Current Contraceptive Practices Research Articles

UNMET NEED FOR FAMILY PLANNING AMONG MARRIED WOMEN IN THE REPRODUCTIVE AGE IN ABDEL-KADER FAMILY HEALTH UNIT AT EL-AMRYEA

INTRODUCTION:Sexually active females in the reproductive age could be classified according to their need for contraception into four categories: females with no need because of being un-fecund, females with no need because of a desire to become pregnant soon, females with no need because of current contraceptive practice and females with unmet need.As having updated estimates of the unmet need for family planning is vital for monitoring success in family planning programs and showing the need for corrective actions that could accelerate the Egyptian achievement of sustainable developmental goals and reduction of maternal mortality. Thus this study was conducted to investigate the problem of unmet need for family planning among married women in the reproductive age in El-Amryea district. This district has similar characteristics of Bedouin population which is infrequently touched. AIM OF THE WORK:The present study aimed to determine the extent of “unmet need for family planning” and its determinants among married women in the reproductive age at Abdel-Kader family health unit in El-Amryea, to identify their socio-demographic characteristics to determine their fertility pattern and use of contraceptives, and to explore the factors affecting the unmet need for family planning among those women.

Repeat induced abortion in 30 Chinese provinces: A cross‐sectional study

To report the proportion and determinants of repeat induced abortions in China. Cross-sectional data were collected of 79 954 women who received an induced abortion from 297 hospitals across 30 Chinese provinces in 2013, using a stratified cluster sampling design. Logistic and Poisson regression models were fitted to identify characteristics associated with repeat abortion. Putative factors included age, household registration (hukou) status, marital status, education, occupation, reproductive history, and current contraceptive practices. Of all abortions, 65.2% were repeat induced abortions. The proportion of repeat abortions varied substantially across provinces, from 36.9% in Qinghai to 85% in Hubei. The strongest factors associated with repeat induced abortion were being older than 40years (adjusted odds ratio [ORadj ] 7.0, 95% confidence interval [CI] 6.2-7.9), divorced or widowed (ORadj 2.1, 95% CI 1.6-2.7), and using oral contraceptives (ORadj 2.1, 95% CI 1.9-2.3). A high proportion of repeat induced abortion was observed across many Chinese provinces, highlighting the need to reduce the incidence of unwanted pregnancy. Several sociodemographic and clinical factors were found to be significantly associated with repeat abortions and should be considered in post-abortion family planning services.

Sexual behavior and contraceptive practices: Study among married heterosexual HIV serodiscordant couples of reproductive age group attending anti-retroviral therapy centre at a Tertiary care hospital in Mumbai, India.

Background:As many as half of people with HIV who are in a long-term sexual relationship have an HIV-negative partner. Data on sexual behavior and contraceptive needs of heterosexual serodiscordant couples are scarce in India. Keeping these facts in mind, it was considered imperative to conduct a study on sexual behavior, contraceptive practices and associated high risk factors among heterosexual serodiscordant couples.Objectives:The objective of the study was to assess the sexual behavior, current contraceptive practices and various risk factors of HIV transmission among married heterosexual HIV serodiscordant couples.Materials and Methods:Descriptive study conducted at antiretroviral therapy (ART) centre from where 100 discordant couples were included, data were collected related to their sexual practices, knowledge about different contraception methods and high risk factors related to infection transmission were recorded.Results:All couples had knowledge of use of condoms (100%) while consistent usage was seen only in 18%. The high risk of HIV transmission was seen among recently married serodiscordant couples. Couples engaged in daily intercourse were more likely to have high risk of transmission (P value < 0.05).Conclusion:This study showed various risk factors for infection transmission to the seronegative partner among serodiscordant couples. Henceforth, given conception that prevention of these factors could reduce overall seroconversion rate among such couples.

Predictors of contraceptive method mix in the Cameroon development corporation plantation camps.

