Family Planning Center Research Articles

Effect of Oral Contraceptive on some Serum Biochemical Parameters

The present study were aimed to determine the level of some biochemical parameters: (alkaline phosphatase ALP, creatine kinase CK, aspartate aminotranferase AST, urea, total bilirubin, albumin and total protein) in serum of 47 healthy women who took oral contraceptive pills (OCPs) during the period 1 to 3years. Their ages ranged between 20-45 years. They were attending to Al-Khanssa Family Planning Center in Mosul. The study also aimed to compare the results with those of another 30 healthy women who did not use any hormonal contraceptive. They were matched for age and weight with the OCPs user groups. Results obtained in this study showed a significant decrease in the activities of ALP, CK, AST, albumin and total protein, while the uric acid value was significantly increased, and no significant differences in the concentration of urea and total bilirubin in OCPs user group compared to control group.

Genitourinary infection prevalence among women who used an intrauterine device or oral contraceptives

The study aimed at investigating genitourinary infection prevalence among women who used an intrauterine device (IUD) and oral contraceptives (OC) in relation with their socio-demographic characteristics. The study was conducted at the Mother and Child Health and Family Planning center between October 2011 and February 2012 and included 81 women who used IUD, 84 who used OC, and 84 who did not use artificial contraceptive methods (coitus interruptus). It was found that there was a difference between the three groups in terms of urinary system infection (X (2) = 9.85, p = 0.000) and genital infection (X (2) = 8.29, p = 0.001). It was also observed that urinary infection was more common in the OC group, whereas genital infection was more common in the IUD group. In urinary culture, it was seen that Enterobacter species was the most common microorganism among the group who used an IUD, while Escherichia coli was the most common microorganism in the group who used OC and the control. In vaginal cultures, Candida albicans was determined to be the first isolated microorganism among the group who used OC, IUD, and the control. It is believed that the most significant reason for genitourinary infections among women was inadequate hygiene practices rather than use of different contraception methods.

Predictors of Sexually Transmitted Infection in Australian Women: Evidence from the Australian Longitudinal Study on Women’s Health

This longitudinal study examined characteristics of women diagnosed with sexually transmitted infections (STI) for the first time in their later 20s and early 30s. Participants were 6,840 women (born 1973-1978) from the Australian Longitudinal Study on Women's Health. Women aged 18-23 years were surveyed in 1996 (S1), 2000 (S2), 2003 (S3), and 2006 (S4). There were 269 women reporting an STI for the first time at S3 or S4. Using two multivariable logistic regression analyses (examining 18 predictor variables), these 269 women were compared (1) with 306 women who reported an STI at S2 and (2) with 5,214 women who never reported an STI across the four surveys. Women who reported an STI for the first time at S3 or S4 were less likely to have been pregnant or had a recent Pap smear compared to women reporting an STI at S2. Women reporting a first STI at S3 or S4 were less likely to have been pregnant or had a recent Pap smear compared to women reporting an STI at S2. Women were more likely to report an STI for the first time at S3 or S4 compared to women not reporting an STI at any survey if they were younger, unpartnered, had a higher number of sexual partners, had never been pregnant, were recently divorced or separated, and reported poorer access to Women's Health or Family Planning Centres at S2. These findings demonstrate the value of longitudinal studies of sexual health over the life course beyond adolescence.

Evaluation of the Factors Concerning the Unexpected Pregnancy of Women who Applied to the Mother and Child Care and Family Planning Center of Van Province

