Prevention Of Unwanted Pregnancy Research Articles

Multilevel analysis on prevalence and associated factors of modern contraceptive uptake in Somaliland: based on The Somaliland Health and Demographic Survey 2020

IntroductionContraception is the deliberate prevention of unwanted pregnancy through various contraceptive methods. Its uptake is low in Sub-Saharan African countries, particularly in east Africa. This might be linked to the high prevalence of unwanted pregnancies and the high fertility rate in the area. Although studies reporting the prevalence and associated factors of modern contraceptive uptake are available in other African countries, no study has been conducted in Somaliland. Therefore, the current study aimed to assess its prevalence and associated factors in Somaliland using Somaliland Health and Demographic Survey (SLHDS) data.Methods and materialsThe study used Somaliland Demographic Health Survey (SLDHS) 2020 data. The survey was a national-level survey using a cross-sectional study design. A total of 3656 reproductive-age women were included in the current study. To determine independent predictors of modern contraceptive uptake, a multi-level multivariable logistic regression analysis was done. Random effect analysis, standard error (SE) and intra-cluster correlation (ICC) were computed.ResultsThe proportion of modern contraceptive uptake among reproductive age groups in Somaliland is 1%. Modern contraceptive uptake is significantly associated with the residence, educational level and wealth index of participants. Women from nomadic communities had lower odds (AOR: 0.25; 95% CI: 0.10, 0.66) of modern contraceptive uptake compared to those from urban areas. Being in the highest wealth quintiles (AOR: 17.22; 95% CI: 1.99, 155.92) and having a tertiary educational level (AOR: 2.11; 95% CI: 1.29, 9.11) had higher odds of using the modern contractive method compared to those with the lowest wealth quintiles and non-formal education, respectively.ConclusionThe prevalence of modern contraceptive uptake in Somaliland was very low. It is associated with the level of education, wealth index and residence of the women.

Interpretation of refusal to use contraceptive methods in university students through systematic literature review

The interpretation of the refusal to use contraceptive methods in university students is important because it helps to understand the beliefs, attitudes and behaviors regarding sexual and reproductive health in this demographic group, and also allows the identification of possible cultural, educational or access barriers that may be affecting decision making related to the use of contraceptives. The objective of this systematic review was to analyze the causes of refusal to use contraceptive methods in university students based on a systematic literature review. For the development of the research, a search of electronic documents was carried out in databases such as PubMed, Scopus, Medline and Embase. Fourteen scientific articles were selected by applying the PRISMA 2020 guidelines, using descriptors such as: ("level of knowledge about contraceptive methods" OR "refusal to use contraceptive methods") AND ("University students") and an evaluation of the quality of the articles based on the use of the STROBE guidelines. The results reflected that most studies agree that students are knowledgeable about contraceptive methods, but do not use contraceptives for the most part. The main causes of refusal are related to inappropriate sexual behaviors, alcohol and drug abuse, early age of sexual debut, gender stereotypes, religion, lack of family counseling, and misuse of contraceptives. Currently, the education and training of students is a key factor in the prevention of unwanted pregnancies and sexually transmitted diseases

Increasing Adolescent Sexual Activity Screening Through a Provider-Based Intervention.

Screening for adolescent sexual activity is a vital aspect of comprehensive pediatric care. Adolescents engage in risky sexual behaviors. Thus, a complete and accurate sexual health history can assist in the prevention and treatment of disease, prevention of unwanted pregnancy, treatment of existing diseases, and optimal planning of future healthcare for adolescents. Current evidence shows that provider-focused strategies improve the delivery of preventive services, including sexual health screenings. In this initiative, we assessed and examined pre- and post-screening rates for sexual activity among adolescents by advanced practice providers. This multi-site initiative was implemented in four school-based health centers and a school-linked center that included 2,102 unique patients ages 9 to 24 years. Our biphasic intervention included education for advanced practice providers and electronic health record modifications. Pre- and post-data collection was conducted to determine changes in the rate of screening for sexual activity during a primary care adolescent health visit over a 3-year period. Data were collected via retrospective medical chart review and analyzed in three time periods for comparison from 2018 to 2021. Screening rates for sexual activity increased significantly after the intervention (all p < .001) with the likelihood more than double that of the year before it was implemented. The intervention was deemed to be a feasible and cost-effective strategy to improve the provider's willingness and ability to provide more adolescent sexual health screenings.

