive methods, all consistently demonstrating interest in and willingness to use new methods. Yet even these studies, inclusive of competitive contraceptive market projections, seem not to be convincing enough. Rather than study whether men would be willing to use male contraceptives, more resources should be devoted to developing the infrastructure and supporting the cultural changes needed to ensure that when new male contraceptives inevitably emerge, that they will be disseminated quickly and made readily accessible. Men's views on what their roles are in society, families, relationships, and pregnancy prevention are changing in ways that may impact what they consider to be acceptable contraceptive risks. As society moves toward more gender equitable beliefs, men's positive involvement in contraception might organically develop into an expected behavior. Interventions aimed at sensitizing men toward gender equitable beliefs may pay dividends in improving male contraceptive acceptability. The current lack of a reversible male contraceptive method prevents us from collecting data that might disprove presumptions that men would be unwilling to take on responsibility for pregnancy prevention. However, studies of men's involvement in (1) over-the-counter emergency contraception, (2) vasectomy, and (3) abortion offer case studies for men's increasing consciousness of opportunities for shared contraceptive responsibility, the structural and sociopolitical barriers that men face when trying to participate in family planning, and how these might translate into new male contraceptive interest and development.

Soil management practice and smallholder agricultural productivity in Nigeria

This study investigates how various soil management practices can enhance soil fertility and pest control, ultimately increasing crop yields among farming households in Nigeria. Utilizing descriptive statistics, logit regression and propensity score matching on data from the 2019 Living Standard Measurement Study, the findings reveal that households using herbicides experience higher agricultural productivity. The use of pesticides and certified crops also positively influences productivity. Key determinants of soil technology access include cooperative membership and the age of household heads, both of which significantly affect access to herbicides, pesticides, organic fertilizers, and certified crops. Education plays a vital role, positively impacting the use of organic and inorganic fertilizers as well as certified crops. Additionally, larger farm sizes correlate with better access to these resources. Conversely, the gender of the household head negatively affects access to certified crops. The study emphasizes the importance of capacity building and knowledge transfer to encourage the adoption of effective soil technology practices among farmers, thereby enhancing agricultural productivity and addressing food security issues.

Assessing the awareness and knowledge of the adverse ocular side effects associated with oral contraceptives among women between the ages of 16 and 40 in Benin-city, Edo state, Nigeria

PurposeOral contraceptives are routinely used by women, because they are effective birth control methods, but few women are aware of their adverse ocular side effects. This study was carried out to determine the level of awareness and knowledge of the adverse ocular side effects associated with oral contraceptive use among women in Benin-City, Edo State, Nigeria. MethodThis was a cross-sectional study conducted over an eight-month period from February 2023 to September 2023, including 402 women (n = 402). The study employed both self-administered online and printed questionnaires. ResultsThe mean age of the participants was 27.76 ± 7.03. A total of 196 had tertiary education, 131 had secondary education and 75 had no educational background. Two-hundred thirty-seven participants were users of oral contraceptives, while 165 had never used them. Of the participants that were users of oral contraceptives, 44 had previously experienced visual problems as a side. The study results reveal that 289 participants (71.9%) were not aware of the potential adverse effects of oral contraceptives, while only 82 participants (20.4%) were aware. ConclusionThe results of this study show that there is poor awareness of the side effects of oral contraceptives, more specifically, the adverse effects on the eyes. It is recommended that more public health awareness campaigns be initiated, with the goal of accurately educating women about the ocular pathologic risks associated with oral contraceptives. Furthermore, healthcare workers should effectively communicate the risks associated with oral contraceptives to their patients. This can help women looking for contraception options make informed decisions about using oral contraceptives.