Introduction: The purpose of this study is to evaluate the experiences of unexpected pregnancy and the related factors of the women who have applied to our center. Material and Method: The study was planned as a descriptive study which enrolled women in the age range of 15-49 on the basis of volunteerism who have applied to the Mother and Child Care and Family Planning Center of Van Province. The participants were administered a survey in which certain situations were questioned, such as age, educational background, age at first labor, income status, number of living children, miscarriage status, unexpected pregnancy status, the presence of trying to undergo an abortion with alternative methods, and the state of receiving consultancy service on pre- and post-pregnancy family planning. Results: The more increased the educational level of 399 women enrolled in the study, the more significant reduction in unexpected pregnancies was detected (P=0.001). When the educational background and the use of alternative methods to have an abortion were compared, the illiterate women were found to use alternative methods (37.6%) at a significantly high ratio (p=0.0001). The average of children number of women with at least one unexpected pregnancy was significantly high (p=0.0001). While the ratio of receiving consultancy on post-pregnancy family planning from health care personnel of the women with unexpected pregnancy was 79.5%, a ratio of 97.9% was detected for the women with planned pregnancy which was significantly different (p=0.0001). Conclusion: The health care personnel may reduce the unexpected pregnancies by training women on family planning in a simple, understandable way and by trying to increase health literacy by taking the dominant social rules in our region into consideration. We consider that the primary healthcare will be more effective and result oriented through newly applied Family Practice in our region. Key Words: Unexpected pregnancy, education, family planning

Breastfeeding experiences of Turkish women

To describe the experiences of Turkish women regarding traditional breastfeeding practices. Breastfeeding is a popular practice in Turkey. Nevertheless, the rate of exclusive breastfeeding in the first six months of life is quite low. Merely about 16% of infants aged between 2-3 months are exclusively breastfed, whereas those fed with supplementary foods are 78%. In the light of this data, we argue that traditional breastfeeding practices may be the underlying reason for low rate of breastfeeding. Significant as it is, however, this subject matter has largely been overlooked in the literature in Turkey. A descriptive, qualitative study based on in-depth interviews, with a purposive sample of 24 mothers of four to- 24-month-old babies. The background information of the mothers was obtained from the Mother and Child Health and Family Planning Centre that offers specific services for mothers. Mothers were visited at home and data were gathered through semistructured and in-depth, audio-taped interviews. The collected data were analysed using the content analysis method. Three themes emerged from the participants' descriptions of their breastfeeding experiences: (1) influence of the older family members, (2) influence of social learning and (3) influence of the religion. This study concluded that traditional breastfeeding practices are still prevalent among mothers, regardless of their age and level of education. Breastfeeding behaviour of mothers was mostly shaped by various cultural social and religious influences imposed on them by their family, close social network and religious community. Nurses can encourage mothers for exclusive breastfeeding by means of individual- and social-based training programmes, which they will prepare in view of traditional breastfeeding practices.

Investigation of ultrasound screening efficiency for neural tube defects during pregnancy in rural areas of China

To understand the uptake and efficacy of ultrasound screening for neural tube defects (NTDs) during pregnancy, and the outcomes when NTDs were detected in rural areas of China. Prevalence study. Four hundred and twenty-four women who delivered or gestated babies/fetuses with NTDs were selected at random in 20 counties of two provinces of China from March 2008 to January 2009. The uptake of ultrasound screening, NTD detection rate and termination of pregnancy (TOP) rate were calculated and analyzed. Generalized estimating equations were employed to control for potential confounding factors. The uptake of ultrasound screening was 98.8%. Among the study subjects, 361 (85.1%) NTDs were detected and 63 (14.9%) were not detected by prenatal ultrasound screening. The total detection rate was 43.3% (15.6%, 49.6% and 52.2% in the first, second and third trimesters, respectively; P<0.05). Taking the possibility of NTD detection in the first trimester as 1.0, the possibilities in the second and third trimesters were 10.9 [95% confidence interval (CI) 6.5-18.3] and 25.2 (95% CI 13.3-47.6), respectively. The detection rate at the township health centres (THCs), family planning centres (FPCs), maternal and child care service centres (MCSCs) and hospitals was 24.5%, 29.1%, 53.6% and 78.1%, respectively (P<0.05). Taking the possibility of NTD detection at THCs as 1.0, the possibilities at FPCs, MCSCs and hospitals were 0.9 (95% CI 0.5-1.6), 3.4 (95% CI 1.9-6.1) and 2.1 (95% CI 1.3-3.4), respectively. Three hundred and fifty-five (98.3%) of the 361 NTDs detected at prenatal ultrasound screening ended in TOP. The uptake of ultrasound screening was satisfactory, but the NTD detection rate was low. Ultrasound screening did not play its full role in the secondary prevention of NTDs in the study areas. Medical institutions in rural areas in China need to improve their ultrasound screening skills in order to increase the efficacy of NTD control.