Introductionlow socioeconomic status is a risk factor for maternal death and contraceptive use has been shown to reduce maternal deaths in those poor settings. Despite the tremendous benefits of contraceptives in the regulation of reproductive health indicators, its use in less developed countries continue to remain unacceptably low. The purpose of this study was primarily to assess the contraceptive method mix and then determine the predictors of contraceptive use in the Cameroon Development Corporation (CDC) plantation camps.Methodsmix sampling was used. Firstly, two CDC camp localities (Tiko and Pena Mboko) were purposively selected. Pre-existing clusters within these localities were then randomly selected and then eligible participants within the sampled clusters systematically selected. Using the main street junction as starting point, direction of sample collection was determined by spinning a plastic bottle. From the start of street junction and moving in direction of the bottle pointer, all households left to the principal investigator were visited in search of eligible participants which were sexually active women aged 15-49 years who gave consent/assent. One participant was selected per household. We used pretested interviewer-administered questionnaires that covered information on socio-demographic characteristics, reproductive health and contraceptive use. Statistical significance was set at p-value ≤ 0.05.Resultssix hundred and thirty four (634) sexually active women aged 15-49 years were included in the study; majority were 25-35 years (246; 38.8%). The current contraceptive prevalence was 63.1% [59.3-66.8] (400); of which 312 participants (78%) used a single method while 88 (22%) participants used contraceptives in combination. The most common methods in use were rhythm (196; 49%), male condom (109; 27.2%) and implants (63; 15.8%). When adjusted, statistically significant determinants for contraceptive use were age range and marital status such that odds of using contraceptives was lower in women < 35 years and those cohabiting (AOR= 0.71 [0.50-1.00] and AOR=0.62 [0.44-0.87] respectively).Conclusioncurrent contraceptive practice in the CDC plantation camps is geared toward less effective traditional methods than the more effective modern methods. More health education is needed to adjust this paradigm.

Long-acting reversible contraceptives: Addressing adolescents' barriers to use.

NPs caring for adolescent females have an opportunity to reduce US teen pregnancy rates through unbiased counseling on contraception options, including highly effective long-acting reversible methods. Intrauterine devices and subdermal implants are safe, effective contraception options for adolescents, but their rates of use remain low among this patient population. This article discusses current adolescent contraceptive practices, barriers to access, and current recommendations for long-acting reversible contraceptive use.

Combined oral contraceptive pill-exposure alone does not reduce the risk of bacterial vaginosis recurrence in a pilot randomised controlled trial

We conducted a pilot open-label randomised controlled trial of combined (oestrogen-progesterone) oral contraceptive pill (COCP)-exposure aimed to examine its effect on BV-recurrence following first-line antibiotics compared to antibiotics alone. Ninety-five women with symptomatic BV were prescribed antibiotic therapy, randomised to COCP-exposure (intervention) or current non-hormonal contraceptive practices (control) and followed monthly for six-months or until BV-recurrence. Modified intention-to-treat methods requiring either ≥1 clinical (primary/Amsel-outcome) or ≥1 microbiological (secondary/Nugent-outcome) BV-recurrence assessment were applied to determine cumulative recurrence rates. Secondary Cox regression analyses assessed factors associated with recurrence in all women. 92/95 women randomised provided baseline requirements. BV-recurrence rates were similar in women randomised to the COCP (primary/Amsel-outcome: 10/100PY, 95%CI: 6,19/100PY) compared to controls (14/100PY, 95%CI: 9, 21/100PY, p = 0.471). In secondary analyses sex with the same pre-treatment regular sexual partner (RSP; Amsel: Adjusted Hazard Ratio [AHR] = 3.13, 95%CI: 1.41, 6.94, p = 0.005; Nugent: AHR = 2.97, 95%CI: 1.49, 5.83, p = 0.002) and BV-history (Amsel: AHR = 3.03, 95%CI: 1.14, 6.28; Nugent: AHR = 2.78, 95%CI: 1.22, 6.33) were associated with increased BV-recurrence. This pilot RCT of COCP-exposure did not improve BV cure but found sex with an RSP and BV-history were associated with recurrence, although impacted by sample size and attrition. These data indicate reinfection from an untreated RSP and persistence of BV-associated bacteria are integral to the pathogenesis of recurrence and may overwhelm potential beneficial effects of hormonal contraception on the vaginal microbiota.

A Survey of Family Planning Training, Knowledge, and Practices Among Health Care Providers Within the Military Health System at Joint Base Lewis-McChord.

