Effective Method Of Birth Control Research Articles

Long-Acting Reversible Etonogestrel Subdermal Implant in Adolescents.

Several effective contraceptive options are available for use by adolescents, including the long-acting reversible subdermal implant and intrauterine devices, which provide a high level of convenience, privacy, and effectiveness for an adolescent. Knowledge of all the effective birth control methods is essential for the pediatrician to be able to provide effective contraceptive counseling for an adolescent. An approach to counseling using a reproductive justice framework, which allows the provider and adolescent patient to engage in shared decision-making, is described. This article focuses on the long-acting reversible etonogestrel (ENG) subdermal implant for adolescents. The ENG implant is labeled for preventing pregnancy by suppressing ovulation. The ENG implant may also have a role in ameliorating dysmenorrhea and heavy menstrual bleeding. Postlabeling studies indicate that the ENG implant is effective for up to 5 years, although the device's labeling states effectivenessup to 3 years. The main contraindication to using the ENG implant is pregnancy itself. Safe initiation of the ENG implant is described, including an approach to determine whether an adolescent is pregnant. The main adverse effect of the ENG implant is an unpredictable bleeding pattern that is most often ameliorated by use of nonsteroidal anti-inflammatory medications, as well as estrogen, if not contraindicated for the patient. Details of the insertion and removal procedures, including potential complications, are described to enable the pediatrician to provide effective anticipatory guidance for the adolescent.

IUD-Related knowledge and practice among women in Afghanistan: A cross-sectional survey study

Background: Intrauterine Devices (IUDs) are T-shaped devices that can be inserted into the uterus to provide contraception. IUDs are a form of long-term contraception that are effective birth control methods with few adverse effects. The purpose of this study is to reveal the current baseline for the knowledge and practice of Afghan women toward intrauterine devices and identify the related sociodemographic factors. Methods: This cross-sectional survey was conducted from October 2022 to December 2022 among married women aged at least 18 years old living in Herat province of Afghanistan. A total of 1000 females in Herat were asked, and 411 agreed to participate in this study (response rate=41.1%). Results: Only one-fourth of the participants responded that health care workers are their primary source of information on health issues (25.3%). More than nine-tenths of the participants had poor knowledge level of IUD (91.5%) while only one-twentieth of participants were using IUD (5.8%). Number of children, education level, occupation, and economic status were found to be significantly associated with participants’ knowledge on IUD. Conclusion: Government and health organizations should provide trainings focused on increase of knowledge on IUD and its related issues. The programs should also persuade women to use IUD and its safety. Training should be targeted not only to women, but to family practice physicians, nurse and midwifery practitioners and other providers who offer family planning counseling and services.

Modern women choose contraceptive vaginal ring

This survey introduces up-to-date statistic data on women’s reproductive health considering current control methods. It includes literature analysis on the contraceptive vaginal ring (CVR) use. Evidential medicine proves that CVR is a long-standing, safe and effective birth control method. CVR usage definitely wins the battle against oral contraception and prolonged contraception methods. The survey includes current patients’ survey results concerning CVR usability particularly during sex. VR’s effect on vagina microbiota and cervix epithelium is also covered, considering the discussions on cervix cancer increase caused by long-term use of combined hormonal contraceptives. Recently, there has been some positive trend towards the protection of reproductive health. However, we have to admit that there are still many unresolved issues, in particular, unavailability of adequate family planning counselling services and advanced effective birth control methods. The pharmaceutical market is saturated with various birth control methods. A careful analysis of medical history details and test results makes it easy to choose the best possible and safe birth control method with due regard of the patients’ wishes. Bearing in mind the less pronounced systemic effect, ease of use, and a favourable safety profile, the choice of CVR as a birth control method seems to be the best solution for women

Emergency Contraception: Ongoing Medical, Pharmacological, Political, and Ethical Controversies