Antimicrobial Peptides with Spermicidal Activity as New Contraceptive Agents: Killing Two Birds with One Stone

Abstract: Antimicrobial peptides (AMPs) have emerged as promising candidates for dual-action contraceptive agents, offering both spermicidal and antimicrobial properties. This perspective explores the potential of AMPs in developing novel contraceptive technologies, focusing on their application in condom coatings and vaginal formulations. AMPs exert their effects through membrane disruption mechanisms, targeting both microbial pathogens and sperm cells. Their broad-spectrum activity against various microorganisms, coupled with spermicidal effects, makes them ideal for multipurpose prevention technologies. The incorporation of AMPs into condoms could enhance barrier protection, while vaginal applications offer non-hormonal, on-demand contraceptive options. However, challenges, such as potential vaginal irritation, microbiome disruption, and the need for long-term safety studies, must be addressed. Future research should focus on optimizing AMP selectivity, developing stable formulations, and conducting comprehensive efficacy and safety trials. The dual-action nature of AMPs aligns with the growing demand for integrated approaches to sexual and reproductive health, potentially revolutionizing contraception and STI prevention. By addressing current challenges and leveraging the unique properties of AMPs, researchers can develop a new generation of contraceptive products that offer improved efficacy, safety, and user acceptability.

Congenital Adrenal Hyperplasia: A Review of Current Knowledge and Future Directions

Introduction: Congenital adrenal hyperplasia (CAH) is a group of diseases in which genetic defects occur that disturb the synthesis of cortisol. The most common variant of CAH (95%-99%) is caused by 21-hydroxylase deficiency as a result of mutations in the CYP21A2 gene and is one of the most common monogenic diseases. CAH is characterized by androgen overproduction along with variable degrees of cortisol and aldosterone deficiency. Age at diagnosis can provide some information about the underlying mutations, with those diagnosed at birth/early infancy being at greater risk of developing serious enzyme defects. Classic and non-classical forms of this disorder have been described in the literature. CAH diagnosis is based on the clinical presentation, hormonal panel, Adrenocorticotropic Hormone (ACTH) stimulation test, and genetic testing. The main goals of treatment for congenital adrenal hyperplasia are glucocorticoid/mineralcorticoid supplementation, control of high adrenal androgen levels, fertility control, genetic counseling, and optimization of patients’ quality of life. Purpose of the work: This study aims to review and characterize the clinical and pathophysiological aspects of congenital adrenal hyperplasia. Materials and methods: A comprehensive analysis of research papers available on PubMed, Google Scholar, Web of Science, Embase and Scopus was undertaken using the searchterms encompassing the following keywords: congenital adrenal hyperplasia, 21-hydroxylase deficiency, CYP21A2 Results: Congenital adrenal hyperplasia is a heterogeneous group of genetic disorders that can lead to serious and even fatal complications in the form of adrenal crisis. Therefore, screening tests and early diagnosis are crucial and can save the lives of newborns. Treatment should be individualized and allow patients to achieve normal growth, sexual development, fertility and a better quality of life.

A guide to protection schemes of synchronous generator-based electric grids

Ensuring the reliability of power systems remains a paramount concern for electrical utilities worldwide. The design and implementation of robust protection is crucial for mitigating faults and ensuring uninterrupted power supply. This paper encompasses the protection deployed in electrical utilities. A comprehensive analysis is conducted on the application protection scheme in practice for the protection of major power components. The reliability of protection schemes is enhanced by adopting the of dual & fast protection schemes on the critical power components for swift & reliable clearing of faults. Additionally, this article also investigates the protection strategies employed for slightly lower priority components, including high-speed main and low-speed backup protection schemes. A thorough review for the protection practices for synchronous power generation, transmission, and distribution has been conducted. In this article, the selection of specific protection schemes and the calculation settings for 600 MW synchronous generator-connected lines and transformers are discussed. Additionally, the limitations of traditional protection schemes in safeguarding inverter-based power systems are explored. The paper also highlights areas for future research in the protection of electrical equipment within evolving grid infrastructures. This study will provide valuable insights for researchers and practicing engineers in planning and implementing protection systems for electrical grids, ensuring high levels of reliability and resilience

Knowledge and experiences of adolescent girls and young women in the use of sexual reproductive health and HIV services at health facilities in Maputo City, Mozambique.