Young Women's Needs Regarding Sexual Preventive Behaviours and Unwanted Pregnancies.

Unwanted pregnancies are considered a public health problem that affects women's mental health and quality of life. The aim of this paper was to access university students' understanding and behaviours regarding unwanted pregnancies and identify their needs to prevent them. Qualitative descriptive design was used, and 13 semi-structured interviews were carried out. Women between 18 and 20 years old participated. They discussed a lack of training for themselves, their partners, and their families, their desire to have access to non-in-person health care resources, and their belief that contraception was expensive. Emotional aspects were relevant, affecting the way communication is established with those close to them and with health professionals. Despite the existence of access to sexual health resources, the findings show the existence of needs related to the prevention of unwanted pregnancies. The findings are presented grouping the main identified needs as "related to capability", "related to opportunity", and "related to motivation". Among the aspects to consider when designing interventions to prevent unwanted pregnancies are the feelings shown by these women, the inclusion of couples and family members in educational programs, and access to non-face-to-face health resources and less expensive contraceptive methods. Interventions for social support and understanding of women are necessary both to prevent unwanted pregnancies and to support adolescents with unwanted pregnancies by avoiding criminalization or blame.

Results of the study of the attitude of women of reproductive age to the integrated gynecological care provision by family physicians.

Aim: To study and analyze the attitude of women of reproductive age to the integrated gynecological care provision by family physicians, their readiness to receive some gynecological services from family physicians, as well as to analyze the level of women's support and readiness for the integrated provision of gynecological care depending on age and level of education. Materials and Methods: For the survey, anonymous questionnaires containing questions on the attitude of women of reproductive age to the integrated provision of certain types of gynecological care by family physicians were developed. 181 women from the Kyiv region took part in the survey. Results: Support of more than 80% of respondents regarding the integrated gynecological care provision by family physicians received the following questions: counseling on the prevention of sexually transmitted infections and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) (92,3%); counseling on family planning and prevention of unwanted pregnancy (83,4%); counseling on the use of various methods of contraception (82,3%); examination and palpation of mammary glands (80,1%); referral of women to a higher level of obstetric and gynecological care (if necessary (86,2%). Conclusions: The majority of respondents (67,4%) are ready or better ready than not ready to receive certain types of gynecological care services from family physicians. Almost the same percentage ratio (more than 60%) of women of each age group and all levels of education are ready or better ready than not ready to receive gynecological care services, which they supported, from family physicians.

Are Female Undergraduates at the University of Calabar Equipped with the Knowledge, Positive Attitudes, and Effective Practices of Contraceptives?

BACKGROUND: The global challenge of rapid population growth necessitates family planning programs to address reproductive health needs and control population increase. However, unintended pregnancies, particularly among adolescents, remain a significant problem, leading to increased risks of sexually transmitted infections and unsafe abortions. In Nigeria, contraceptive use is low among youths, resulting in high incidences of induced abortions and sexually transmitted infections. Barriers such as religious beliefs, cultural factors, limited availability, personal beliefs, and fear of side effects contribute to the under-utilization of contraceptives. METHODS: A descriptive cross-sectional study was conducted among female undergraduates of the University of Calabar, Cross River State. Data was collected using a 42-item questionnaire after obtaining informed consent. Multi-stage sampling was employed, and data was analyzed with IBM SPSS version 26 using descriptive and inferential statistics. RESULTS: The mean age of respondents was 21.5 ± 2.72 years. Most participants were in their first (26.7%) or second (22.6%) level of study. 28.8% were in sexual relationships, while 71.2% were not. Approximately a quarter of respondents had experienced symptoms of sexually transmitted infections. 71.5% had no knowledge of emergency contraception. Condoms (71.2%) and pills (54.5%) were the most commonly mentioned methods of contraception, while tubal ligation was the least popular (4.7%). The main benefit cited for contraception was the prevention of unwanted pregnancy (92.2%). 47.3% had no idea about the side effects of contraception, with irregular menstruation being the most commonly mentioned side effect (19.3%). Friends/peers, the internet, and school were the primary sources of information on contraception. 56.4% believed that contraception is not solely for females and should not be reserved for the literate. Over a third of respondents thought contraception encourages promiscuity and has too many side effects, with more than half demanding contraceptive services on campus. Less than half of the respondents (43.9%) reported using contraception at some point, with even smaller percentages using contraception in the last six months (25.2%) or during their last sexual intercourse (23.8%). Of the 101 who used contraceptives in their last sexual intercourse, the majority (83%) used condoms, while pills (7%) and emergency contraception (10%) were less common. Preferred sources for contraception were pharmacies (57.5%) and chemist shops/patent medicine vendors (24.7%). Religion (41.5%), fear of side effects (34.9%), and partner consent (28.3%) were the main influences on contraceptive use. Several factors were significantly associated with contraception utilization, including age, partner's educational level, knowledge of contraception, and level of study (p&lt;0.05). CONCLUSION: The low utilization of contraception among female undergraduates at the University of Calabar despite high awareness and poor knowledge highlights the need for interventions. Factors influencing utilization include age, knowledge, and level of study. Barriers such as religion, fear of side effects, and partner consent must be addressed. Recommendations include sensitization campaigns, establishing a youth-friendly center on campus, incorporating contraception into curricula, collaborating with NGOs, and increasing funding for research.