The aim of the critical analysis is an illumination of unresolved issues on Emergency Contraception (EC). This form of contraception has been offered as an effective method of birth control to women since the end of the last century. At present -- in the post-Roe generation where access to abortion has been restricted -- the interest in EC is increasing. It is important therefore to provide accurate and complete information on which prospective users of EC can rely. Material and Metho The material encompasses documents issued by leading health authorities -- such as the World Health Organization (WHO), the US Food and Drug Administration (FDA), and the US Centers for Disease Control and Prevention (CDC) -- as well as research articles published in high-ranked scientific journals. This material is assessed by a critical analysis which compares the discrepancies in data provided and in claims made. Results The result is evidence of publications containing unreliable claims and conflicting views on some of the most salient aspects of EC such as safety, efficacy, mode of action, drug-drug interactions, legislation on abortion medication, and ethical discussions on the protection of life. Implications Consumers and patients should be critical towards claims made by health agencies and rather rely on high-level research in the area of pharmacovigilance and on publications by legal experts.

Advances in microneedle patches for long-acting contraception

Despite the advances in contraceptives, there is still a high rate of unintended pregnancies worldwide, due in large part to the lack of effective, convenient, and safe birth control methods. Compared with short-acting contraceptives, approaches that offer long-term pregnancy protection have attracted greater interest because of the reduced dosing frequency and improved patient compliance. As a novel transdermal drug delivery system, the microneedle (MN) patch has been widely used for a variety of biomedical applications, including long-acting contraception, due to unique properties, such as painless self-administration and elimination of biohazardous waste. In this review we provide a systemic review of MN patches that have been utilized for long-term contraception, including dissolvable MN patches, polymeric biodegradable MN patches, and silk fibroin-based biodegradable MN patches. The acceptability and biosafety of these contraceptive MN patches are also discussed. Finally, we give our perspectives on the future clinical translation of MN patches for long-acting contraception.

Are postpartum adolescents more likely to diverge from their prenatal stated contraceptive plan?

Background: Approximately 1 in 5 teen births is a repeat birth. Only about 1 in 5 teen mothers use the most effective contraceptive methods. The prenatal and postpartum periods provide opportunities to counsel on and provide effective birth control methods respectively. We hypothesized that adolescents were more likely to diverge from contraceptive plans stated prenatally compared to adult patients.

Pattern and Determinant of Contraceptive Use among Women in Indonesia from 2007 to 2017: Evidence from Demographic and Health Survey

Background: Modern contraceptives are proven as the most effective birth control methods. However, it was a change in the pattern of modern method use in Indonesia to traditional. Objectives: This study investigated the pattern of contraceptive use and its determinant in Indonesia between 2007 and 2017. Methods: The study employed data from the Indonesian Demographic and Health Survey (IDHS) 2007, 2012, and 2017. Eligible participants included all women aged 15–49 who were married/living together with a partner. The dependent variable was contraceptive method use categorized as long-term, short-term, and traditional. Weighted pooled logistic regression analysis was applied to determine the shifting patterns of the independent variables related to contraceptive use over time. Results: The trend of contraceptive use in Indonesia has shifted over the three periods of the IDHS. During the three survey periods, contraceptive use was still dominated by short-term contraception, although over the last five years, the proportion has shown a decline of around 9%. Traditional contraceptive adoption followed the same patterns as long-acting reversible contraception (LARC), although having a smaller prevalence. Education level was significantly unassociated with the use of the traditional method at the beginning of the observation. However, more educated and knowledgeable women about contraceptive methods were more likely to use traditional contraceptives, switched from long-acting use following the next five and ten years. Long-term methods were no longer significantly more common among women in Java and Bali after five and ten years; the likelihood of using traditional methods in Java and Bali was growing. Conclusion: This study showed that contraceptive use and determinants were always dynamic over time. Therefore, family planning strategies and policies should adapt accordingly. Giving an understanding of contraceptive methods' benefits and risks through adequate method information is encouraged to prevent contraceptive dropout or switch to less-effective methods.