Knowledge and use of sexual reproductive health and human immunodeficiency virus (SRH and HIV) services are crucial for the prevention of pregnancy and sexually transmitted infections (STIs) among adolescent girls and young women (AGYW). This study aims to assess the knowledge and perceptions of AGYW about the SRH and HIV services offered in health facilities in Maputo, Mozambique. A cross-sectional descriptive study was conducted based on exit surveys with AGYW held at Zimpeto and 1° de Junho Health Facilities in Maputo City, between May 1, and June 9, 2023. Data were analyzed through descriptive statistics, t-test and ANOVA, using SPSS version 20. 590 AGYW, aged 15-24 years of age, were included in the study. In general, knowledge of SRH and HIV services was fairly high, with knowledge of each specific service offered ranging between 38% and 97%. Knowledge about SRH and HIV services differed depending on the health facility where the AGYW sought SRH and HIV services; the participant's age; their occupation; their religion, and who they lived with. Counseling services were the most commonly reported services attended, with >90% of participants reporting having received counseling for each of the following: STI and HIV and pregnancy prevention, sexuality, and safer sex practices. The quality of SRH and HIV services, and attitudes of the providers were considered good by >90% of AGYW. Roughly 95% of AGYW at Zimpeto Health Facility were either "satisfied" or "very satisfied". Whereas at 1° de Junho Health Facility, only roughly 75% of AGYW were either "satisfied" or "very satisfied", and roughly 20% of AGYW were "little satisfied that their needs had been met that day. Among AGYW there is high levels of knowledge about counseling services in contrast to diagnostics, treatment and clinical care. Specific attention should be given to ensuring appropriate physical infrastructure, such as dedicated adolescent friendly spaces and comfortable seating, and targeted interventions designed and implemented for those health facilities's identified. Targeted interventions should be designed and implemented for those HF's identified with lower AGYW perceived quality of service delivery.

Rewilded horses in European nature conservation - a genetics, ethics, and welfare perspective.

In recent decades, the integration of horses (Equus ferus) in European rewilding initiatives has gained widespread popularity due to their potential for regulating vegetation and restoring natural ecosystems. However, employing horses in conservation efforts presents important challenges, which we here explore and discuss. These challenges encompass the lack of consensus on key terms inherent to conservation and rewilding, the entrenched culture and strong emotions associated with horses, low genetic diversity and high susceptibility to hereditary diseases in animals under human selection, as well as insufficient consideration for the social behaviour of horses in wild-living populations. In addition, management of wild-living horses involves intricate welfare, ethics and legislative dimensions. Anthropocentric population-control initiatives may be detrimental to horse group structures since they tend to prioritise individual welfare over the health of populations and ecosystems. To overcome these challenges, we provide comprehensive recommendations. These involve a systematic acquisition of genetic information, a focus on genetic diversity rather than breed purity and minimal veterinary intervention in wild-living populations. Further, we advise allowing for natural top-down and bottom-up control - or, if impossible, simulating this by culling or non-lethal removal of horses - instead of using fertility control for population management. We advocate for intensified collaboration between conservation biologists and practitioners and enhanced communication with the general public. Decision-making should be informed by a thorough understanding of the genetic makeup, common health issues and dynamics, and social behaviour in wild-living horse populations. Such a holistic approach is essential to reconcile human emotions associated with horses with the implementation of conservation practices that are not only effective but also sustainable for the long-term viability of functional, biodiverse ecosystems, while rehabilitating the horse as a widespread wild-living species in Europe.

The Perception of Contraceptive Practice Among Female Patients Treated With Isotretinoin in Saudi Arabia.

Background Practicing and following a Pregnancy Prevention Program (PPP) is crucial to prevent isotretinoin-induced teratogenicity. Our study aims to assess the current practice of dermatologists about PPP when prescribing oral isotretinoin and the compliance of the patients toward contraceptive methods. Methods The research used a cross-sectional design and utilized a probability sampling method in Saudi Arabia. An online self-administered questionnaire was used to collect data that included female participants who were previously treated/being treated with isotretinoin for acne. Data was analyzed using SPSS (IBM Inc., Armonk, New York). Results Our study examined 359 female patients receiving isotretinoin treatment. Isotretinoin was primarily used for severe nodular forms of acne resistant to regular treatment 229 (63.8%). Regarding awareness, 326 (90.8%) were familiar with isotretinoin's teratogenic effects, and 112 (31.2%) were familiar with the Saudi Food and Drug Authority's Pregnancy Prevention Program. Physicians were among the most prevalent information sources 254 (71%). In terms of isotretinoin usage, 227 (63.2%) had one course. Regarding contraceptive practice, 167 (46.5%) were informed about the necessity of a negative pregnancy test before starting treatment, and 29 (50.9%) of those who received more than two courses had good awareness. Conclusion The study identified a notable awareness gap among the participants, as over two-thirds demonstrated a poor awareness level regarding isotretinoin. A significant proportion of participants were informed about the importance of contraceptive practices, including the necessity of a negative pregnancy test before, during, and after treatment.