Prevalence of baby factory and educational access in public secondary schools in Rivers State

This paper examined the prevalence of baby factory and educational access in public secondary schools in Rivers State. Specifically, the paper aimed at determining the impacts of baby factory prevalence on educational access of students, identifying areas mostly used for baby factory in Rivers State, determining factors responsible for the prevalence of baby factory in Rivers State, and to ascertain the extent baby factory prevalence impacts on educational access of students in Rivers State. The study adopted qualitative and descriptive research approach where secondary data were used as the main sources of data collection. The secondary data were collected from published journals, articles, seminar papers, periodicals, as well as interviews and semi-structured questionnaire. The population of the study consisted of all 185,146 senior secondary schools Students in Rivers State. A sample of 400 students was used. This was derived using Taro Yamane population determination formula. A self-designed questionnaire instrument titled: “Prevalence of Baby Factory and Educational Access Questionnaire (PBEAQ)” was used to elicit information from the respondents. Test re-test method was used to determine the reliability of the instrument which reliability co-efficient of 0.84 at 0.05 level of significance. Data collected was analysed using mean and standard deviation with the criterion mean of 2.50 as accepted while below is rejected. The study revealed that maternity, clinics, water bottling companies, prayer houses etc., are areas mostly used for the perpetuation of baby factory. The study further revealed that poverty, lack of information on human trafficking, corruption, are among the factors responsible for the prevalence of baby factory and can impact on access to education .Based on the confirmation, the following recommendations were made among others; intensive advocacy against baby factory prevalence, promulgation of laws, enlightenment of the teenage girls on prevention of unwanted pregnancy among others.

Perspectives on the side effects of hormonal contraceptives among women of reproductive age in Kitwe district of Zambia: a qualitative explorative study

BackgroundGlobally, hormonal contraceptives have proved to be effective in the prevention of unwanted pregnancies. However, despite evidence of the many benefits associated with the use of hormonal contraceptives, concerns related to their safety and side effects have been reported. We conducted a study to explore the perspectives on the side effects of hormonal contraceptives among women of reproductive age in Kitwe district of Zambia.MethodsAn explorative qualitative study was done among 32 women of reproductive age (18–45 years). Participants were selected conveniently as they accessed family planning services at a designated reproductive, maternal, and child health facility. Data collection was done through in-depth interviews (IDIs). Recruitment of participants and data collection continued until the saturation point was reached. The interviews were recorded, translated, and transcribed verbatim. Data were imported into NVivo.x64 for coding and node generation after which categories and themes were developed manually.ResultsOverall, participants demonstrated a considerable amount of knowledge of family planning, recounting the economic and health benefits as well as demerits of family planning use. The main reasons for discontinuing and switching hormonal contraceptive methods were the desire to get pregnant and the fear of unpleasant side effects, including excessive bleeding or prolonged menstruation, headache, dizziness, lower abdominal/back pain, and weight gain. Most importantly, participants cited concerns about the delay in the resumption of fertility after the termination of contraception and how the side effects disrupted their daily activities at home.ConclusionThere is a need for family planning providers to offer family planning services that address the side effects of hormonal contraceptives during counselling and how women can manage them. Family planning services should adopt a patient-centred approach that takes into consideration the concerns regarding side effects and how this affects the quality of life among women. Also, there is a need to extend family planning services to include scheduled follow-ups and clinical management of contraceptive side effects among women.