Oral Contraceptive Pills Are an Effective Method of Preventing Pregnancy in Women With Crohn's Disease.

Oral contraceptive pill (OCP) use in the general population is associated with a failure rate as low as 0.3% with perfect use but as high as 9% with typical use. Women with Crohn's disease (CD) may have malabsorption in the setting of small bowel disease or resection, which could affect absorption of OCPs. Our aim was to determine the incidence of pregnancy in women with CD on OCPs. This is a retrospective study assessing the incidence rate of OCP failure in females between 18 and 45 years of age seen at the Mayo Clinic with a diagnosis of CD and provided a prescription for OCPs, between 2016 and 2020. Failure was defined as clear documentation of becoming pregnant while using OCPs or having an active prescription of OCP at the time of conception. A total of 818 female patients with CD between 18 and 45 years of age with a prescription for an OCP were included in our study. Sixty-six patients (8%) conceived in this cohort. Of the 66 patients who became pregnant, 57 stopped the OCP before conceiving, 5 were excluded due to lack of data, and 4 women had active oral contraceptive prescriptions when they became pregnant (pregnancy rate of 0.5%). In female patients with CD who are using OCPs for contraception, we found a low rate of pregnancy (0.5%) similar to the rate of pregnancy with perfect use of OCPs in the general population. OCPs are an effective method of birth control in women with CD.

An Exploration of the Reproductive Health Concerns in Women with Systemic Lupus Erythematosus

An Exploration of the Reproductive Health Concerns in Women with Systemic Lupus Erythematosus

How safe is Contraception use among Obese Diabetic Women?

Incidence of diabetes mellitus is increasing is worldwide. The incidence of obesity is also increasing among the diabetic people. Sexually active obese women are commonly encountered nowadays due to increase in the global burden of obesity and diabetes mellitus Obesity and diabetes mellitus is associated with many health risks and a pregnant obese diabetic woman has health risks not only for herself but also to the foetus she carries. Thus, an effective birth control method is important to reduce pregnancy related complications. Though most of us are aware of management of diabetes and obesity, we may not be aware of the contraceptive usage among premenopausal women and HRT [hormone replacement therapy] use among perimenopausal women. A study was conducted to find the incidence of obese diabetics among the women attending a religious function. Later the study was extended to find the contraceptive use among the obese diabetic women and HRT usage among obese perimenopausal diabetic women. It has been found that 16/84 are prediabetic 25/84 are diabetic and 35/84 are overweight and 22/84 are obese. Follow up study was done to find out what contraceptive method was used by them and their knowledge about the contraceptive use. 77% (n=364) of the sexually active obese women are using contraception, with most of them using hormonal contraception. We are aware that some of the oral contraceptives will aggravate diabetes and obesity. Introduction: There is global increase in diabetes mellitus together with increasing incidence of obesity among women. This increase in obese diabetic women includes increasing numbers of women of a reproductive age whose reproductive health and contraception need careful consideration. We have conducted a study among obese diabetic women and their contraceptive usage. This study explored the level of knowledge, attitude, and practice of contraception usage of the sexually active obese women. Among the respondents (25.6%) were not aware of the best contraceptive for sexually active obese women. It is noted that 32.1% of obese women with underlying medical illness were still on hormonal contraception. The awareness of health risk associated with hormonal contraceptive usage of the amongst the obese diabetic women is less. This study has revealed that there is a lack of education and counselling with regards to safe and appropriate use of contraceptive to the women who need it for family planning. Objective: This study aims to look at the knowledge, attitude and practice (KAP) in the choice of contraceptives among obese and sexually active women. Methods: This study was conducted at Ministry of Health, health facilities and Private General Practitioners’ Clinics inPeninsular Malaysia. A self-designed questionnaire was used to assess KAP of the participants. A total of 473 respondents participated in the survey. Results: 77% (n=364) of the sexually active obese women are using contraceptives. Majority used hormonal contraceptives (n=204, 56%) and barrier method was the preferred method (39%, n=142) among the others. Women with Hypertension and Type II Diabetes Mellitus have the highest rate of using hormonal contraception (51.6%, n=32, 52.6%, n=30) respectively. Both groups have low awareness on the health risk associated with hormonal contraception which was 69% and 83% respectively. Most of the respondents were satisfied with the method of contraception they use, and majority mentioned ‘Easy to take’ as the reason for using it. 32%(n=152) of the respondents have underlying medical illnesses. 24.5% thought that hormonal contraception is the best. 23.5% choose IUCD as the method of choice. Conclusion: In the first part of the study the incidence of diabetes mellitus and obesity among the women was done. In the second part the study explored the level of knowledge, attitude, and practice, of the sexually active obese women based on their sociodemographic data in the choice of the appropriate contraceptive considering their existing medical conditions and sources of procurement. Majority of obese women used non hormonal contraception and almost half of the rest chose hormonal contraception. A quarter of the respondents claimed that hormonal contraception was the best choice. Many obese women with underlying medical illnesses were on hormonal contraception. It is noted that 32.1% of obese women with underlying medical illness were still on hormonal contraception. The awareness amongst the diabetic and hypertensive respondents on health risk associated with hormonal contraceptive used was noted to be poor, being 38.7% and 42.9% respectively. The use of IUCD as the preferred and appropriate choice for those with medical conditions is very discouraging (less than 3%).

