Contraceptive Use Research Articles

U.S. Medical Eligibility Criteria for Contraceptive Use, 2024.

The 2024 U.S. Medical Eligibility Criteria for Contraceptive Use (U.S. MEC) comprises recommendations for the use of specific contraceptive methods by persons who have certain characteristics or medical conditions. These recommendations for health care providers were updated by CDC after review of the scientific evidence and a meeting with national experts in Atlanta, Georgia, during January 25-27, 2023. The information in this report replaces the 2016 U.S. MEC (CDC. U.S. Medical Eligibility Criteria for Contraceptive Use, 2016. MMWR 2016:65[No. RR-3]:1-103). Notable updates include 1) the addition of recommendations for persons with chronic kidney disease; 2) revisions to the recommendations for persons with certain characteristics or medical conditions (i.e., breastfeeding, postpartum, postabortion, obesity, surgery, deep venous thrombosis or pulmonary embolism with or without anticoagulant therapy, thrombophilia, superficial venous thrombosis, valvular heart disease, peripartum cardiomyopathy, systemic lupus erythematosus, high risk for HIV infection, cirrhosis, liver tumor, sickle cell disease, solid organ transplantation, and drug interactions with antiretrovirals used for prevention or treatment of HIV infection); and 3) inclusion of new contraceptive methods, including new doses or formulations of combined oral contraceptives, contraceptive patches, vaginal rings, progestin-only pills, levonorgestrel intrauterine devices, and vaginal pH modulator. The recommendations in this report are intended to serve as a source of evidence-based clinical practice guidance for health care providers. The goals of these recommendations are to remove unnecessary medical barriers to accessing and using contraception and to support the provision of person-centered contraceptive counseling and services in a noncoercive manner. Health care providers should always consider the individual clinical circumstances of each person seeking contraceptive services. This report is not intended to be a substitute for professional medical advice for individual patients; when needed, patients should seek advice from their health care providers about contraceptive use.

“An obedient wife never says “no” to her virtual god.” High fertility conceptions and barriers to contraceptive use among mothers of Southern Pakistan: a qualitative study

IssueBiomedical approaches want to change locals’ behaviors without understanding the sociocultural rationales and contextualizing the cultural and structural backdrop of women’s agency.ObjectivesThis study explored the perceptions and practices of rural mothers about fertility and reproductive health and further examine the lack of preference for contraception and birth spacing in Southern Pakistan.MethodologyUsing purposive sampling we recruited 15 healthcare providers and 20 mothers from Southern Punjab. Key informants and in-depth interviews were used for data collection. We extracted themes and sub themes to analyse qualitative data.FindingsFive major themes identified preventing birth spacing and contraceptive use: (1) cultural barriers (2) economic difficulties and demographic factors; (3) gender-related hurdles; (4) spiritual and religious obstacles, and (5) medico-ethical complications. Nearly, ten sub-themes contributing to these major themes were: custom of girls’ early marriages, in-laws’ permission for contraception, women’s concern for medical complications and preference for safer methods, misuse of contraceptive methods by the medical community, mothers’ perception of contraception as sinful act and controlling birth is against faith, economic and rural-ethnic factors for high fertility, masculine disapproval of condom use, and wishing to give birth to male children.SuggestionsWe advocate for understanding the sociocultural explanations for low contraceptive use and urge practice of more natural methods of birth spacing over commercial solutions. The study suggests socio-economic development of less developed communities and empowerment of poor, illiterate, and rural women along with behavior change communication strategies.

U.S. Selected Practice Recommendations for Contraceptive Use, 2024.

