Contraceptive Practices Research Articles

CONTRACEPTION KNOWLEDGE AND PRACTICES AMONG FEMALES PRESENTED WITH CARDIAC DISEASES AT GULAB DEVI HOSPITAL LAHORE

Objective: To assess the knowledge and practices of contraception in females presented with cardiac disease.Methodology: This cross sectional study was conducted at obstetrics and gynaecology department, Gulab Devi Hospital, Lahore. A total of 246 consecutive female subjects referred to gynaecology and obstetrics ward by cardiology department were enrolled. Informed consent was taken and confidentiality was ensured. The cardiac disease of the respondent was noted and a detailed obstetric history, number of previous pregnancies, date of last child born and last menstrual period (LMP) was taken. Knowledge and practices of contraception was gathered through a structured questionnaire. Data were entered and analyzed by SPSS version 20.0. Categorical data were presented in the form of frequencies and percentages & presented through graphs while mean+SD was computed for quantitative data.Results: The mean age of the study participants was 28±6.7 years. Majority of the study participants (48.7%) were from to the age group of 20-30 years. Regarding parity, 60 (24.3%) women had 01 child, 68 (27.6%) had 2 children, 65(26.4%) had 3 children and 53(21.5%) had 4 or more children. Regarding knowledge of contraception 110 (44.7%) females had no knowledge, 80 (32.5%) had partial knowledge and 56 (22.7%) had full knowledge about contraception. Out of 246 females only 92 (37.39%) had ever practiced contraception. Barrier method (Condoms) was the most common method reported by females that ever practiced contraception followed by surgical tubal ligation and intrauterine device.Conclusion: Females with cardiac diseases should be treated by a group of experienced obstetrician, cardiologist, general physician and health care providers; each patient needs individual counselling regarding her family size to attain proper spacing between two children or as a continuous contraceptive method. If possible their cardiac disease should be treated before getting pregnant.Key Words: Contraception, Cardiac Diseases, Reproductive Health, Maternal Health

Contraceptive Uptake After Obstetric Anal Sphincter Injuries (OASIS): A 5-Year Retrospective Review [08J

INTRODUCTION: OASIS is a complication of vaginal delivery. Although recurrence rates are low, women often feel apprehensive regarding subsequent births, with some wishing to delay future pregnancy. We aimed to evaluate contraceptive practices and interpregnancy interval of women who sustained OASIS. METHODS: We conducted a retrospective chart review of women who sustained OASIS from 2012–2017. We selected women who delivered during the same time period without OASIS as controls. We abstracted relevant demographic characteristics, delivery data, and documented postpartum contraceptive choice provided. We performed our analysis using independent two-sample t-test and chi-square test for unadjusted analyses and multivariable logistic regression for adjusted analyses, with alpha<0.05. RESULTS: We included 314 women with OASIS and 297 without as controls. Women who experienced OASIS were more likely to be nulliparous, have an assisted vaginal delivery, and experience a wound complication. There were similar rates of postpartum contraceptive uptake in both groups (82% vs 84%, P=.58). Greater than 50% of women in each cohort chose hormonal or long-acting contraceptives, with the majority choosing long-acting methods. Our multivariable regression showed no difference in method choice between groups. Of women with OASIS who had a subsequent delivery, 14% chose elective Cesarean section and the OASIS recurrence rate was 6%. Average interpregnancy interval was no different between cohorts (19.6 vs 20.7 months, P=.53). CONCLUSION: Although there were no significant differences in contraception uptake or type used in women who experienced OASIS, overall hormonal and long-acting contraception uptake was high. Experiencing OASIS does not appear to affect interpregnancy interval.