The Contrasting Effects of Education on Fertility over Time Casalguidi, 1819–1960

AbstractEducation has been frequently claimed to shape demographic outcomes. Mortality, fertility, and nuptiality have all been attested to be affected to some extent by education attainment. This article investigates the effects of education on fertility over time in a rural Italian community once controlled for potential confounders. Using individual-level data drawn from various sources, the study analyzes the role of education in shaping reproductive behaviors not only during the demographic transition (1890–1960) but also in the pretransitional period (1819–59). The results highlight the contrasting effects of literacy on fertility, which passed from a positive association in the ancien régime to a negative one in the transitional phase. Educated couples were therefore forerunners in the process of fertility decline because they were not only in the position to be the most pressed to control reproduction but also because they were likely aware of reproductive mechanisms, had the knowledge of more effective birth-control methods, had the economic possibility to get them, and had the necessary capacity to use them.

Comparison of Intrauterine Device Insertion-Related Pain and Ease of Procedure at Different Times During Menstruation.

ObjectiveFear of pain during the copper intrauterine device (Cu-IUD) insertion may lead patients to reject this highly effective birth control method. The aim of this study was to investigate the pain scores associated with IUD insertion and the ease of procedure at different times during menstruation.MethodIn this prospective cohort trial, eligible women received IUD at three-time segments of menstruation: Group I, at 0.5 to 0.69-time segment (n=53); Group II, at 0.7 to 0.89-time segment (n=67); and Group III, at 0.9 to 1-time segment (n=72). The time segments during menstruation were calculated for each participant by dividing the menstrual cycle day of IUD insertion to total number of menses days. The score of pain experienced at different steps of IUD insertion during and five min. after the procedure measured by Wong-Baker FACES Pain Rating Scale (WBS) and the ease of insertion were compared among groups.ResultsThere were significant differences in age (p=0.011) and time since the last delivery (p=0.017). After adjusting for potential confounding factors, the mean WBS score and the ease of insertion were not statistically significant among groups, respectively (p=0.664 and p=0.149). The most painful step was observed as uterine sounding (median, 4 [interquartile range {IQR}, 2]). No significant correlation was observed between WBS scores, the ease of insertion, and main characteristics of the participants.ConclusionThe most painful step of IUD insertion was observed as uterine sounding. IUD insertion-related pain and the ease of procedure do not appear to be different at any time in the second half of menstruation.

Medicaid Expansion Increased Preconception Health Counseling, Folic Acid Intake, And Postpartum Contraception.