The 2024 U.S. Selected Practice Recommendations for Contraceptive Use (U.S. SPR) addresses a selected group of common, yet sometimes complex, issues regarding initiation and use of specific contraceptive methods. These recommendations for health care providers were updated by CDC after review of the scientific evidence and a meeting with national experts in Atlanta, Georgia, during January 25-27, 2023. The information in this report replaces the 2016 U.S. SPR (CDC. U.S. Selected Practice Recommendations for Contraceptive Use, 2016. MMWR 2016;65[No. RR-4]:1-66). Notable updates include 1) updated recommendations for provision of medications for intrauterine device placement, 2) updated recommendations for bleeding irregularities during implant use, 3) new recommendations for testosterone use and risk for pregnancy, and 4) new recommendations for self-administration of injectable contraception. The recommendations in this report are intended to serve as a source of evidence-based clinical practice guidance for health care providers. The goals of these recommendations are to remove unnecessary medical barriers to accessing and using contraception and to support the provision of person-centered contraceptive counseling and services in a noncoercive manner. Health care providers should always consider the individual clinical circumstances of each person seeking contraceptive services. This report is not intended to be a substitute for professional medical advice for individual patients; when needed, patients should seek advice from their health care providers about contraceptive use.

Effectiveness of digital interventions to reduce school-age adolescent sexual risks: A systematic review.

The increase in risky sexual behaviors among adolescent students has sparked alarm and has become an area of research interest. As adolescents prioritize confidentiality and accessibility, digital interventions are becoming increasingly relevant in sex education. We therefore posed the following research question: Are digital application interventions effective to prevent risky sexual behaviors in school adolescents? A systematic peer review was conducted between January and December 2023 in five databases (PubMed, Web of Science, Scopus, EMBASE, and PsycINFO) without restricting for language or year of publication. We included randomized control trials or quasi-experimental studies that measured the effectiveness of interventions targeting young people aged 10-19 years or their parents and developed in a school setting. Interventions aimed at young people with intellectual disabilities, learning difficulties, or any disease requiring a specific intervention were excluded. The search ultimately yielded 27 studies covering a total of 18 digital interventions that demonstrated positive effects, not maintained over time, on knowledge, attitudes, and behaviors, although the latter to a lesser extent. We have found very interesting digital interventions with effects, among others, on knowledge, attitudes, and contraceptive use in adolescents. In general, digital interventions have positive effects on knowledge and attitudes, but it is more difficult to modify behaviors with strictly digital interventions or combined with complementary face-to-face sessions or group class activities. We thus believe that digital interventions are adequate to reduce adolescent sexual risk behaviors, and our systematic review facilitates the implementation of these interventions by sharing existing digital interventions that have had positive effects, as well as the main characteristics a digital intervention should possess to reduce sexually risky behaviors in adolescents. Digital interventions with adolescents improve sexual behaviors and can be a valuable resource in education on this topic due to their accessibility and confidentiality, two key points for young people.

No test medical abortion - a review of the evidence on selective use of preabortion testing.

The last decade has seen a cascade of different telemedicine models for medical abortion (MA) being tested and implemented. Among these service delivery models is the 'no-test' MA model, in which care is provided remotely and eligibility for the MA is based on history alone. The purpose of this review is to provide an overview of the existing evidence for no-test MA. The evidence base for no-test MA relies heavily on cohort and noncomparative studies predominantly from high resource settings. Recent findings indicate that no-test MA is safe, effective, and highly acceptable. Diagnoses of ectopic pregnancy and underestimation of gestational age were rare. Identified advantages included shortening time to access MA and mitigating access barriers such as cost, and geographical barriers. Abortion seekers valued omitting the ultrasound citing reasons such as privacy concerns, costs, more flexibility, and control. The impacts of no-test MA on unscheduled postabortion contacts and visits and on contraceptive use were unclear due to limited evidence. No-test MA can be provided to complement other care pathways including those with some or no in-person care. Further research is needed to allow for widespread adoption of no-test MA and scale-up in a variety of contexts, including low-resource settings.