Influence of Sociodemographic Factors on the Utilization of Contraceptive Methods Among the Married Women of Jowai Town, West Jaintia Hills District, Meghalaya

Family planning refers to the practices that help individuals or couples avoid unwanted births, regulate the intervals between pregnancies, and determine the number of children in the family. The present study was undertaken to know the extent of knowledge, attitude, and adoption of family planning methods among the married women of Jowai town, West Jaintia Hills District, Meghalaya. An attempt has also been made to find out the sociodemographic factors influencing the use of contraceptive methods among the studied population. The information on awareness as well as the use of contraceptives was collected from 719 married women of the reproductive age group 15–49 years using a structured scheduled. Among the women in Jowai town, the knowledge of family planning methods is widespread. In addition, a majority of the women have a favorable attitude towards family planning. However, there exists a gap between the knowledge and the practice of contraceptive methods among the women of Jowai town. Ingesting an oral contraceptive pill is the most preferred contraceptive method among the women. Contraceptive use among women is seen to be positively correlated with educational level and income (significant at p < 0.01), and negatively correlated with current age, age at marriage, number of live births, and family type (significant at p < 0.01). Bivariate analysis substantiates the role of women’s education, household income, current age, age at marriage, number of live births, and family type in influencing the utilization of contraceptive methods.

Contraceptive Attitudes and beliefs Among Hmong Young Adults

Introduction: While different contraceptive attitudes have been reported among different ethnic groups inthe US, little if any research has been conducted to understand the reproductive health needs and attitudesamong Hmong young adults. To our knowledge, this is the first study to investigate the relationship amongcontraceptive perception of this community. Objective: The purpose of this research was to identify attitudesthat influence Hmong college students’ contraceptive practices. Methods: A campus-wide online survey wasused as part of the data collection at a midsize institution in Central California. The questionnaire was a 32-items scale instrument called Contraceptive Attitude Scale (CAS), developed by Dr. Black. Results: Three hundred and forty-four students successfully completed the 32-items scale instrument CAS, which measured general contraceptive attitudes among Hmong young adults in rural California. The data reveals a high prevalence of unmarried (85%) Hmong college students reporting being sexually active (67%), with 62% having at least one sexual partner over the past 12 months; however, only 36% reported to use condom compared to 58% who did not use condoms during the last time of sexual intercourse. Conclusion: The findings indicated statistically significant differences between groups on the characteristics of sexual partners, contraceptive methods, marital status, birthplace, primary language spoken at home, years spent in college and years lived in the United States. The findings greatly contribute to the understanding of factors that influence contraceptive choices among the Hmong college population. More importantly, the information is crucial in designing programs to promote contraceptive knowledge and practices that are specific to the Hmong.

Reasons women terminate their pregnancies legally and their contraceptive practices at Soshanguve 3 Community Health Centre, Tshwane district, South Africa.

BackgroundVarious reasons have been cited in studies conducted in South Africa on why women legally terminate their pregnancies. We sought to determine the reasons for women to terminate their pregnancies legally and their contraceptive practices. This study was conducted at Soshanguve 3 Community Health Centre (CHC), located in a semi-rural zone in the north-west of Pretoria, Gauteng province of South Africa.MethodA cross-sectional study design was adopted in this study.ResultsOf the 250 respondents, high participation (23.2%) was noted amongst women aged 18–20 years. Eighty-three (33.2%) respondents did not have children, 108 (43.2%) had completed their secondary school education and 226 (90.4%) were Christian. Of the participants, 80% were single and 62.8% were unemployed. About 85.6% (214) of respondents had not had a previous abortion. A total of 24% of respondents requested abortion because they wanted to focus on their education, while 23.1% were not ready to be parents and 21.7% experienced financial difficulties. With regard to practice, all respondents had already used contraception and the most used contraceptive was the male condom (43.5%), followed by an injectable contraceptive (7.1%).ConclusionWhile academic reasons, not being ready to be a parent and financial difficulties were named as the main reasons for terminating a pregnancy legally, the selected pregnant women at Soshanguve 3 CHC demonstrated an unsatisfactory practice of contraceptive measures.