No effect of Implanon® on inflammatory cardiovascular parameters

Objective. Recently, we found decreased levels of C-reactive protein (CRP) during use of the low-dosed contraceptive implant Implanon®. To further elucidate, whether this finding might be a sign for a lower inflammatory reaction and is associated with changes in levels of other cytokines, we investigated the effect of this implant on interleukin-6 (IL-6) and adiponectin. Plasma lipids and sex hormone levels have been shown to interact with the investigated parameters in vivo and in vitro. Therefore these parameters were measured as well.Design. Prospective case–control study.Setting. Family-planning centre, University hospital.Subjects. Thirty-six non-smoking women with regular cycles.Interventions. Blood samples for the measurements were taken in the early follicular phase of the cycle in both groups. A second sample was taken 12 weeks after Implanon insertion or in the controls during the early follicular phase of cycle 4.Results. Implanon did not cause significant changes in IL-6, adiponectin or lipoprotein (Lp)(a). At baseline, there was a significant positive correlation between IL-6 and CRP and a negative correlation between adiponectin and CRP.Conclusion. We did not observe a negative impact of Implanon on risk markers for atherosclerotic disease such as IL-6, adiponectin, and Lp(a). These data are reassuring for clinicians who prescribe progestagen-only preparations as first choice contraceptives in females with cardiovascular risk factors.

Van Mother-Child Health and Family Planning Center Pap Smear Clinics of Information, Evaluation of Applicants

Objective: In this study of women admitted to our center with information on pap smear test, to evaluate the attitudes and behavior. Materials and Methods: This descriptive study of Van Mother-Child Health and Family Planning Center on a voluntary basis, women aged 15-49 were admitted to the control. The education level of participants, age at first marriage, before the presence of vaginal infection, the story, and motivations pap smear level of information availability, and a family history of cancer, administered a questionnaire asking the state to have a regular income. Results: The study included 362 women with age and hear the pap smear test was significantly increased (p = 0.01). Working women and pap smear level of knowledge (p = 0.04) and pap smears than women not working for International rates significantly higher (p = 0.02). Treatment of vaginal infection at least once before to get there was a significant relationship between the pap smear motivations (p>0.05). Family history of gynecologic cancer or non-gynecologic cancer smears have significantly increased the level of motivations (p = 0.0001). Pap smear information, regular the economic income of those levels, significantly higher than those without regular income (p = 0.0001). Conclusion: We serve the region, with low socio-economic characteristics that are considered, gynecological examination by health workers or women from the home visits, pap smear test for what purpose and how often you get the work done and the importance of explaining and giving more space to this issue suggest that the written and visual media. Keywords: Pap smears, health care, education

Assessment of Patients that Request Prescription by Primary Care Physicians\ Views

Objective: In this study it was aimed to assess the request of patients that admitted for prescription and to determine the situation regarding to the effect of present health system on primary care services. Materials and Methods: Patients admitted to Van Mother-Child Health and Family Planning center for prescription in 5 workdays between 1 and 8 February 2010 were included into the cross-sectional study. A questionnaire was performed to the participants, including information about the health insurance, residence, time to come to the last control of the patient that request prescription, by whom and when the medication was recommended, demand of health insurance abuse, number of medications, whether information about the medication prescribed was given by the physician or not. Results: A total of 441 participants, 41.5’% of them were admitted for prescription of their own medications, 45.8% for prescription of their first-degree relatives’ medication. The 79.4% of them were from urban, 20.6% from rural areas, and 58.5% of them were examined at secondary care unit, 32% at private hospitals. Health insurance of patients whose medications were prescribed at the last three days was green card with a rate of 86.5%. The 65.3% of medications requested were Rx drugs, 34.7% were over the counter. The 15.6% of the participants requested the medication to be prescribed over the health insurance of the people other than the patient that use medication. The 68.4% of participants that requested Rx drugs were informed by the physician. A significant association was found with those who requested Rx drugs and over the counter drugs regarding to be informed about medications (p=0.0001). Conclusion: The low socioeconomic level and education level, society and the multiplicity of health problems in our region, increase the burden on health care facilities especially on primary care units