Within the active duty U.S. military population, the age-adjusted unintended pregnancy rate is higher than the national average. Unplanned pregnancy within the military impacts individual and unit medical readiness. Contraceptive education and availability are means to reduce unintended pregnancy rates; health care providers are key facilitators in provision of contraception. Understanding provider knowledge and practices related to contraceptive provision may identify strengths and gaps in order to provide focal points for sustainment or improvement in family planning practices. The purpose of this study was to assess family planning knowledge, training, and practices among health care providers serving military and dependent beneficiaries within the military health care system at Fort Lewis, Washington. This was a cross-sectional survey of health care providers on Joint Base Lewis-McChord in Tacoma, Washington who deliver health care services to U.S. uniformed service members and their dependents in varied settings, including outpatient clinics and a tertiary care center. The survey included questions regarding prior contraceptive training, and current contraceptive knowledge and practices. Survey results were evaluated using descriptive and bivariate analyses. The study was approved by both Institutional Review Boards at Emory University and at Madigan Army Medical Center. Overall, 79 eligible health care providers completed the survey. Eighty-six percent of women's health providers consistently ("always or most of the time") provided family planning services to female service members, compared with 38% of primary care providers. Women's health providers were more likely to counsel by method effectiveness and adapt their counseling to consider patients' reproductive life plans. There were no differences between provider type in considering service members' deployment status during contraceptive counseling. Overall, providers identified the correct effectiveness of long-acting contraceptive methods, but tended to overestimate the effectiveness of short-acting methods. Family planning services available to service members may be improved through enhanced provider education, targeting efficacy-based counseling and identification of barriers to access and provision of long-acting reversible contraceptive methods.

Family planning and contraception use in transgender men

ObjectivesFemale-to-male (FTM) transgender men (affirmed males) can experience planned and unplanned pregnancy during and after testosterone therapy. We conducted an exploratory study to understand current contraceptive practices and fertility desires among transgender men during and after transitioning. Study designSelf-identified transgender and transmasculine individuals assigned female at birth, ages 18–45, completed an anonymous online survey derived from standardized family planning surveys. We recruited participants from LGBT health centers, online listservs, and online groups for transgender men and used a mixed-methods analysis to evaluate quantitative and qualitative data. ResultsOf the one hundred and ninety-seven participants included in the study, the median age was 30 years old, most respondents were white, and 86% were taking masculinizing hormones (testosterone). Of the 60 pregnancies reported, 10 (17%) pregnancies occurred after stopping testosterone, 1 (1.6%) while taking testosterone irregularly, and 5 of 7 abortions occurred in participants who had been using testosterone in the past. Over half of the respondents desired at least one child, and a quarter reported fears of not getting pregnant. The majority of participants reporting using contraception (n=110, 60.1%), with condoms and pills used most commonly (n=90, 49.2% and n=62, 33.9% respectively). Methods of contraception used did not differ between testosterone users and non-users, except for hormonal IUDs (20% testosterone versus 7% non-testosterone). Thirty participants (16.4%) believed that testosterone was a form of contraception, and 10 (5.5%) participants reported that their healthcare providers advised testosterone as contraception. ConclusionTransgender men use contraception and can experience pregnancy and abortion, even after transitioning socially and hormonally. Transgender men need counseling and care regarding reproductive health, including contraceptive and conception counseling. ImplicationsProviders should be aware that transgender men may desire pregnancy and use contraception; this study highlights the need for further research regarding fertility, fertility desires, and optimal contraception among transgender men.

A Survey of Bariatric Surgical and Reproductive Health Professionals' Knowledge and Provision of Contraception to Reproductive-Aged Bariatric Surgical Patients.

Over 80% of bariatric surgical patients are women with obesity in their reproductive years. Obesity adversely affects fertility; the rapid weight loss following bariatric surgery can increase fecundity. Current guidelines recommend avoiding pregnancy for up to 24months following surgery, but little is known about current contraceptive care of women who undergo bariatric surgery. Two surveys were undertaken with bariatric surgical and contraceptive practitioners in England to establish current contraceptive practices in both groups. Two anonymous on-line surveys were sent to all 382 members of the British Obesity and Metabolic Surgery Society (BOMSS) and an estimated 300 contraceptive practitioners in the North East of England. The BOMSS survey elicited a response rate of 17% (n = 65), mainly from bariatric surgeons (n = 24 (36%)). Most respondents (97%) acknowledged the need to educate patients, but contraceptive information was only provided by 7% (n = 4) of respondents in bariatric surgical clinics. Less than half of respondents were confident discussing contraception, and the majority requested further training, guidance and communication with contraceptive practitioners. The majority of respondents to the contraceptive practitioner survey were general practitioners (28%, n = 20). Three quarters of respondents reported little knowledge of bariatric surgery, and many reported not seeing women with obesity requiring contraception before (66%, n = 45) or after surgery (71%, n = 49). There is a need to increase knowledge levels of contraception within bariatric surgical teams and to understand why, despite increasing levels of bariatric surgery, women do not seem to be appearing for advice in contraceptive settings.