Análisis del comportamiento diferencial de la práctica anticonceptiva por sexo, origen social y educación en la población urbana de México

En un contexto marcado por un pronunciado descenso de la fecundidad y una extensa difusión de la anticoncepción, como el mexicano, buscamos detectar comportamientos innovadores en el comienzo de la práctica anticonceptiva que podrían cuestionar la tradicional vinculación entre sexualidad, unión y procreación entre la población urbana. Para ello, estudiamos la temporalidad del comienzo de la práctica anticonceptiva en relación con la entrada en unión y el nacimiento de los hijos en la experiencia de hombres y mujeres de tres generaciones y tres estratos sociales. Con los datos de la Encuesta Demográfica Retrospectiva (EDER) de 2011 realizamos diversos análisis demográficos y estadísticos, con los cuales logramos detectar algunos cambios.

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A systematic review of the views of healthcare professionals on the provision of long-acting reversible contraception.

What are the views of healthcare professionals outside of the general practice setting on long-acting reversible contraception? Despite global sexual health organisations advocating for widespread prescription of long-acting reversible contraception, uptake in developed countries remains relatively low. The role of healthcare professionals outside of the general practice setting in long-acting reversible contraception provision requires further attention. Systematic review. Five electronic databases were searched for existing qualitative findings using terms related to long-acting reversible contraception and healthcare professional views for the period 2013-2018. A rigorous protocol was applied following the Preferred Reporting Items for Systematic Meta-Analyses checklist and flow diagram. The Critical Appraisal Skills Programme tool was used to assess the quality of studies. A total of six studies were included for thematic analysis. Three key themes emerged through analysis that had significant impact on healthcare professional views of long-acting reversible contraception: (a) contraceptive counselling practices and constraints; (b) knowledge and training about long-acting reversible contraception; and (c) concerns and personal beliefs about long-acting reversible contraception. Healthcare professional views on long-acting reversible contraception are shaped by practical time constraints, levels of knowledge and training, and personal beliefs and concerns. Further research is required to address these issues in order to improve clinical training and guidelines for all settings, not just general practice. Settings outside of general practice need to be included within the scope of initiatives that aim to improve clinical practice around access to new and emerging contraceptive methods. Further research could inform models of clinical practice that enable healthcare professionals to take enough time to talk through all contraceptive options with patients in a way that both focuses on their individual needs and is fully informed by up-to-date evidence and training.

A study on contraceptive use among women attending immunization clinic at McGann teaching hospital, Shimoga

Background: India is the first country to implement National family planning programme in 1952. Use of contraceptives can prevent at least 25% of all maternal deaths by allowing women to prevent unintended pregnancies and unsafe abortions, and protect themselves from sexually transmitting diseases. Even though there is wide availability of various types of contraceptives, the rate of population growth and unplanned pregnancies is still high. The acceptance and knowledge of contraceptive methods varies within the societies and factors responsible operate at the individual, family and community level.Methods: A hospital based, cross-sectional study was conducted during August 2018 at McGann Hospital, Shimoga. The study sample included 200 women in the age group of 20 to 40 years attending immunization clinic with their children. Informed consent was taken from the subjects after explaining the purpose of the study to them. A pre-tested, semi-structured questionnaire was used to collect data by face-to-face interview of the study participants.Results: Out of 200 women 51% were aged between 20 to 24 years of age. Majority (72%) were Hindus. 67.5% were currently using contraception. Among acceptors of family planning 42.3% had undergone tubectomy. OCP was the most commonly used temporary method of contraception. Age of the woman, religion, education, husband’s education and number of children were found to be significantly associated with contraceptive usage.Conclusions: Factors influencing fertility and contraceptive practices should be properly assessed and addressed. Newly married couples should be motivated for accepting spacing methods.

Partner Discussion as a Mediator of the Effects of Mass Media Exposure to FP on Contraceptive Use among Young Nigerians: Evidence from 3 Urban Cities

Evidence suggests that despite high knowledge of family planning (FP), unwanted pregnancies and birth rates remain high among young Nigerians. There is a critical gap in understanding the nexus between exposure to FP information and contraception practices among this population. This study aimed to fill this gap and tested a pathway of the impact of media exposure to FP messages on modern contraceptive use. Data came from a 2018 cross-sectional baseline survey of young people aged 15–24 in three urban centers in Nigeria – Lagos, Kaduna, and Kano. This was part of an impact evaluation of a television-based drama designed to improve contraceptive use among young individuals. The study was limited to 777 young men and women who were sexually active. We found evidence of the mediation effect of media exposure to FP messages on partner discussion about FP, which in turn was associated with an increased likelihood of modern contraceptive use. Contraceptive self-efficacy also had positive associations with contraception. Our study elucidated a potential pathway through which media communication programs can significantly contribute to increased modern contraceptive use and underlined the importance of providing young people in Nigeria with opportunities to learn and practice obtaining and using contraception.