Assessing Mandated Breastfeeding Education in Istanbul

To assess the implementation of a breastfeeding education program for women in Istanbul against the backdrop of the relevant policies adopted by the country of Turkey. Descriptive and cross-sectional survey of mothers of 801 infants, ages 0 to 12 months, who presented at the vaccination and neonatal follow-up unit of the Yenibosna Mother and Child Health and Family Planning Center in Istanbul. Mothers were interviewed using a questionnaire developed by the investigators. Frequency distributions and chi-square analyses were used for the data. Forty-six percent of the women in the sample had received breastfeeding education either when they gave birth or right afterward; 63.8% had initiated breastfeeding in the first hour after birth. The rate of exclusive breastfeeding was 81.1% in the first month, 51.5% in the fourth month, 19.8% in the sixth month, and 1% in the twelfth month. The average duration of exclusive breastfeeding was 3.45 months (+/-2.1). Introduction to a supplementary food started at an average of 4.4 months (+/-2.1), usually with tea, water, fruit juice, or yogurt. Despite a government mandate to educate every new mother about the advantages of breastfeeding, less than one-half of the women in this study actually reported receiving the education. Nurses who work with pregnant and postpartum women can use this study to help guide implementation of interventions to increase breastfeeding programs. It is clear that more effort needs to go into teaching women not only about initiating breastfeeding, but also about exclusive breastfeeding until at least 6 months of age.

Views of Women about Domestic Violence against Women: Turkish Sample

The study was conducted for the purpose of determining views of women about domestic violence against woman. The research sample was composed of 1524 women. The samples were identified using the files of Number One Yenimahalle Mother-Child Health and Family Planning Center. The data were collected through the interviews with the subjects. According to the research, the most common type of violence stated by the participants is physical violence. Employment status of the subjects is found to have partial effects on their views. Regarding the reasons for domestic violence against women, the view of the participants is. “alcohol and/or substance abuse by husband”. The participants mostly state that the necessary action to avoid violence against women is to educate both women and men.

Screening for Chlamydia trachomatis in secondary schools, family planning and occupational health centres in Luxembourg

Background:We conducted a prospective pilot screening study in three settings in Luxembourg where routine urine testing is carried out independently for other purposes with a short sexual behaviour questionnaire to...

Evaluation of the birthweight values of newborns presenting at the Mother–Child Health and Family Planning Center in Yenibosna, Istanbul, Turkey

This study was conducted to examine the effect of a number of variables related to the mother (age, educational level, employment status, cigarette smoking during pregnancy) and to the baby (sex and birth order) on newborns' birthweight. The research was carried out in the province of Istanbul, one of Turkey's large metropolises, at the Mother-Child Health and Family Planning Center in the district of Yenibosna, where 0-1 month old infants had been brought in for phenylketonuria screening and vaccinations. The mean age of the mothers was 26.1 +/- 4.8 years and the mean birthweight of the newborns was 3236.7 +/- 542.2 g. Of the infants, 6.3% were classified as having a low birthweight and 8.3% were large infants. The mean birthweight showed a statistical significance depending upon the infants' sex and birth order. The mean birthweight of the infants of the working mothers, as opposed to the unemployed mothers and the mothers in nuclear families, as opposed to the mothers in extended families, was higher.