Contraceptive risk events among family planning specialists: a cross sectional study

BackgroundProponents of abortion restriction cite advancements in contraceptive technology as a reason against the need for abortion care today, most recently through oral arguments in the Supreme Court of the United States case, Dobbs v. Jackson Women’s Health. However, consistent and correct use of contraception requires reproductive health literacy. Our objectives were to quantify contraceptive risk events and assess contraceptive history and preferences among a population well-equipped to evade contraceptive risks, family planning specialists following initiation of their medical training. “Risk events” are defined as reported episodes of contraceptive failure, emergency contraception use and/or unprotected or underprotected intercourse.MethodsThis was a cross-sectional study among current members of a professional organization of family planning specialists. Inclusion criteria included: status as a current or retired clinician, consensual penile-vaginal intercourse and personal or partner capacity to become pregnant since the start of medical training. Descriptive statistics were performed. This study was IRB exempt.ResultsAmong 229 respondents, 157 (69%) reported experiencing a contraceptive risk event since training. Twenty-nine (13%) respondents reported an occurrence within the last year. By category, 47% (108/229; 3 reported unknown) reported under- or unprotected intercourse, 35% (81/229) reported emergency contraception use, and 52% of participants (117/227; 2 unknown) reported known or suspected contraceptive failure. The mean number of contraceptive methods used was 3.7 (SD 1.7) out of the 13 methods listed. Almost all (97%) participants reported at least one method was not an acceptable option, with a mean of 5.6 (SD 2.7) of the 13 listed methods.ConclusionsThe majority of family planning specialists have experienced contraceptive risk events during times of active pregnancy prevention since their medical training. Contraceptive method change is common and most respondents were limited in the number of methods that were personally acceptable to them. Dialogue idealizing the role of contraception in minimizing or eliminating abortion need is simplistic and inaccurately represents the lived realities of pregnancy-capable individuals and their partners, including among those with exceptional contraceptive literacy and access.

ANALYZING SOCIODEMOGRAPHIC DISPARITIES AND FACTORS INVOLVED IN NON-USE OF MODERN CONTRACEPTIVES AMONG YOUNG AND NON-YOUNG MARRIED FEMALES IN INDIA: EVIDENCE FROM NFHS 2019-21

It has been observed that married women refrain from utilizing contraceptive methods owing to a variety of reasons, including postpartum-amenorrhea, side-effects-worries, rarely or never having sex, no contraception while breastfeeding, or frustration with a particular method. The current study sought to investigate the sociodemographic disparities and contributing factors related to married women who are young (15–24 years old) and non-young (25–49 years old) and who do not utilize contemporary contraceptive methods. The research utilized cross-sectional data obtained from the fifth round of the National Family Health Survey (NFHS-5) to explore the determinants of contraceptive non-utilization among 175,652 married women in India. Multiple logistic regression analysis was utilized for the examination. The study found that non-young married females (25-49) had a higher prevalence of not using contemporary contraceptives (72%) compared to young married females (45.8%). The majority of non-users were from the central region (24.4%), followed by the east (17.4%), north-east (17.2%), north (15.9%), south (15.2%), and west region (9.9%). The majority of non-users were non-working and had male and female household heads. Most non-users knew about modern contraceptives but were unaware of family planning on radio and TV. Higher odds ratios in the non-use among married females were found significant among central-region females (OR=2.189, CI: 1.815-2.641), East-region (OR=1.324, CI: 1.148-1.527), South-region (OR=1.262, CI: 1.063-1.497), females who don’t know caste (OR=1.898, CI: 1.176-3.062), females having primary (OR=3.466, CI: 2.889-4.157) and secondary education (OR=2.281, CI: 1.890-2.753), females who used since last birth (OR=1.851, CI: 1.658-2.068) and never used (OR=1.632, CI: 1.474-1.806). The study found that economically disadvantaged females, household heads, and those with multiple children are less likely to avoid birth control methods, while marital status, religion, caste, education, and birth order did not have a significant impact on non-usage. The study highlights sociodemographic disparities in contraceptive use, emphasizing the need to address issues like low education, media exposure, and ignorance towards birth-control practices, and recommends immediate actions to reduce non-use among married females.