Characteristics of Male Sex Men Who Screen for Sexually Transmitted Infections in an Effort to Prevent HIV/AIDS

HIV/AIDS is an infectious disease that is currently happening in Indonesian society. Globally, the number of HIV (Human Immunodeficiency Virus) has tended to increase from 2010-2019 with the spread of the virus in all age groups. The high number of HIV cases in Indonesia is due to free-sex behavior and the low level of public knowledge about risky sexual behavior, prevention of unwanted pregnancies, and sexually transmitted diseases. The total number of people with HIV/AIDS (ODHA) in Indonesia as a whole until March 2021 was recorded at 427,201 people, and AIDS cases were 131,417 people. Data from the Ministry of Health of the Republic of Indonesia, the number of people living with HIV based on risk factors found that 27.2% of homosexuals were 26.3% of the male sex men and 0.9% of drag. One of the high-risk groups is male sex men who have abnormal sexual deviations and have a tendency to lead to sexual crimes. This study aims to obtain an overview of the characteristics of male sex men who carry out screening for Sexually Transmitted Infections to prevent HIV/AIDS. This research method uses a quantitative description method. The population is male sex men as many as 85 people. The sampling technique used purposive sampling, obtained a sample of 46 male sex men. Data collection techniques with questionnaires. Data analysis using univariate analysis. The results showed that the age of the majority (63%) of the respondents was between 21-30 years old, the domicile of the majority (65.2%) of the respondents resided in Bandung, the last education of the majority (56.5%) of the respondents had a senior high school education, almost all respondents (76.1%) as many as 35 people had jobs, history of screening Sexually Transmitted Infections negative and the activity of using condoms during sex, the majority (71.7%) of respondents always use condoms during sex. Productive age is an age that needs to get special attention, especially in risky sexual activity, this can be seen from the use of condoms when male sex men have sexual intercourse. This becomes our joint consideration in efforts to prevent HIV/AIDS in productive age. This study aims to obtain the results of risky sexual behavior in male sex men through screening for Sexually Transmitted Infections to prevent HIV/AIDS

"I Don't Support It for My Children": Perceptions of Parents and Guardians regarding the Use of Modern Contraceptives by Adolescents in Arua City, Uganda.

Despite the high rates of adolescent pregnancies, the utilization of modern contraceptives is still low among adolescents in Uganda which highlights a missed opportunity for the prevention of unwanted pregnancies among adolescents. We explored the perception of parents and guardians regarding the use of modern contraceptives by adolescents and the roles parents and guardians play in the use of modern contraceptives by the adolescents. A descriptive qualitative study was conducted in one of the suburbs of Arua city in the West Nile subregion in Uganda. Fifteen (15) in-depth interviews were conducted with parents and or guardians to explore their perceptions and roles regarding the use of modern contraceptives by adolescents. Thematic analysis was used in qualitative data analysis. Parents did not support adolescents' use of modern contraceptives. Lack of parental support was related to perceptions that modern contraceptives promote sexual promiscuity, fear that it causes infertility and that it is incompatible with cultural, religious, and moral norms. Parents and guardians opted to emphasize the importance of abstinence, conformity with cultural and religious norms, and the need to focus on completing school instead of encouraging the use of modern contraceptives. Few parents and guardians supported the use of modern contraceptives, specifically condoms, to prevent unwanted pregnancy by the adolescents and parents/guardians, sexually transmitted infections, and early school dropouts. Parents and guardians expressed feelings of inadequacy related to discussions on contraception use with their adolescent children and therefore avoided talking about it. Our study reveals a lack of parental support regarding the use of modern contraceptives among adolescents. Public health interventions which promote intergenerational, socioculturally, and religiously appropriate communication should be instituted in the communities in order to promote sustainable adoption of modern contraceptive use among adolescents.

The Role of Electronic Health Tools in Unwanted Pregnancy Prevention, Abortion and Post-Abortion Follow-Up: A Systematic Review.