P240 Evaluating current contraceptive practice in women attending termination of pregnancy services in glasgow

<h3>Background/introduction</h3> Despite free contraception in Scotland, over 12,000 terminations of pregnancy (TOP) are carried out annually at great financial cost. <h3>Aim(s)/objectives</h3> To quantify methods of contraception in women presenting with unintended pregnancy at a large urban integrated sexual health unit, to identify reasons for failure. <h3>Methods</h3> A retrospective case note review of a random sample of 100 women attending termination referral services between October 2013–March 2014. <h3>Results</h3> Of attendees, mean age was 26 years. 38% had used male condoms. 35% “no contraception”. 25% Oral contraceptive pill. 24% of condom users and 43% of COCP reported imperfect use. Additionally, 9% fell pregnant despite reported use of emergency contraception. 45% had undergone at least one therapeutic termination previously, of these: 22% reporting no use of contraception at time of conception. 4% no contraception ever. 44% of repeat attenders and 28% of whole sample reported using LARC methods in the past. 63% of women stated intention to undertake a LARC method post-procedure, however it is not clear if these were implemented. <h3>Discussion/conclusion</h3> Large numbers of repeat TOPs suggests problems with uptake of reliable contraception post-procedure. Counselling at initial consultation – especially for repeat attendees; specific post-termination clinics and support; interventions and education targeted at high risk groups; and advocated use of LARC should reduce repeat procedures. LARC methods of contraception should continue to be encouraged in all females for primary prevention given their extreme effectiveness. Future studies of the actual uptake versus stated intention to use LARC may be insightful.

Men's contraceptive practices in France: evidence of male involvement in family planning

ObjectiveTo describe contraceptive practices of men in a relationship in France, where use of female-controlled methods is predominant, and to explore their involvement in managing contraception within the couple. Study designData are drawn from a national probability cross-sectional survey on sexual and reproductive health conducted in France in 2010. The study sample comprised 3373 men aged 15–49, 1776 of whom were asked about their current contraceptive practices after they reported that they were fecund and sexually active and did not currently want a child. Analyses were performed with logistic regression models. ResultsFew men aged 15–49 with a partner did not use contraception (3.4%). Most reported using only a female method (71.7%), 20.4% only cooperative methods, such as condoms, withdrawal and the rhythm method and 4.5% both. Among contraceptive users, withdrawal (7.7%) was more likely to be used by men with low incomes or low educational levels. Condom use was reported as a contraceptive method by 18.9% of men. Its prevalence was higher for those in new and noncohabiting relationships (36.1%) and lower for those in cohabiting relationships (12.4%), in which STIs/HIV prevention is less of a concern. ConclusionMen's high awareness of contraceptive practices and their use of some cooperative methods reveal their involvement in contraceptive practices within the context of relationships. Condom use is associated with the prevention of STIs/HIV for noncohabiting men, but men who live with their female partner seem to use condoms mainly as a contraceptive method. Withdrawal appears to be associated with low level of education and financial difficulties. Finally, having engendered a pregnancy that was terminated appears to influence men's contraceptive practices. ImplicationsStudying men's contraceptive practices helps to understand their involvement in contraceptive management within relationships.

Medical abortion: is it a blessing or curse for the developing nations?