The period before pregnancy is critically important for the health of a woman and her infant, yet not all women have access to health insurance during this time. We evaluated whether increased access to health insurance under the Affordable Care Act Medicaid expansions affected ten preconception health indicators, including the prevalence of chronic conditions and health behaviors, birth control use and pregnancy intention, and receipt of preconception health services. By comparing changes in outcomes for low-income women in expansion and nonexpansion states, we document greater preconception health counseling, prepregnancy folic acid intake, and postpartum use of effective birth control methods among low-income women associated with Medicaid expansion. We do not find evidence of changes on the other preconception health indicators examined. Our findings indicate that expanding Medicaid led to detectable improvements on a subset of preconception health measures.

Reasons Why Young Women in the United States Choose Their Contraceptive Method.

Background: Understanding reasons for birth control method choice may inform interventions that help young women choose the best method for them. The purpose of this study was to examine why young women in the general population select their method of contraception. Methods: An online survey was advertised through social media in 2017. After consenting, participants were gated through questions that ensured they were female, within the age range (16-25 years old), lived in the 50 U.S. states, and using intrauterine devices (IUDs), hormonal birth control, or barrier methods specified in the survey. Surveys with incompatible responses were excluded. Satisfaction, plans to discontinue, and primary reason for using current contraceptive method were examined and compared by contraception types using chi-square analyses. Multivariable binary logistic regression was used to examine satisfaction between contraceptive methods and races/ethnicities. Results: A total of 2632 responses were included. A high frequency of women using less effective methods (48.6% of nonhormonal birth control) chose them primarily to prevent pregnancy (20.6% of Copper T IUD, 23.0% of hormonal IUD, and 30.9% of Mirena IUD users), while other more effective birth control methods were often chosen primarily for other reasons. Recommendations from family or friends (14.6%) were used by some to make their contraception decision. Black respondents were less likely and Hispanic respondents were more likely to be satisfied with their birth control compared to white women. Conclusion: Providers should consider that their young patients may want to better understand benefits and side effects of their birth control outside of pregnancy prevention. Furthermore, young women may utilize their friends and family to make their contraceptive choice, which should be taken into consideration when counseling patients.

First-in-Human study of JNJ-55920839 in healthy volunteers and patients with systemic lupus erythematosus: a randomised placebo-controlled phase 1 trial.

Activation of the type I interferon (IFN) pathway is associated with systemic lupus erythematosus (SLE). We assessed the safety and tolerability of JNJ-55920839, a human monoclonal antibody that selectively neutralises most human IFNα subtypes and IFNω, in healthy participants and those with SLE. This was a two-part, first-in-human, phase 1, randomised, double-blind, placebo-controlled, multicentre study of single-ascending intravenous doses of 0·3-15 mg/kg or a single subcutaneous dose of 1 mg/kg JNJ-55920839 administered to healthy participants (part A) and multiple intravenous doses of 10 mg/kg JNJ-55920839 administered to participants with SLE (part B). Healthy men and women (women had to be postmenopausal or surgically sterile) aged 18-55 years; bodyweight of 50-90 kg; and body-mass index (BMI) of 18-30 kg/m2 were eligible for inclusion in part A. Men and women with SLE were recruited to part B, fertile female participants were required to have a negative pregnancy test result before and during the study and be using two highly effective methods of birth control. The inclusion criteria for participants with SLE in part B matched part A, except for bodyweight (40-100 kg). In both parts, participants were randomly assigned (3:1) to receive JNJ-55920839 or placebo; a computer-generated randomisation schedule was used in part A, and randomisation was stratified by racial and ethnic subpopulation and elevated levels of serological disease activity in part B. The primary outcome was evaluation of safety and tolerability of the study regimen assessed using clinical and laboratory tests compared with placebo. This study is registered with ClinicalTrials.gov, NCT02609789. Between Dec 11, 2015, and Sept 20, 2018, 48 healthy participants from a single site and 28 participants with mild-to-moderate SLE from 19 participating centres in seven countries were enrolled in the study. 12 healthy volunteers in part A and eight participants with SLE in part B received placebo. The most common treatment-emergent adverse events in both part A and B were in the system organ class of infections and infestations with a higher percentage of participants administered JNJ-55920839 with infections (ten [28%] of 36 in part A and nine [50%] of 18 in part B) than those exposed to placebo (two [17%] of 12 in part A and one [13%] of eight in part B). Particpants in part B were permitted to continue on defined ongoing standard of care medications. In two participants with SLE, locally disseminated herpes zoster of the skin was reported. No other clinically significant safety or tolerability issues were identified beyond the infections observed in participants treated with JNJ-55920839. JNJ-55920839 was well tolerated and safe. Additional studies are warranted to determine optimal dosing of patients and further explore safety. Janssen.