More than 30% of women experience at least one abortion. To date, there has been no comprehensive mobile health project on the impact of technology on access to abortion, contraception, and post-abortion follow-up. The purpose of this study was to review published studies on the role of electronic health in the prevention of unwanted pregnancy, abortion, and post-abortion follow-up. The Web of Science, PubMed, ScienceDirect, and EMBASE databases were searched to find relevant articles published between 2008 and 2018. A systematic review study was conducted on 33 relevant articles. All studies related to the use and impact of electronic health on unwanted pregnancy prevention, abortion and post-abortion follow-up in English from January 2008 to December 2018 were included. The quality of the studies was evaluated using the PRISMA-S. Thirty-three studies met the inclusion criteria for the review. The Studies were divided into four main groups of women's experiences on the use of mobile health and telemedicine technologies for at-home medical abortion, unwanted pregnancy prevention, abortion, and post-abortion follow-up. The results showed the significant impact of using electronic health on unwanted pregnancy prevention, abortion, and post-abortion follow-up. Health technologies have the potential to be used as a low-cost and accessible method to replace abortion services. They can facilitate remote care and quick access to information to complete the gaps in access to abortion. Therefore, it is necessary for health service providers to be aware of the possibility of the client's access to electronic health tools.

Contraception in Women with Sexually Transmitted Infections

Contraception in Women with Sexually Transmitted Infections Abstract. The use of contraception in sexually active women has two main functions; the prevention of unwanted pregnancy and the protection against sexually transmitted infections (STIs). In both cases, contraception does not guarantee complete protection. Unfortunately, the most effective contraceptive method against pregnancy offers minimal protection against STIs and the best contraceptive method against STIs, namely the condom, is not popular amongst many and when typically used does not offer the most effective prevention against pregnancy. In addition, there are a number of factors to consider when choosing a contraceptive method for women who already have a STI. For example, which contraceptive methods may be used safely and if there are any interactions to be aware of between medication and the contraceptive in question. Thus, the choice of the most suitable contraceptive method depends heavily on the individual and needs to be carefully considered. It is the balance between prevention of pregnancy, the protection against STIs as well as minimising the risk of STI transmission to an uninfected partner. These considerations must be discussed with the woman and if required and appropriate for the woman, with her partner as well.

Fear of childbirth among pregnant women in Eastern Ethiopia: A community-based study

IntroductionFear of childbirth refers to feelings of uncertainty and anxiety before, during, or after childbirth by thinking about future labor and birth or experience of others. Evidence on burden of fear of childbirth and its associated factors is limited in Ethiopia. In this study, we assessed magnitude of fear of childbirth and its associated factors among pregnant women in Eastern Ethiopia. MethodsA community-based cross-sectional study was conducted among randomly selected pregnant women recruited from Kersa Health and Demographic Surveillance System—an open cohort consisting of continuous registry of health and demographic conditions in eastern Ethiopia. Women were interviewed and fear of childbirth was assessed using the Wijma Delivery Expectancy Questionnaire. Data were entered using EpiData 3.1 and analyzed using SPSS 20. Factors associated with fear of childbirth were identified using binary and multiple logistic regression and described using adjusted odds ratio (aOR) along with 95% confidence interval (CI). Finally, statistical significance was set at p < 0.05 in the multiple logistic regression. ResultsOf a total of 476 pregnant women included in the study, 111(23.3%; 95% CI 19.3-26.9) had fear of childbirth. Fear of childbirth was more likely among women who had no antenatal care (aOR = 2.6; 95% CI:1.22-5.50), no husband support (aOR = 5.7; 95% CI: 2.32-13.10), unplanned pregnancy (aOR = 7.8; 95% CI: 3.92-15.42), and had history of complication in labor and pregnancy (aOR = 10.4; 95% CI: 5.20-20.81). ConclusionA quarter of pregnant women in eastern Ethiopia had fear of childbirth. Helping women to have positive pregnancy experience requires strengthening antenatal care, partner support, and prevention of unwanted pregnancy.