Determinants of Contraceptive Use Among Teenage Girls Aged (15-19) in Eastern Province, Zambia

Access to sexual and reproductive health information and services among the young people remains a highly contested issue in many traditional societies Zambia included. Access to youth-friendly health services such as contraceptives is vital for ensuring the well-being of adolescents. This study endeavoured to establish determinants of contraceptive use among teenage girls aged 15 to 19 years in Eastern Province, Zambia. This was a mixed methods study that employed a sequential explanatory design. In the quantitative arm, the study utilized the 2018 Zambia Demographic and Health Survey (ZDHS) women's dataset for Eastern Province, focusing on 326 teenage girls aged 15-19 years. The ZDHS data collection was done using multiple cluster sampling method and through household survey. The qualitative arm involved 6 focus group discussions with parents, 4 interviews with teachers and 6 interviews with healthcare providers in Petauke district. Contraceptive prevalence rate, and socio-economic and demographic factors influencing contraceptive use were measured in the quantitative part. The perception on teenage contraceptive use among key influencers was assessed in the qualitative arm. The prevalence of contraceptive use among teenage girls in Eastern province was at16%. Age, marital status, parity, visiting a health facility, being visited by a health provider and hearing about family planning on radio were significantly associated with contraceptive use (p< 0.05). Moreover, teenage girls who had ever been married had higher odds of contraceptive use than unmarried ones (AOR 3.57, 95% CI, 1.59, 8.01, p = 0.002). Further, those who heard about family planning at the health facility (AOR 2.37, 95% CI, 1.08, 5.21, p = 0.031) and those who heard on radio (AOR 2.55, 95% CI, 1.05-6.19, p = 0.038) had higher odds of contraceptive use than those who did not. The qualitative results found that most parents and teachers opposed the use of contraceptive by teenagers, while health providers supported it. Barriers to contraceptive use included religious beliefs, personal beliefs of healthcare providers, myths and misconceptions, and the fear of social stigma by teenagers. Whether or not adolescents have access to contraceptives, the decision to use them is heavily influenced by parents, and to some extent, teachers and health providers. Therefore, it is important to implement comprehensive educational programs not only for teenagers, but also for parents, teachers and healthcare providers, dispelling myths about contraceptives.

Parents Financial Distress and Time Allocation with Youths Responsible for Increasing Trends of Risky Behaviours among Youths in Mumbai Metropolitan Region

Youths are powerful economic agent for any nation. An educated, healthy, hardworking youths are human asset for nation, society, and family in long term. Youths must have trained with quality education. It is job of government, families, and society to ensure that they will acquire maximum skills, knowledge, healthy behaviour, nutritional status. But male youths are driving four wheelers and female drive two wheelers without proper license and trend is increasing since 2013 to 2023. The smoking, alcohol consumption has increased among males. Youths are more depressed in region. They fight physically more and do not eat healthy diet. The incidence of risky behaviours became double in a decade. Few youths involved in multiple sex with opposite sex relationship with lack of understanding and use of contraceptives. Logistic regression model 2013 survey shows that multiple risky behaviours are co-related to youths walk to college, spend more time in college, travel by train and car. But 2023 survey, shows that multiple risky behaviours are co-related to age of youths, loans taken by parents. The role of parents is important in controlling risky behaviours such as risky driving, smoking cigarettes, drinking alcohol, depression, and opposite sex relationship. Parents must teach youths nutritious food habits, traffic rules, no smoking and alcohol, physical fight. Long term policies for youths and parents required to reduce risky behaviours on urgent basis in Mumbai Metropolitan Region.

Multilevel modelling of the determinants of low birth weight in frontier, outermost and underdeveloped regions: Evidence from the Indonesian National Socioeconomic Survey (2019–2021)