Knowledge, attitude and practice of post abortion contraception among MTP Seekers in a tertiary care hospital of North India

Introduction: Medical termination of pregnancy (MTP), despite legalization, is a greatly neglected health care problem of women in their reproductive age group and is not free from complications. Therefore, the present study was undertaken to study the factors influencing MTPs & the subsequent adoption of contraceptive methods following MTP. Materials and Methods: This cross-sectional study was conducted over one year and included 148 women who underwent MTP at the hospital. The details regarding their socio-demographic profile, reason for seeking abortion and acceptance of post abortal contraception were taken and analyzed by SPSS software. Results: Majority of women (93.92%) were aware of the various contraceptive methods available and awareness was maximum for condom (87.16%). The main source of information was television (76.35%). 85.81% women had no knowledge about emergency contraception. 89.20% patients came early for termination of pregnancy below 8 weeks. Completed family was the most common reason (62.84%). Post abortion contraception was accepted by 92.56% women. IUCD was the most preferred choice (51.35%). Decision regarding contraception was taken by both husband and wife in 45.95% cases. Conclusions: There is need to counsel women of reproductive age group that MTP is not a way to control unwanted birth and it is not free from risk. Eligible couples have to be educated regarding the availability of different methods of contraception and their proper use to avoid pregnancy. Keywords: Medical termination of pregnancy, MTP seekers, Socio demographic profile, Post abortion contraception, Emergency contraception, Eligible couples.

Contraceptive Knowledge and Practices of Undergraduate Female Students at Makerere University, Uganda

A study of contraceptive knowledge and practices of female Makerere University students shows that awareness of contraceptive methods did not translate into practice. Only about one-half of the students currently used contraceptives, mostly oral contraceptives (21.4%) and the male condom (26.4%). A third (30.2%) knew about long-term reversible contraception methods (LARCs) but only 13.4% used them. Staying in hostels outside campus is associated with 1.28 odds of using contraceptives compared to those who stayed in other residences. Sexual reproductive health education and other behavior-change interventions are urgently needed to deliver correct contraceptive information and increase their uptake by students.

Locus of control, knowledge, attitude and practice for contraception among adolescents.

to assess the relation of the locus of control with the adolescents' knowledge, attitude and practice (KAP). this is a cross-sectional study with 1,192 high school students. Data were collected using the KAP questionnaire and the Levenson locus of control scale and analyzed by descriptive statistics, Mann-Whitney U test and Kruskal-Wallis H test. Women presented higher Externality Powerful Others locus of control than man (p=0.0015) and adolescents over 17, higher Externality Chance locus of control (p=<0.0001). Students who used contraceptive methods at the first contraceptive method had higher Externality Powerful Others (p=0.0107) and those who used coitus interruptus, had higher Externality Chance (p=0.0013). Internality was inversely proportional to the practice in relation to the dimensions of the locus of control. The dimensions of the locus of control were related to some contraceptive practices, but little or no relation to knowledge and attitude.

A study of knowledge, attitude, and practice of contraception among nursing staff in All India Institute of Medical Sciences, Jodhpur, Rajasthan.