The Prevalence and Causes of Sexual Problems among Premenopausal Turkish Women

Sexual dysfunction in females is an important public health problem worldwide. It is suggested that sexual problems among women are more common than the number of diagnosed female sexual dysfunction (FSD) cases indicates. To determine the frequency and causes of sexual problems among premenopausal and married women who attend primary healthcare facilities. This study was conducted at the Mother and Child Health and Family Planning Center. All women who attended this center during a 3-month period were included in the study. Sexual problems were evaluated via questionnaire and a standardized scale known as the Golombok Rust Inventory of Sexual Satisfaction (GRISS). MAIN OUTCOME MEASURE. A cross-sectional study. Although a total of 422 women aged 19-51 years were eligible for inclusion in the study, the participation rate was 27%. Nearly two-thirds of the women were aged 20-34 years, and of this group, 84.3% were unemployed. According to self-reports, 15.7% (18) of the women had sexual problems, whereas the prevalence of sexual dysfunction using GRISS was 26.1%. Vaginismus (41.7%), infrequent intercourse (39.1%), and nonsensuality (38.3%) were the most common complaints of the women with sexual problems. The rate of sexual dissatisfaction was found to be 7%. Sexual problems among women who had a long-term marriage (more than 11 years) and who were sexually inexperienced at the time of their marriage were significantly higher (P = 0.036, P = 0.034, respectively). It was found that discussing sexual problems with husbands and healthcare professionals did not reduce sexual problems. According to GRISS, nearly one-quarter of the women were suffering from sexual problems. The most common sexual problem was vaginismus, followed by infrequent intercourse. It is suggested that inadequate knowledge and the attitudes of spouses and health workers in primary healthcare settings are the important causes of FSD in this population.

Sexual behaviour and contraception in people under the age of 20 in Alicante, Spain

Objective To describe and to analyse the relationship between patterns of sexually-risky behaviour and emergency contraception among young females attending a Family Planning Centre (FPC).Methods Data was obtained from a systematic analysis of 384 health records.Results Mean age of the sample subjects was 18.24 years (SD 1.47, range 13–20). Of these, 92% were single, 60% students and 83% were with the same partner. Age at first intercourse was 16.5 years (SD 1.52, range 11–20). Those who used condoms systematically totalled 72%. Mean number of sexual partners was 1.85 (SD 2.91, range 1–50). A total of 9% had become pregnant and 2% had had an abortion. Emergency contraception was resorted to by 26% of the young women on at least one occasion. Emergency contraception was related to younger age at first sexual intercourse (p < 0.001) and to a great number of partners (p = 0.011). Of the total number of subjects, 48.4% demonstrated sexually-risky behaviour. This behaviour was related to alcohol consumption (p < 0.0001) and to the existence of dysfunction (p < 0.001).Conclusions Spanish youngsters have enough knowledge regarding contraception. Condoms are mostly used on the occasion of a first sexual intercourse. However, the frequency of sexually-risky behaviour is still high due to the limited use of condoms in successive sexual relations with the same partner. Sexually-risky behaviour is also related to a high number of partners and to alcohol consumption on weekends.

Long-Term Progestin-Only Contraceptives Result in Reduced Endometrial Blood Flow and Oxidative Stress

Because of their safety and efficacy, long-term progestin-only contraceptives (LTPOCs) are well-suited for women with restricted access to health care. However, abnormal uterine bleeding (AUB) causes half of all users to discontinue therapy within 12 months. Endometria of LTPOC-treated patients display aberrant angiogenesis with abnormally enlarged, thin-walled, fragile blood vessels, inflammation, and focal hemorrhage. In this study, similar effects were observed with a new third-generation implantable LTPOC. We hypothesized that LTPOC reduces uterine and endometrial blood flow, leading to hypoxia/reperfusion, which triggers the generation of reactive oxygen species. The latter induce aberrant angiogenesis, causing AUB. Endometrial perfusion was measured by laser-Doppler fluxmetry in women requesting LTPOCs. Endometrial biopsies were obtained for in vivo and in vitro experiments. The study was conducted in the Yale University School of Medicine and Family-Planning Center in Western Australia. Seven women 18 yr or older requesting implantable LTPOCs were recruited in Western Australia. Women received etonorgestrel implants. LTPOC treatment resulted in reduced endometrial perfusion and increased endometrial oxidative damage. We propose that LTPOCs result in hypoxia reperfusion, which leads to aberrant angiogenesis resulting in AUB.