<strong>Objectives:</strong><em> </em>Medical abortion is definitely a safer and a better option but in developing countries, its widespread misuse has led to partial or septic abortion thereby increasing maternal mortality and morbidity. The study was carried out to analyze the use and misuse of abortion pill and to analyze the factors responsible for avoiding the government facilities. <strong>Methods: </strong>The study included all female patients who visited the rural health centre of our institute with pre-tested questionnaire, designed in a manner to obtain the qualitative information regarding their attitude towards the abortion services, use of medical methods of abortion and the current contraceptive practices among them. At the end of study, the data was compiled systematically and was subjected to statistical analysis with simple non parametric tests and the value of P&lt;0.05 was considered significant. <strong>Results:</strong><em> </em>Only 49.62% of the patients had complete abortion while rest was reported with incomplete (41.54%), septic (6.54%) or failed abortion (1.15%) or ectopic pregnancy (1.15%). Local dais (36.55%) and pharmacists (29.61) were the main channels of procurement of pills used for medical abortion. Non-availability of medical methods (65.38%) and compulsion for the accompanied contraception (35%) were the most commonly cited reasons for avoiding government sector facilities. <strong>Conclusions: </strong>The low level of awareness, education and misuse of medical methods of abortion are responsible for converting a safe abortion into an unsafe practice. We suggest for an urgent need for strict legislations by the government to regulate the supply of drugs used for medical abortion.<strong> </strong> <strong>Key words: </strong>abortion; contraception; ectopic gestation; medical abortion; mifepristone; misoprostol; pregnancy DOI: <a href="http://dx.doi.org/10.4038/sljog.v33i3.4015">http://dx.doi.org/10.4038/sljog.v33i3.4015</a> <em>Sri Lanka Journal of Obstetrics and Gynaecology </em>2011; <strong>33</strong>: 84-90 <em></em>

Married women's decision making power on modern contraceptive use in urban and rural southern Ethiopia

BackgroundWomen in developing countries are either under collective decision making with their partners or completely rely on the male partner's decision on issues that affect their reproductive live. Identifying the major barriers of married women's decision making power on contraceptive use has significant relevance for planning contextually appropriate family planning interventions. The objective of this study was to determine current modern contraceptive practices and decision making power among married women in Tercha Town and surrounding rural areas of Dawro zone, Southern Ethiopia.MethodsCommunity based comparative cross-sectional design with both quantitative and Qualitative study has been employed in March and April 2010. The respondents were 699 married women of child bearing age from urban and rural parts of Dawro zone. After conducting census, we took the sample using simple random sampling technique.ResultsCurrent modern contraceptive use among married women in the urban was 293 (87.5%) and 243 (72.8%) in rural. Married women who reside in urban area were more likely to decide on the use of modern contraceptive method than rural women. Having better knowledge about modern contraceptive methods, gender equitable attitude, better involvement in decisions related to children, socio-cultural and family relations were statistically significant factors for decision making power of women on the use of modern contraceptive methods in the urban setting. Better knowledge, fear of partner's opposition or negligence, involvement in decisions about child and economic affairs were statistically significant factors for better decision making power of women on the use of modern contraceptive methods in the rural part.ConclusionsHigh level of current modern contraceptive practice with reduced urban-rural difference was found as compared to regional and national figures. Urban women had better power to make decisions on modern contraceptive than rural women. Modern family planning interventions in the area should be promoted by considering empowering of women on modern contraceptive use decision making.

Hormonal contraceptive practices in young Australian women (⩽25 years) and their possible impact on menstrual frequency and iron requirements

Objectives To investigate the hormonal contraceptive practices of female university students aged ⩽25 years, their menstrual bleeding frequency, and interest in contraceptive regimens that reduce menstrual frequency or duration. Study design A 20-item questionnaire was distributed to female students at Griffith University, Gold Coast campus. This included questions relating to: demographics, menstrual bleeding frequency, current contraceptive practices, and interest in future oral contraceptive regimens that reduce menstrual bleeding frequency and duration. Main outcome measures Determination of hormonal contraceptive practices and menstrual bleeding frequency undertaken by the sample population. Results Eight hundred and fifty one participants completed the questionnaire, ∼2/3rds of respondents are currently using a hormonal contraceptive (66% of all respondents), with the oral contraceptive pill (OCP) being most common. Most women (73%) reported monthly menstruation, although 16% indicated that they sometimes missed their monthly period, with bleeding every two months. Of all OCP users, approximately 2/3rds have skipped their monthly period at some time, the most common reasons being for convenience (89%). Approximately 70% of respondents were interested in OCP regimens that reduced frequency or duration of menstruation. Conclusion OCP use is popular amongst Australian university women, with many being interested in the concept of using the OCP to delay menstruation. Given this interest and the availability of hormonal contraceptives that reduce menstrual frequency and duration, assessing the impact of reduced menstrual blood loss on iron stores may be warranted.