Skin tone discrimination and birth control avoidance among women in Harris County, Texas: a cross-sectional study

IntroductionStructural racism plays a major role in reproductive health inequities. Colorism, discrimination based on skin color, may profoundly impact reproductive health access and service delivery. However, quantitative research in this area is limited.MethodsWe administered an online survey of women (n = 1,299) aged 18–44 from Harris County, Texas to assess the relationship between skin color discrimination and reproductive health service avoidance. The survey included questions on demographics, self-reported skin tone, and dichotomous measures of previous discrimination experiences and avoidance of care because of perceived discrimination. Binary logistic regression was used to examine whether race/ethnicity, skin tone, and previous discrimination experiences were related to avoidance of contraceptive care because of perceived discrimination.ResultsApproximately one-third (31.5%) of the sample classified themselves as non-Hispanic Whites (31.5%), 22.4% as Black, 27.4% as Hispanic and born within the US, and 7.6% as Hispanic born outside of the US. Approximately one-third of women classified themselves in the lightest skin tones, whereas almost one in five women classified themselves in the darkest skin tone palates. Darker skin tones had increasingly greater odds of reporting that they avoided seeking birth control out of a concern for discrimination compared to the lightest skin tone. After adjusting for race/ethnicity and sociodemographic variables (model 3), darker skin tones remained significantly associated with avoiding birth control.DiscussionThis study demonstrates the role that skin color discrimination plays in negative reproductive health experiences. While this is not surprising given that those with racist ideologies developed the concept of these racial and ethnic categories, the apparent association with darker skin colors and avoidance of seeking birth control provides evidence that structural and individual racism continues to have far-reaching and insidious consequences.ConclusionContraception is recognized for reducing maternal mortality, improving child health, increasing female empowerment, and decreasing poverty. However, not all women equally enjoy the benefits of access to contraception. Addressing colorism within reproductive healthcare has become critically important as the nation becomes increasingly diverse. Focusing on skin tone-based discrimination and its roots in anti-blackness expands our understanding beyond a Black–White binary traditionally applied when addressing racism in healthcare delivery.

Reproductive healthcare utilization for women in the sex trade: a qualitative study

BackgroundWomen in the sex trade encounter significant challenges in obtaining reproductive healthcare. Reports of reproductive healthcare for women in the sex trade center on the prevention and termination of pregnancies, yet most women in the sex trade globally experience full term pregnancies and bear children. This study aimed to explore barriers and enabling factors to providing reproductive healthcare for women in the sex trade in Israel.MethodsWe conducted a qualitative study utilizing a grounded theory method. Data were collected through semi-structured interviews, conducted between June 2021 and July 2022. Interviews were conducted with practitioners in healthcare settings (n = 20), practitioners in social services settings (n = 15), and women in the sex trade who received reproductive health care-related medical services (n = 13) in Israel. The interviews were audiotaped, transcribed, and thematically analyzed.ResultsThe findings indicated a multilayered structure of healthcare system-related factors and women-related factors. Stigma was noted as a multidimensional barrier, reflected in service providers’ attitude towards women in the sex trade, impairing the patient-provider relationship and impeding women’s help-seeking. However, the creation of a relationship of trust between the women and healthcare providers enabled better health outcomes.ConclusionsBased on the findings, we propose recommendations for designing and implementing reproductive healthcare services for women in the sex trade. The recommendations offer to (a) include women with lived experiences in planning and providing reproductive healthcare services, (b) adopt a trauma-informed approach, (c) emphasize nonjudgmental care, (d) train healthcare providers to reduce stigma and bias, and (e) enhance the affordability of health services for women experiencing marginalization.