BackgroundThe prevalence of low-birthweight infants is increasing in Indonesia. A low birth weight can have a negative effect on a child's development. Understanding the factors influencing low birth weight may enable preventative actions. AimTo analyse the determinant factors of low-birthweight infants in frontier, outermost and underdeveloped regions in Indonesia. MethodsA cross-sectional study was conducted using a secondary dataset from the Indonesian National Socioeconomic Survey, 2019–2021. The sample included 27,678 inhabitants aged 16–64 years. The Indonesian regions of Nusa Tenggara Timur, Nusa Tenggara Barat, Sulawesi Tengah, Sulawesi Tenggara, Gorontalo, Maluku, Maluku Utara, Papua and Papua Barat were included. A multilevel logistic regression was conducted to determine the relationship between variables. p < 0.05 was considered to indicate significance in the fixed-effects model findings. FindingsWomen who lived in a rural area [OR 1.176, 95 % confidence interval (CI) 0.088–0.235] and had never used contraception (OR 1.227, 95 % CI 0.096–0.313) were more likely to have low-birthweight infants. In contrast, water resources, social assistance/welfare, maternal age and gross domestic product per capita had no significant effect on the prevalence of low-birthweight infants. Discussion and conclusionLiving in a rural area and lifetime non-use of contraception were found to be significant risk factors for low birth weight in frontier, outermost and underdeveloped regions in Indonesia. Increasing health facilities in rural areas and establishing programmes on the use of contraception may be positive strategies to reduce the prevalence of low-birthweight infants.

Increased Serum Levels of Inflammatory Markers and Promoter Hypermethylation of BRCA1 and BRCA2 in Oral Contraceptive Users

Background: Oral contraceptives (OCs) are widely used to prevent pregnancy, particularly among reproductive-age women. Although undesired physiological consequences, such as increased susceptibility to cancer, have been suggested, the exact molecular mechanism is not well elucidated. Thereby, the current study aimed to assess the effects of OCs on the inflammatory markers and BRCA1 and BRCA2 gene-specific DNA methylation in the serum of OCs-exposed women. Methods: The current cross-sectional study involved 70 adult women, 35 of whom had used oral contraceptive pills (OCP, 0.03 mg ethinyl estradiol, and 0.15 mg levonorgestrel) to prevent pregnancy, and 35 of whom had used condoms. The promoter methylation status of the two mentioned tumor suppressor genes was assessed by methylation-specific PCR. Moreover, serum levels of IL-1, IL-6, and TNF-α were evaluated using the ELISA method. Results: The findings revealed a significant difference in cytokines between groups (p &lt;0.001). However, no significant differences were revealed regarding TNF-α between the two groups. Additionally, the frequency of promoter hypermethylation of BRCA1 and BRCA2 in OCP users was significantly higher (p &lt;0.05). Conclusion: The current findings suggested that OCP usage could increase serum levels of inflammatory markers and promote the hypermethylation of two suppressor genes. Hence, further studies are encouraged to reveal the association between OCP usage and cancer through hypermethylation of BRCA1 and BRCA2 and induction of inflammation.

Chronic venous disease of the lower extremities as a risk factor for PE when taking combined oral contraceptives: a clinical case

The use of combined oral contraceptives (COCs) is one of the risk factors for thrombotic complications, particularly pulmonary embolism (PE). Although clinical observations suggest that the risk of thrombotic complications with OCs is low and decreases after several months of use, medical counseling is necessary as with any other hormonal therapy. A clinical case of PE in a young patient taking COCs is presented. In the context of early diagnosis, thrombolysis was successful because thrombus retraction had not yet occurred. After completion of treatment of the underlying pathology, the patient was recommended to be followed up with a vascular surgeon for treatment of lower limb venous disease. Exclusion of lower extremity venous disease is critical before prescribing COCs, as it increases the risk of PE at any age.

“I will find the best method that will work for me”: navigating contraceptive journeys amongst South African adolescent girls and young women