Why Withdrawal? Why Not Withdrawal? Men's Perspectives

Withdrawal is an ancient and prevalent form of male contraception which has largely been ignored by family planning programme managers all over the world. The objective of this study was to understand men's perspectives on withdrawal use, both users and non-users. In-depth interviews with 62 male factory workers in western Turkey are reported, on use of withdrawal, attitudes to family planning, information on contraception, marital and sexual experience, and gender values and attitudes. Advantages reported both by users and non-users of withdrawal were being free from side effects, ease of access and having no cost. While current users said withdrawal was easy to use and practical, non-users complained about the difficulties of using withdrawal, that it was coitus-dependent, caused anxiety and decreased pleasure during sexual intercourse. Current users emphasised taking responsibility as husbands for family planning and protecting their wives from possible adverse effects of contraceptives. Withdrawal should be seen as a valuable choice in a world where increasing method choice, male participation and responsibility taking in reproductive health are all desirable. With its cited advantages withdrawal is likely to fill an important niche among current contraceptive practices and deserves more attention and support.

Emergency contraception: What do our patients know?

Study objective Unintended pregnancy is a major medical, social, and public health problem. Emergency contraceptive pills can prevent 75% to 85% of unintended pregnancies if administered within 72 hours of intercourse. We perform this study to measure knowledge, attitudes, practices, and perceived needs about emergency contraception in a sample of women seeking emergency department (ED) care. Methods This was a prospective survey of women presenting to an inner-city ED during an 8-week study period. Women who were aged 18 to 45 years, English speaking, and not critically ill and who presented during 56 randomly generated 4-hour time blocks were eligible. Trained research assistants administered a 20-question survey that included questions on current sexual and contraceptive practices and knowledge, acceptance, and preferences about postcoital contraception. Results Two hundred thirty-two women met eligibility criteria; 158 (68%) women agreed to participate. Participants and nonparticipants were similar in age, race, ethnicity, and insurance status. The participants' mean age was 30 years. Twenty-five percent were married, whereas 49% had never married and 25% were separated or divorced. Fifty-two percent (95% confidence interval [CI] 44% to 60%) reported at least 1 previous unintended pregnancy; 28% (95% CI 21% to 35%) had 1 or more previous elective abortions. Of women who had been sexually active in the past month, half (47%) reported unprotected intercourse during that time. Among all respondents, 122 (77%; 95% CI 71% to 84%) had heard of emergency contraception as a way of preventing pregnancy after unprotected intercourse. Of these respondents, one fourth to one half did not have enough knowledge to use emergency contraceptive pills effectively. Fifty-seven percent of women were willing to use emergency contraceptive pills in the future, and 16 women said they would consider a change in regular contraception to emergency contraceptive pills if widely available. Conclusion Sexually active women seeking ED care have high rates of unintended pregnancy and abortion. There is broad acceptance of emergency contraceptive pills to prevent pregnancy, but knowledge of availability, timing, and proper use is limited. Emergency contraceptive pills are a safe, effective, and low-cost primary preventive and emergency care intervention, and information about their use should be made available to ED patients. Patients should be advised not to abandon their use of barrier or other traditional contraceptives.

Emergency contraception: what do our patients know?