HUBUNGAN PENGETAHUAN IBU AKSEPTOR KB TENTANG METODE KONTRASEPSI JANGKA PANJANG (MKJP) DENGAN KEIKUTSERTAAN MENJADI AKSEPTOR MKJP DI KELURAHAN NGAL KARIMUN TAHUN 2018

Long-Acting Reversible Contraceptives (LARCs) are the most effective method of birth control for long-term period of time. The IUD, Implant, MOW and MOP are some of the LARCs example. Thi study aims to investigate the correlation of knowledge levels of the female acceptors of Long-Acting Reversible Contraceptives (LARCs) and their participation in becoming LARCs’ acceptors with analytical survey using a cross sectional approach study design. The population of this study was 147 people and further through simple random sampling, 62 respondents were selected as the sample. The research was held from February to July 2018 at Kelurahan Ngal of Karimun. As the data collection instrument, questions were utilized, then the data was analyzed using Chi-Square statistical test. The result of the study concerning the age, education, number of children and type of contraception of the respondents, 38 people (61.3%) have poor knowledge about the LARCs, The active acceptors of LARCs family planning in Kelurahan Ngal is noted to be the lowest participation since only 13 respondents (0.01%), On the other hand, Chi-Square test at significant level of α = 0.05 obtains p value = 0.026 meaning that there is a significant correlation between female acceptors’ knowledge about LARCs and their involvement in becoming active acceptors of LARCs. The Communication, Information, and Education on family planning, whereas, the availability of costs and services and means of transportation were addressed as the problems. Finally, it is hoped for the health workers to be able to improve family planning counseling as well as qualify and trustworthy service to all people, particularly female contraceptive acceptors about the LARCs.

Resumption of postpartum sexual activity and menses among HIV-infected women on lifelong antiretroviral treatment compared to HIV-uninfected women in Africa.

To determine time from delivery to resumption of sexual activity and menses among HIV-infected women on antiretroviral treatment (ART) and HIV-uninfected women. HIV-infected women on ART and HIV-uninfected women were recruited from five health facilities at delivery and followed prospectively for a maximum of 1year in Blantyre, Malawi from January 2016 to September 2017. Sociodemographic, clinical, and laboratory data were collected at delivery and 1.5, 3, 6, 9, and 12months. Descriptive, time to event Kaplan-Meier, and multivariable Cox proportional hazards analyses were conducted. Data on 878 women (460 [52.4%] HIV-uninfected and 418 [47.6%] HIV-infected, P=0.156) who attended at least one follow-up visit were analyzed. Among HIV-uninfected compared to HIV-infected women, respectively, the median number of days to resumption of sexual activity was 180 vs 181; to irregular menses was 82 vs 71; and to regular menses was 245 vs 366. In multivariable models, being married was associated with early resumption of sexual activity (hazard ratio [HR] 1.91, P<0.001), and being HIV-infected and use of an effective method of family planning were associated with later start of regular menses (HR<1.0, P<0.050). Counseling of women on reproductive intentions should start early irrespective of HIV infection or use of ART.

