Cessation Of Contraceptive Use Research Articles

Embodiment, agency, unmet need: Young women’s experiences in the use and non-use of contraception in Khayelitsha, South Africa

ABSTRACT Globally, high rates of unintended pregnancy occur despite widespread distribution of modern contraceptive methods, reflecting the complexity of individual contraceptive use. The concept of unmet need provides a framework for addressing the gap between women’s desire to prevent pregnancy and the ability of health services to meet women’s contraceptive needs. Through in-depth interviews in Khayelitsha, South Africa, we examine 14 young women’s experiences with contraception, interrogating how and why reproductive intentions and outcomes often differ markedly. Three main themes were identified and explored. First, unintended pregnancies were common in our sample, despite high knowledge about contraceptive options and availability of multiple methods. Second, women’s contraceptive preferences are strongly shaped by concerns with side effects and other embodied experiences, leading to pivotal moments of method-switching or cessation of contraceptive use. Third, using contraception provides participants with the potential for purposeful and self-directed action. These enactments of agency though, occur within intimate and familial relationships, where gendered expectations of the participants’ choices ultimately shape both method preference and use. These findings demonstrate the need for an understanding of women’s lives and narratives as the basis for understanding complex health behaviours such as contraceptive use.

Male-mediated spontaneous abortion among spouses of stainless steel welders.

Male-mediated spontaneous abortion has never been documented for humans. The welding of stainless steel is associated with the pulmonary absorption of hexavalent chromium, which has genotoxic effects on germ cells in rodents. Clinical and early subclinical spontaneous abortions were examined among spouses of stainless-steel welders. A cohort of first-pregnancy planners was recruited from members of the union of metal workers and 3 other trade unions. The cohort was followed for 6 menstrual cycles from the cessation of contraceptive use. Altogether, 280 pregnancies were conceived, of which 35 were detected by human chorionic gonadotrophic hormone analysis and did not survive to a clinically recognized pregnancy. Information on exposure was collected prospectively in relation to the outcome and was available for all cycles resulting in a pregnancy. Information on pregnancy outcome was collected for all 245 clinically recognized pregnancies. Increased risk of spontaneous abortion was found for pregnancies with exposure to paternal stainless-steel welding (adjusted relative risk 3.5, 95% confidence interval 1.3-9.1). The results were consistent in analyses of both biochemically and clinically recognized abortions. There was no increased risk for spontaneous abortion in pregnancies with paternal exposure to the welding of metals other than stainless steel. Male welding of stainless steel was associated with an increased risk of spontaneous abortion in spouses. A mutagenic effect of hexavalent chromium has been found previously in both somatic and germ cells, and the findings could be due to mutations in the male genome.

Rates and outcomes of planned pregnancy after use of Norplant capsules, Norplant II rods, or levonorgestrel-releasing or copper TCu 380Ag intrauterine contraceptive devices

The objectives were to measure rates of planned pregnancy and factors affecting these rates after use of very-long-acting contraceptive methods (Norplant or Norplant II implants, a levonorgestrel-releasing intrauterine contraceptive device, or the copper T (model TCu 380Ag) intrauterine contraceptive device. The design was a concurrent, multicenter prospective study of 372 women who stopped contraception for planned pregnancy. Analysis was by life-table, log-rank, and standard chi 2 methods. Pregnancy rates 12 and 24 months after cessation of contraceptive use were 82 and 89 per 100, respectively. Age at removal and family planning intentions at initiation of contraception were both significantly correlated with pregnancy rates (p less than 0.05), but former contraceptive regimen and duration of contraceptive use were not. Pregnancy outcomes did not deviate from normal limits and did not differ by contraceptive formerly used. Contraceptive implants releasing 30 micrograms/day of levonorgestrel or intrauterine contraceptive devices releasing 20 micrograms/day of levonorgestrel or having copper surface areas of 380 mm2 are associated with normal fertility after use for women seeking pregnancy at termination. Durations of use do not affect pregnancy rates.