The evaluation of family planning services given in Erzurum mother–child health and family planning centerin Eastern Turkey

Objectives This study was done on women who attended to Mother–Child Health and Family Planning (MCH-FP) center asking for FP services or materials. Data were collected about their opinion of the services and about the performance of the service itself.Methods This is a descriptive and cross-sectional study composed of 235 women.Results In Family Planning, counseling was done by midwifes in 67.3%, by nurses in 26.6%, and only 4.5% by doctors. Proper hygienic conditions were confirmed by 89% of the women, about the equipment the percentage was 91%. Privacy was taken care of properly in 95.5% of the cases. The quality of service with regard to waiting was expressed as not waiting at all in 22.6%, and 76.6% found free seats while waiting. The cleanliness of the waiting hall was appreciated by 97.4%. In general 95.7% of the attendants appreciated the kindliness of the staff.Conclusions This study reveals that the performances of the MCH-FP service are well appreciated by the public.

Change in contraceptive choices and the effect of education on use of contraception at the family planning clinic of Şişli Etfal Training and Research Hospital, Istanbul, Turkey

Objective To investigate change in contraceptive use and the effect of education on fertility and contraceptive attitudes at our family planning clinic.Methods For this retrospective review, medical charts from Şişli Etfal Training and Research Hospital Family Planning Center were obtained. Records were evaluated for 2514 women in 1997 and 2268 women in 2002.Results During the 6-year period studied, significant decreases occurred in the number of births, elective abortions, gravidity and number of living children (p < 0.001). When the patterns of method use were compared, use of intrauterine devices and of coitus interruptus diminished whereas pill and condom use increased. Parallel with the rise in educational level, intrauterine device use declined whereas pill and condom use rose significantly (p < 0.001).Conclusion The sociocultural and educational levels of women affect their contraceptive choices. Policies aimed at raising the socioeconomic and educational level of women should be supported to prevent maternal and fetal complications as a result of unwanted pregnancies.

Chlamydia trachomatis infections in Greece: first prevalence study using nucleic acid amplification tests

The present retrospective study was initiated to determine the prevalence of Chlamydia trachomatis and to assess the risk factors for infection in adult women and men presenting to general practitioners, gynecologists, dermatologists, and family-planning centers in Greece. The study was carried out in four different Greek hospital centers using highly sensitive nucleic acid amplification techniques. Altogether, 16,834 women and 1,035 men were enrolled from October 1998 to April 2004. Two types of specimens were collected from each patient: cervical swabs from women, urethral swabs from men, and first-catch urine from women and men. All specimens were examined with the Cobas Amplicor C. trachomatis polymerase chain reaction assay (Roche Molecular Systems, Branchburg, NJ, USA) or the LC x C. trachomatis ligase chain reaction assay (Abbott Laboratories, Abbott Park, IL, USA). Demographic and behavioral data were collected by clinicians using a standardized questionnaire. A total of 704 (3.9%) patients were infected with C. trachomatis. The prevalence among female patients was 3.5% and that among male patients 11.2%. Among infected patients, 88% were under 30 years of age, 71% reported more than one sexual partner, and 91% reported a new sexual partner within the last year. In conclusion, the prevalence of C. trachomatis infection in Greece is low. Young age and new and multiple sexual partners within the last year were factors consistently associated with an increased risk of chlamydial infection.

What do midwives and nurses in Turkey know about nutrition in the first six months of life

to discover what midwives and nurses in Turkey know and advise about nutrition in the first 6 months of life. a descriptive, cross-sectional study. health clinics and mother and baby health and family planning centres in the municipality of Ankara. 301 midwives and nurses selected by stratified, random sampling. nine questions related to the features and benefits of breast milk. The mean number of questions answered correctly was 7.55 (standard deviation [SD]=1.25). Participants agreed that the babies should be breast fed for the first 6 months of life (n=184; 61.1%) and that complementary food could be introduced at 6 months of age (n=291; 96.7%). Most participants (n=223; 74.1%) recommended that mothers who have to resume work should express and store breast milk, and their babies should be fed with it. Many participants noted that there may be one or more situations when artificial milk should be given in the first 6 months of life (n=286; 95.0%). Almost all of the participants (n=292; 97.0%) gave one or more suggestions of when breast milk was sufficient or insufficient. most midwives and nurses in this research had adequate knowledge related to babies in the first 6 months of life. However, with continuing education, knowledge deficits can be corrected, and awareness of their roles and responsibilities can be increased in achieving one of Turkey's priority goals for the 21st Century, that of decreasing the baby death rate.