ЭФФЕКТИВНОСТЬ ОРГАНОСОХРАНЯЮЩЕЙ ТАКТИКИ ВЕДЕНИЯ ПРИ ШЕЕЧНОЙ БЕРЕМЕННОСТИ

Abstract. Diagnosis of cervical pregnancy is carried out based on the analysis of data obtained during the study of the gynecological status during bimanual abdominal - vaginal and ultrasound examinations. Treatment consists in performing organ-preserving manipulations and, in the absence of their effectiveness, extirpation of the uterus. Prevention of the development of cervical pregnancy consists in the rational treatment of gynecological diseases, refusal of abortions, carrying out full-fledged rehabilitation after intrauterine interventions. In this clinical case, prevention of unwanted pregnancy by prescribing rational contraception, timely diagnosis of the causes of infertility and miscarriage, as well as prevention and effective treatment of chronic endometritis would avoid the risk of cervical pregnancy. Careful management of pregnancy by an obstetrician-gynecologist made it possible to identify the ectopic location of the fetal egg in the early stages of pregnancy and prevent the occurrence of severe life-threatening complications, as well as perform organ-preserving surgical treatment, giving the patient the opportunity to realize the childbearing function in the future. Based on the study of this clinical case, it can be concluded about the effectiveness of the proposed management tactics of a patient with cervical pregnancy and the possibility of recommending this variant of medical tactics in the treatment of patients with this pathology.

Determinants of hormonal contraceptive use and its effects among married women of reproductive age group in Kathmandu, Nepal

The prevention of unwanted pregnancy, unsafe abortion and maternal mortality remains an important part of the practice of medicine. Several forms of hormonal contraception have been used to control female fertility. These are associated with benefits and risk. The current study aimed to study the determinants of hormonal contraceptive use and its effects among married women of reproductive age group in Kathmandu. This is a community based cross sectional study among 250 married women using hormonal contraceptives aged between 15-49 years residing in wards 8 and 9 of Gokarneshwor Municipality. The information was obtained using self-constructed structured questionnaire. Height, weight and blood pressure were recorded and hypertension was defined as per Joint National Committee (JNC) VII guidelines. Around one third of the participants were of 30-34 years and Depo-Provera was the most commonly used hormonal contraceptive. There were several side effects among the users and commonest were menstrual irregularities and weight gain. Around 47 participants had hypertension and 120 had raised BMI. The factors associated with hormonal contraceptive use were socioeconomic status, religion, BMI and monthly income of family of the study population. The present study provides valuable information regarding significant positive correlation of age, BMI and duration of hormonal contraceptive use with systolic and diastolic BP.

Theaudio-Visual (video) Media’s Concern for the knowledge and Attitudes of Adolescents about Abortion in the Southern Konawe Coastal Area

The phenomenon of abortion is familiar among the people of Indonesia. Many unsafe abortions are performed in Indonesia. Overall, nearly half of all women seek abortion services in Indonesia. Early health education is considered the best solution in dealing with the problem of high abortion rates in adolescents. One of the learning media that can be used is audio visual media (video). The use of audio visual media in the learning process is one of the plans prepared to make the learning process more interesting and can motivate students in learning. The study used a pre-experimental design of one group pre-posttest. The sample in this study was 51 girls of class XII at Sma 6 Konawe Selatan. Sampling technique with proportional stratified random sampling. The instruments used are knowledge and attitude questionnaires. The data was analyzed with the Wilcoxon test using SPSS version 26. The results showed the influence of health education using audio visual media (video) on the knowledge and attitudes of adolescent girls about unsafe abortion with P value = 0.000 (P < 0.05) for the knowledge and attitude of young women about unsafe abortions at SMA 6 South Konawe. Researchers suggest the need to use audio-visual media as a means of health promotion and KIE in adolescent girls and parents about adolescent reproductive health, especially the prevention of unwanted pregnancies and the impact of unsafe abortion practices.

Low-dose intrauterine contraception is an innovative approach to the prevention of unwanted pregnancy

Long-acting reversible contraception (LARC) is recognized as a highly effective and convenient method for preventing unwanted pregnancy. However, in real clinical practice, the level of implementation of LARC remains relatively low, which, presumably, may be related to misconceptions about their contraceptive efficacy and side effects among health professionals and patients. One method of long-acting reversible contraception is the intrauterine device. Hormone-containing intrauterine systems are recognized as one of the most affordable contraceptive methods, characterized by a very low failure rate (less than 1%), which does not depend on the patient’s compliance. A review of the literature focuses on the efficacy and safety of a low-dose levonorgestrelcontaining intrauterine system containing 19.5 mg of levonorgestrel (LNG-IUD 12). We present data on the advantages of this intrauterine system in comparison with its counterparts. Analysis of the literature has shown that adherence to low-dose contraception is observed among women of reproductive age. The smaller diameter of the guide tube is associated with a more successful and less painful insertion of the device into the uterine cavity. This may be an obvious advantage for young, nulliparous women. In addition, the LNG-IUD has a predominantly local progestogenic effect on the endometrium, so there is a relatively low development of systemic effects. Despite its lower levonorgestrel content, the LNG IUD 12 (Kyleena LNG 19.5 mg, levonorge strel-releasing intrauterine system with an average LNG release of 12 µg/24 h in vivo over the first year of use) has a high level of contraceptive efficacy. Thus, LNG-IUD 12 is associated with a favorable efficacy and safety profile regardless of a woman’s age or parity, which has been confirmed by the results of clinical trials.