Objective:Despite the increase in contraceptive usage over the years, there still exists a gap in the knowledge, attitude, and practices regarding contraception. The study has been designed to assess the knowledge, attitude, practice, and preferences on contraceptive methods among the nursing staff, to determine the association between knowledge and attitude on contraceptive methods with the variables.Materials and Methods:A cross-sectional descriptive study of 173 nursing staff using a structured questionnaire on knowledge, attitude scale, and practice and preference were done at AIIMS, Jodhpur during June 2018 to August 2019.Results:It was observed that 82.6% were of 21–30 years of age, 86.7% were Hindus, 67% were from the nuclear family, 41% were married between 19 and 25 years, 86.7% were nulliparous, 75.7% had access to various contraceptives through health workers, 79.8% got information through media. 73.4% were willing to use postpartum contraception. In our study, a major reason for 80.9% to use family planning was to prevent unintended pregnancies. Majority 71% had the favorable attitude and 14.4% had an unfavorable attitude toward contraceptive methods. In this study, 64.1% preferred male condom as Rank 1, intrauterine device 57.8% as Rank 2, and Lactational Amenorrhea Method 58.3% as Rank 3 for postpartum contraception. There was an association between the practice of family planning and marital status, age, and family size.Conclusions:The study showed that the majority of the females nursing staff had moderate knowledge and favorable attitude toward contraception use.

Differences in contraceptive practice in the city of São Paulo, Brazil: results of the Ouvindo Mulheres population survey

Contraception is essential for women to be able to regulate their fertility, exercising a key dimension of reproductive rights. However, little is known about how women deal with this challenge in Brazil's largest city, São Paulo. To fill this gap, the population survey Ouvindo Mulheres: Contracepção no Município de São Paulo was conducted with a probabilistic sample of 4,000 women 15 to 44 years of age living in this city in 2015. This article presents the prevalence of contraceptive practice and analyzes factors associated with lack of contraception use and with types of contraceptives. Prevalence of contraception was estimated for women with at least one heterosexual relation in the 12 months prior to the interview and who were not pregnant. Logistic regression was used to verify factors associated with lack of contraception use, and the CHAID model was used to identify associations with the types of contraceptives used. Prevalence of contraception was 84.8% (95%CI: 83.2-86.3). The most prevalent contraceptives were the pill and condoms. Factors associated with lack of contraceptive use were religion (Pentecostal), number of children (fewer than 3), not having used contraceptives in the first sexual relation, not having a partner, and not having had sex in the previous month. Number of children and woman's age were the first two levels of discrimination of the types of contraceptives used. Prevalence of contraception was high, but maintaining a concentration in two methods: historically, female sterilization and the pill prevailed, nowadays, the pill and condoms do. New hormonal contraceptives should be incorporated by the Brazilian Unified National Health System (SUS), besides promoting the use of long-acting methods such as IUDs.

Knowledge and practice of hormonal contraceptives among females aged 18-45 in 3 districts of Belize. Is prescription still a barrier to contraceptives?

Knowledge and practice of hormonal contraceptives among females aged 18-45 in 3 districts of Belize. Is prescription still a barrier to contraceptives?

Provision of Emergency Contraceptive Pills in Kinshasa's Informal Drug Shops: Results from a Mystery Client Study.

Despite the prominence of informal drug shops as sources of contraceptives in Kinshasa, Democratic Republic of the Congo, evidence on the quality of services they provide is scant. Given efforts to leverage the private sector to increase contraceptive access, evaluating the contraceptive knowledge, attitudes and practices of these providers is warranted. In April-May 2018, a mystery client study on the provision of emergency contraception (EC) was conducted in 854 informal drug shops in Kinshasa. Twelve mystery clients, presenting as younger or older than 18 and married or unmarried, visited the outlets to request something to "avoid getting pregnant" after unprotected sex, and to purchase the recommended medicine. Frequencies of key outcomes were calculated, and chi-square testing assessed associations between client age and marital status and the methods and counseling received. Overall, providers recommended EC in 77% of visits, and in 54% of visits, clients left with the method. In 62% of the visits in which providers recommended EC, they specified a time frame for taking the pill; the correct window of efficacy was indicated in 75% of these visits. In 18% of visits, other (noncontraceptive) drugs were provided, and in 7% of visits, providers did not help the client. Regardless of the visit outcome, providers were nearly always deemed respectful (96%). Leveraging informal outlets to increase contraceptive provision will require identifying quality outlets, strengthening supply chains and advocating for policy changes that recognize them as effective contraceptive providers without decreasing their perceived advantages for women.