BackgroundGiven that South Africa has one of the highest rates of pregnancy amongst adolescent girls and young women (AGYW) globally, the provision of contraceptives to this group has been a key focus in recent years. Pregnancy prevention involves an on-going continuum of decision-making around contraceptive method choice, uptake, use, experience, continuation, and discontinuation.MethodsThis paper presents analysis of data from a cross-sectional survey with 2376 AGYW, as well as qualitative in-depth interviews (IDIs) with 54 AGYW, inclusive of contraceptive journey narratives. We examine the preferences, valued characteristics, choices, beliefs, understandings and experiences of choosing and using contraceptives amongst AGYW in two South African communities characterised by high rates of pregnancy.ResultsThese findings shed light on the preferences towards, beliefs about, and experiences of choosing, using and discontinuing contraceptive methods amongst this population, with survey data suggesting that the most popular methods were the injection, followed by the implant, and then the oral pill. Findings illustrate the complexity and dynamic nature of contraceptive decision-making and the varied embodied and lived experiences of contraceptive use, and how these are impacted by contraception service provision.ConclusionsOur findings show that contraception experiences of each individual are cumulative, and comprise a continuum of method initiation, use, discontinuation, method switching and on-going circular decision-making influenced by multiple social, structural, contextual and interpersonal factors, combined with shifting preferences, values and needs. To maximise the use of contraceptives amongst South African AGYW, it is necessary to provide responsive contraception service provision to reflect the changing contexts and preferences of users, in order to ensure that pregnancy prevention needs are catered for throughout their reproductive life course.

Contraceptive behaviors and awareness in an urban slum community of south India

Objective: To assess the factors associated with knowledge, attitude and behavior of contraception use among urban slum population in Chennai. Methods: A cross-sectional study was conducted in the urban slum of Anakaputhur, Chennai. Married couples between ages of 19-49 years and living in slum areas were taken up for the study by simple random sampling. Pregnant women, postnatal and postmenopausal women were excluded from the study. Data collection was done using a pretested structured questionnaire focusing on details regarding contraception knowledge, attitude, and practices. Data analysis was done using IBM SPSS version 22. Analytical test like Chi square and odds ratio (OR) were used to identify association between knowledge, attitude, and behavior of contraception with the associated variables and enter method of logistic regression analysis was done. Results: Out of the 360 respondents, 228 were females, with a mean age of (34±5) years. Approximately 43% demonstrated adequate knowledge of contraception use, and 91% were aware of at least one contraceptive method. Notably, 72% exhibited a positive attitude towards contraceptive use. Nevertheless, 43% (155 individuals) did not utilize any contraceptive method. Among contraceptive users, intrauterine devices were the most commonly adopted, followed by barrier methods and female sterilization. There was significant association between knowledge of contraception and education (aOR 7.29, 95% CI 2.93-18.10, P&lt;0.05), age (aOR 2.04, 95% CI 1.193.50, P&lt;0.05) and socioeconomic class (aOR 3.66, 95% CI 1.71-7.85, P&lt;0.05; aOR 3.97, 95% CI 2.12-7.49, P&lt;0.05). Regarding attitude towards contraception use, education (aOR 8.54, 95% CI 2.35-31.03, P&lt;0.05), sex (aOR 0.15, 95% CI 0.06-0.37, P&lt;0.05), age (aOR 0.53, 95% CI 0.28-0.99, P&lt;0.05), socio-economic class (aOR 4.42, 95% CI 1.97-9.92, P&lt;0.05; aOR 9.83, 95% CI 3.63-26.58, P&lt;0.05) and number of children (aOR 10.04, 95% CI 4.26-23.66, P&lt;0.05) were the variables that had a significant association. Conclusions: These findings underscore the imperative for enhanced dissemination of health education pertaining to contraception use within the slum population. The health sectors of the area and other stakeholders need to make sure to extend penetration of family planning related services to the urban slum population.

Sexual function, quality of life, anxiety, and depression in women of reproductive age using hormonal, nonhormonal, and no contraceptive methods.