Impact of Social Determinants of Health on the Choice and Use of Long Acting Reversible Contraceptives

Modern women have increased options for birth control with the development of Long Acting Reversible Contraceptives (LARCs). These methods are reliable, easy to use, and require less daily maintenance while providing contraception for an extended period of time. However, despite the surge of LARCs as contraceptive options, the prevalence of unintended pregnancies is still alarmingly high in the United States. As LARCs are the most effective reversible method of birth control at preventing pregnancy, and therefore the potential social, financial, and medical complications associated, we examined whether social determinants of health play a role in LARC usage. While parity and marriage do not seem to affect LARC utilization, increased research is needed to determine the effects of race. Age can affect the type of LARC implemented, as younger women prefer implants to intrauterine devices (IUDs). Insurance coverage was an apparent influencer of LARC usage, as low out-of-pocket costs translate to increased utilization. This is linked to socioeconomic status (SES), as lower SES is associated with decreased access to healthcare in general. Increased research is needed in order to draw conclusions about the effects of education, intimate partner violence, geographic location, and other SDH on LARC usage.

Risk factors for non-compliance in post vasectomy follow up

Vasectomy is regarded as the most effective method of birth control, with over half a million performed annually in the United States. Poor compliance with providing a post vasectomy semen analysis (PVSA) has previously been reported in both the Family Medicine and Urologic literature, with rates ranging from 34-46%. Reasons for poor compliance with PVSA are not well described. Only one prior study was identified that examined socioeconomic factors predictive of non-compliance. We sought to further characterize this population by examining the pre operative characteristics of patients of a large volume vasectomy surgeon that were predictive of failure to provide a PVSA. A retrospective, single institution chart review Records were reviewed from April 2015 to April 2018, which identified 1137 patients who underwent vasectomy by a single surgeon. Patients who underwent vasectomy for non-fertility related reasons were excluded. Other exclusion criteria included requiring in vitro fertilization to conceive prior to the procedure. Patient characteristics analyzed include age, race, marital status, insurance type, and number of children. Univariate and multivariate logistic regression were performed to compare our two cohorts and to assess for factors predictive of post vasectomy compliance. 1,137 patients underwent vasectomy. The average age was 37.5 years. 89.5% and 88.7% of the patients were White/Caucasian and married, respectively. 27.5% of patients did not follow up for PVSA at any interval. Age was similar between patients who did and did not submit a PVSA (37.8 vs 37.3 years). However race, martial status, and insurance did differ, as patients in the no PVSA cohort were more likely to be African American (8.3% vs 3.7%), single (15.3% vs 9.7%) and have Title 19/Medicaid (2.9% vs 1.2%) insurance coverage (all p values <0.05). On multivariate analysis, single relationship status was independently predictive of failing to present for post vasectomy semen analysis (RR 1.86, p = 0.02). Age (RR 1.02, p = 0.08) and increasing number of children (RR 1.11, p =0.09) approached significance. A significant percentage of patients do not provide a PVSA confirming sterility, with single relationship status being most predictive of noncompliance when controlling for all other preoperative variables. As with all vasectomy patients, counseling these patients that they are not sterile until proven with a PVSA is paramount.

Employment Status and Contraceptive Choices of Women With Young Children in Turkey

The childcare burden is one of the main reasons behind the lower employment rate of women in Turkey, and the opportunity cost of childbearing is high for employed women (especially for those in higher-paid jobs). Since using an effective birth control method allows women to control the timing of reproduction, there may be differences in contraception behavior between employed women and women not working for pay. This study analyzes the impact of employment status of women with young children on their contraception behavior using data from the 2013 Turkey Demographic and Health Survey (TDHS). Results show that employed women, including family workers, are more likely to choose a modern method over a traditional one, particularly those working as government employees. Results also indicate that the likelihood of employment can be enhanced by increasing the share of public provision of childcare and preschool services.