Sexuality and Emergency Contraceptive Practice among Female Undergraduates in Lagos, Nigeria

Background: Young people, especially those in tertiary institutions are vulnerable to unplanned and unprotected sexual intercourse which predisposes them to unintended pregnancies and subsequently unsafe abortions. One of the key interventions for reduction of unwanted pregnancies and unsafe abortions is effective use of emergency contraceptives. Objectives: To assess the sexuality, perception, attitude towards and determinants of usage of emergency contraception among female undergraduates in Lagos, Nigeria. Methods: Cross-sectional survey conducted in June 2016 among 805 female students of the Lagos State University. Data were collected through structured self-administered questionnaire by obtaining information on demography, sexual and contraceptive history, perception, attitude towards and use of emergency contraceptives. Data obtained were analyzed using SPSS version 16. Chi-square and logistic regression models were applied to variables to test for significance that predicts the use of emergency contraceptives. Results: Of the 725 (90%) completed questionnaires, 334 (46%) of the respondents were sexually active with 115 (34%) having previous history of pregnancy. Eighty-two percent of those pregnancies were unintended. Eighty-eight percent of those with unintended pregnancy had them terminated by induced abortions, 54% of which was carried out by untrained persons. Only 29% of those who had unprotected sexual intercourse used emergency contraceptives. Lack of knowledge and promotion of sexual promiscuity were identified as the main reasons for not using emergency contraceptives. Previous use of contraceptives, married status, increasing age and year of study were positive predictors for the use of emergency contraceptives while poor knowledge was a significant predictor of non-use. Conclusion: There was poor knowledge and low utilization of emergency contraceptives among respondents. Information on contraceptives should be introduced in secondary schools and in general studies courses in tertiary institutions while parents and caregivers should discuss issues relating to sex and contraceptives with adolescents.

Pathocentric Health Care and a Minimal Internal Morality of Medicine.

Christopher Boorse is very skeptical of there being a pathocentric internal morality of medicine. Boorse argues that doctors have always engaged in activities other than healing, and so no internal morality of medicine can provide objections to euthanasia, contraception, sterilization, and other practices not aimed at fighting pathologies. Objections to these activities have to come from outside of medicine. I first argue that Boorse fails to appreciate that such widespread practices are compatible with medicine being essentially pathocentric. Then I contend that the pathocentric essence, properly understood, does not prohibit physicians from engaging in actions that are not aimed at combating pathologies, but rather supports an internal morality of medicine that allows medical providers to refuse without penalty to engage in practices that promote pathologies.

Modern contraceptive methods knowledge and practice among blind and deaf women in Ethiopia. A cross-sectional survey

BackgroundEvidences from various parts of the world reveal that women with disabilities are facing widespread barriers in accessing public services. Service providers and program managers do not grasp the relevance of their work and interventions in addressing the sexual and reproductive health needs of women with disabilities. The present study therefore aimed to assess family planning knowledge and practice among women with sensory disabilities.MethodsA mixed method approach using quantitative and qualitative methods was employed to collect the data. The study included 326 blind and deaf women using respondent driven sampling technique and 29 purposely selected key informants. We carried out the study from August 2016–April 2017. The quantitative data were analyzed using SPSS and the qualitative analysis was done using Open code software version 4.02 and triangulated with the quantitative findings.ResultsThe findings showed that nearly two third of the respondents of were sexually active. The majority (97.2%) of study respondents had heard about FP methods, however the level of comprehensive knowledge on modern contraceptive methods was 32.5%. The prevalence of unwanted pregnancy was 67.0% and abortion was 44%.Almost half of sexually active respondents ever used modern contraceptive methods, yet the contraceptive prevalence at the time of survey was 31.1%. Implants were the most commonly used (51%) contraceptive method among current users.ConclusionsThe use of modern contraceptive methods among women with sensory disabilities was low. Thus, the government and concerned organizations need to address the attitudinal, social, and physical barriers women with sensory disabilities are facing while seeking, accessing to and using family planning services.