Hormonal contraceptive use has been related to adverse effects, including impacts on sexual function and sexual satisfaction, although the difference in the effects on sexual function with the use of hormonal vs nonhormonal contraceptive methods remains controversial. In this study we sought to compare the prevalence of dyspareunia, sexual function, sexual satisfaction, quality of life, anxiety, and depression between women using hormonal, nonhormonal, or no contraceptive methods and to compare these outcomes between the most frequently used contraceptive methods. This cross-sectional study included sexually active women of reproductive age who were stratified into 3 groups: women using hormonal, nonhormonal, or no contraceptive methods. Based on the use of questionnaires administered to the study participants, we compared sexual function in the 3 groups and more specifically among users of oral contraceptives, copper and hormonal intrauterine devices, and barrier methods. Participants completed 4 questionnaires to assess sexual function (Female Sexual Function Index), sexual satisfaction (Sexual Quotient-Feminine Version), quality of life (12-item Medical Outcomes Short Form Health Survey), and anxiety and depression (Hospital Anxiety and Depression Scale). This study included 315 women classified into 3 groups on the basis of contraceptive use: 161 in the hormonal contraceptives group (median [interquartile range] age, 24 [23-28] years), 97 in the nonhormonal contraceptives group (age 26 [23-30] years), and 57 in the no contraceptive methods group (age 28 [24-35] years). Dyspareunia prevalence showed no difference between the groups. In the quality of life domain, compared with women in the nonhormonal contraceptive group, women in the hormonal contraceptive group were younger and had lower sexual function satisfaction, reduced arousal, and heightened pain (P< .05), as well as higher anxiety and depression levels (P= .03, for both), increased pain (P= .01), and poorer overall health (P= .01). No difference was found between these groups in other quality of life domains. Regarding contraceptive methods, women using copper intrauterine devices had better sexual function, including higher rates of arousal and lower anxiety, than women using oral contraceptives (P< .05). The results of this study highlight worse sexual function and sexual satisfaction and higher levels of anxiety and depression in women using hormonal contraceptive methods than in women using nonhormonal methods. The findings of this study strengthen the evidence of differences in sexual function between women using oral contraceptives and those using copper intrauterine devices. Sexual function was also compared among users of oral contraceptives, copper and hormonal intrauterine devices, and barrier methods. However, less frequently used contraceptive methods, such as hormonal injections and vaginal rings, could not be compared in this sample. Women using hormonal contraceptive methods were younger, had lower sexual function and satisfaction, and experienced higher anxiety and depression levels than women using nonhormonal contraceptive methods.

Role of men in women’s health service utilisation in northern Nigeria: a qualitative study of women, men and provider perspectives

BackgroundThe 2018 Nigeria Demographic and Health Survey shows poor maternal health in northern Nigeria. Contraceptive use remains low and maternal mortality high. Studies show that cultural norms related to men’s...

Assessing the effect of concerns about contraceptive-induced fertility impairment on hormonal contraceptive use by parity and residence: evidence from PMA Ethiopia 2020 cross-sectional survey

ObjectivesThis study aims to describe patterns of beliefs about contraceptive-induced infertility and assess their relationship with current contraceptive use, including whether these relationships vary by parity and residence.DesignWe use data...

Acceptance of contraception in couples receiving contraceptive counselling in antenatal period.

Objective: To conduct research in order to determine the effect that antenatal counseling has on the use of contraception during the immediate postpartum period in the conservative society that exists in the rural areas surrounding Lahore, Pakistan. Study Design: Randomized Clinical Trial. Setting: Central Park Teaching Hospital in Lahore, Pakistan. Period: Jan, 2022 to April, 2022. Methods: A random selection was used to divide 400 antenatal patients who were at least 28 weeks along in their pregnancies into two groups. Patients who did not receive antenatal counseling regarding birth control options were included in Group X while patients who received antenatal counseling regarding the use of birth control were included in Group Y. A pre-designed proforma was completed following a written informed consent. Data was analyzed using SPSS 26. Results: Data was collected from 400 females (200 in each group) who visited CPTH. The mean age of the female participants was 27.26 + 4.78 years. Most of the participants lived in extended family systems. Nearly one third of the females was illiterate or has primary level of education. Approximately one-fourth of the females were graduated or above. After first pregnancy, 68% in group I and 86% in group II mentioned that they used contraceptive method, (p = 0.005, statistically significant). After second and fifth pregnancy, effect of counseling was affective and difference was statistically significant. The most common contraceptive method was barrier method followed by injection after first and second pregnancy. Conclusion: Antenatal contraceptive counseling proves to be a highly effective intervention in enhancing the acceptance and utilization of contraceptives within the conservative societies of Pakistan. Health care providers ought to undergo comprehensive training and exhibit unwavering motivation in order to effectively engage in antenatal contraceptive counseling.