Unintended pregnancy is a major medical, social, and public health problem. Emergency contraceptive pills can prevent 75% to 85% of unintended pregnancies if administered within 72 hours of intercourse. We perform this study to measure knowledge, attitudes, practices, and perceived needs about emergency contraception in a sample of women seeking emergency department (ED) care. This was a prospective survey of women presenting to an inner-city ED during an 8-week study period. Women who were aged 18 to 45 years, English speaking, and not critically ill and who presented during 56 randomly generated 4-hour time blocks were eligible. Trained research assistants administered a 20-question survey that included questions on current sexual and contraceptive practices and knowledge, acceptance, and preferences about postcoital contraception. Two hundred thirty-two women met eligibility criteria; 158 (68%) women agreed to participate. Participants and nonparticipants were similar in age, race, ethnicity, and insurance status. The participants' mean age was 30 years. Twenty-five percent were married, whereas 49% had never married and 25% were separated or divorced. Fifty-two percent (95% confidence interval [CI] 44% to 60%) reported at least 1 previous unintended pregnancy; 28% (95% CI 21% to 35%) had 1 or more previous elective abortions. Of women who had been sexually active in the past month, half (47%) reported unprotected intercourse during that time. Among all respondents, 122 (77%; 95% CI 71% to 84%) had heard of emergency contraception as a way of preventing pregnancy after unprotected intercourse. Of these respondents, one fourth to one half did not have enough knowledge to use emergency contraceptive pills effectively. Fifty-seven percent of women were willing to use emergency contraceptive pills in the future, and 16 women said they would consider a change in regular contraception to emergency contraceptive pills if widely available. Sexually active women seeking ED care have high rates of unintended pregnancy and abortion. There is broad acceptance of emergency contraceptive pills to prevent pregnancy, but knowledge of availability, timing, and proper use is limited. Emergency contraceptive pills are a safe, effective, and low-cost primary preventive and emergency care intervention, and information about their use should be made available to ED patients. Patients should be advised not to abandon their use of barrier or other traditional contraceptives.

Effects of oral contraceptive use on body mass index and blood pressure among female villagers in north-east Thailand.

The use of contraceptives has become prevalent among females in Thailand in the past 20 years, and oral contraceptive use has been suggested to trigger changes in fat intake, energy expenditure, fat metabolism and blood pressure. Based on field investigations of 391 married women aged 20 years or over in Yasothon Province, North-east Thailand, this study aims to elucidate the effects of oral contraceptive use on body mass index (BMI: kg/m2) and blood pressure, taking into account reproductive histories and socioeconomic conditions. The proportion of obese (BMI > or = 25) subjects was high in the age groups 30-39, 40-49 and 50-59, accounting for, respectively, 39.4%, 51.1% and 48.5% of these populations. The proportion of women with hypertension (90/140 mmHg) was 23.7%, 18.5% and 26.2% in the 40-49, 50-59 and 60-69 age groups. Current contraceptive practices in the studied population included sterilization by operation, oral contraception and injection. These methods accounted for 43.0%, 12.8% and 8.2% of the population, respectively. Sociodemographic factors such as reproductive history, years of education and household income were not significantly related to BMI or to blood pressure (ANOVA with age adjustment). In contrast, oral contraceptive users had significantly higher BMIs and diastolic blood pressures (p<0.01, ANOVA with age adjustment). Multiple regression analysis also revealed that oral contraceptive use was a weak but significant contributing factor to both high BMI and blood pressure when sociodemographic factors were taken into account and controlled for statistically. It can thus be concluded that the use of contraceptive pills, which contain oestrogen and progestin and are provided free of charge to Thai women, tend to increase BMI and to elevate blood pressure.

Selected Data on Health Status of Migrant Women Respondents

Reproductive health is 'a state of complete physical, mental and social well-being in all matters relating to the reproductive system and to its functions and processes. Implicit in this is the right of men and women to be informed and to have access to safe, effective and affordable and acceptable methods of family planning of their choice, as well as other methods of their choice for regulation of fertility, which are not against the law, and the right of access to health-care services that enable women to go safely through pregnancy and childbirth.' The survey on Health Problems of Migrant Workers included a section on Women's Health covering aspects of reproductive health. This was based on concerns over reproductive health needs of migrant women workers, particularly since the large majority are in the reproductive age-group, and the utilisation of government healthcare facilities. The latter has implications for the potential burden on public healthcare services in terms of resources and costs.Specifically, the Women's Health section included questions on pregnancy, place of delivery of last baby (born in Malaysia), postnatal care related to this delivery, and mode of payment. For those currently pregnant, questions were asked of sources of antenatal care, postnatal care and respective modes of payment for those services. This section also included questions on current contraceptive practices, source of supplies, and mode of payment for contraceptive methods.

Contraceptive Effectiveness of Breastfeeding and Current Contraceptive Practice in Bangladesh

Contraceptive Effectiveness of Breastfeeding and Current Contraceptive Practice in Bangladesh