Contraception Initiation after Early Abortion in a Family Medicine Setting: A Retrospective Chart Review.

Early abortion increasingly is provided in the primary care setting, allowing improved access, continuity of care, and contraception, if desired. We aimed in this retrospective chart review to describe postabortion contraception provision in a family medicine office. Participants were those patients who obtained an induced abortion during an 11-year period at a family medicine office. We documented contraception provision within 30 days of abortion and used simple proportions, Fisher exact tests, and χ2 tests to describe differences in contraceptive provision by type of abortion and continuity status. Most of the patients who underwent abortions (254/353, 72%) had documentation of a contraceptive method within 30 days of abortion, which was similar for patients who had either a medication (124/166, 75%) or an aspiration abortion (130/187, 70%, P = 0.71). The most common contraceptives were contraceptive pills (104/353, 29%) or intrauterine devices (68/353, 19%). Patients who chose a tier 1 method were more likely to have a procedure abortion (50/87, 57%), whereas patients who chose a tier 2 method were likely to have a medication abortion (83/160, 52%). Fewer than half (45%, 158/353, P = 0.0002) were continuity patients and established patients in the primary care office. Most tier 1 contraceptive users were continuity patients (49/87, 60%), whereas most patients without a contraceptive method were noncontinuity patients (72/99, 73%). The primary care setting is uniquely equipped for providing early abortion and postabortion contraception. Although the providers offered all contraceptive options to eligible patients, continuity patients were more likely to receive more effective contraception in their primary care office.

Dr. Nitya Anand: The Visionary Behind Saheli and the Advances in Medicinal Chemistry.

Dr. Nitya Anandwas a leading figure in Indian pharmaceutical research. His career spanned several decades, during which he significantly contributed to advancement in drug development and public health. His innovation of Centchroman (Saheli), the world's first non-steroidal oral contraceptive pill, changes the course of contraception use in India. He had done groundbreaking work in leprosy treatment, synthetic peptides, and antibiotics. With over 400 publications and 130 patents, he supervised over 100 PhD students. His work has been recognized with many prestigious awards, including the Padma Shri and the National Nehru Science Award, which have left a long-lasting impact on medicinal chemistry and public health.

Efficacy of intrauterine device procedural analgesics.

Nearly half of all pregnancies worldwide are unintended. Intrauterine devices are an effective, long-acting form of pregnancy prevention that require minimal maintenance, and also can be used in patients with menorrhagia. However, they are underused because of pain associated with their insertion. Topical and local anesthesia are good options for reducing procedural pain in select patients. IUD placement falls within the scope of practice for physician associates/assistants (PAs) practicing in family medicine, internal medicine, and women's health. PAs should be aware of these additional analgesia options available to patients in order to increase use of effective contraception.

Analisis Faktor-Faktor yang Memengaruhi Penggunaan IUD Pasca Plasenta

High maternal mortality rate and infant mortality rate in Indonesia can be suppressed by increased coverage of MKJP methods. The aim of the research was to analyze the factors that influence the use of post-placental contraceptives with IUD methods in Praya RSUD. Research design used analytical observation with case control study. The results of the research obtained the level of knowledge of the WUS and the promotion or KIE activities given by the health personnel are significantly related to the use of post-placental IUDs in RSUD Praya with a P-value of 0,000. However, the health care competence factor is not related to the use of post-placental IUDs in Praya RSUD with a P-value of 0.715. Conclusion The level of knowledge and promotional activities/KIE by health care personnel has been linked to the use of post placental IUD in RSUD Praya. Whereas health care competence has nothing to do with it.