Postabortion Contraceptive Acceptance Rate and Its Determinants among Women Receiving Abortion Service before Discharge from the Health Facilities in Harar, Eastern Ethiopia.

Background Annually, around 121 million unintended pregnancies occur in the world and more than 73 million encountered abortion. Ethiopia is also losing 19.6% of mothers due to unsafe abortion. Despite that postabortion contraceptive service is a climactic entry point for the prevention of unwanted pregnancy and associated deaths, the service magnitude and determinants immediately before discharge are not characterized well in Ethiopia. Hence, this study aimed to assess the magnitude of postabortion contraceptive utilization and associated factors among women receiving abortion care service before being discharged from health facilities in Harar, Eastern Ethiopia. Methods A facility-based cross-sectional study was conducted among 390 women receiving abortion care services. At discharge, data about contraceptive acceptance and related maternal characteristics were collected. A binary logistic regression model was used to assess the association between independent and dependent variables (postabortion contraceptive utilization). Analysis was done with SPSS 22. Statistical significance was considered at P < 0.05. Result The overall prevalence of postabortion contraceptive utilization was 81.5% (95% CI: 77.9, 85.4). Being unmarried (AOR, 0.05; 95% CI (0.02, 0.16)), having no history of previous abortion (AOR, 0.11; 95% CI (0.04, 0.34)), being multigravida (AOR 8.1; 95% CI (2.20, 13.40), lacking desire to have an additional child (AOR, 6.3; 95% CI (2.65, 15.34), and history of family planning use (AOR, 17.20; 95% CI (6.5, 38.60)) were determinants of postabortion contraceptive utilization before being discharged from the health facilities. Conclusion Postabortion contraceptive utilization in Harar health facilities still needs improvement as per the WHO and national recommendations. Therefore, the family planning provision strategies should be convincing and friendly, especially for unmarried mothers, and those who had no history of abortion should be counseled in friendly and systematically convincing schemes for enabling them to take the service before discharge from the health facility.

ARTIFICIAL TERMINATION OF PREGNANCY IS A TOPICAL PROBLEM OF MEDICINE AND SOCIETY

Abstract: Currently, the issue of preserving the reproductive potential of women of childbearing age remains relevant. The leading problem is the increasing prevalence of the use of methods of artificial termination of pregnancy, which are one of the main links in the pathogenesis of infertility, miscarriage and delay in fetal development in subsequent pregnancies. In 33% of cases, artificial termination of pregnancy leads to complications: the frequency of early complications is 6-17%, the frequency of more severe late complications is 11-36%. In 18% of cases, this intervention leads to a fatal outcome. The article reflects a comparison of the main methods of termination of pregnancy, their advantages and disadvantages are evaluated. The leading histological changes of the endometrium after abortions (atrophy of the functional layer of the endometrium, necrosis, dystrophy, fibrosis of the stromal component, diffuse inflammation), hormonal disorders (decrease in the concentration of estradiol and testosterone in the blood by at least 1.8 times, significant androgenic activity of the adrenal glands without a tendency to normalization), oncological risks (imbalance of the ratio of estrogen metabolites towards increased synthesis of the metabolite 16-hydroxyestrone, which is characterized by 4 times more pronounced estrogen activity with suppression of apoptosis and increased proliferative changes with an increased risk of dysplastic processes and cervical cancer, endometriosis, leiomyoma, fibrocystic disease and breast cancer), psychological changes. As a prevention of unwanted pregnancy, the advantages of using the method of intrauterine contraception are present, due to the low number of complications during its use, the absence of cancer risk, the frequency of inflammatory processes slightly exceeding their frequency in the general population.

Emergency contraception methods: efficacy, safety and acceptability

Prevention of unwanted pregnancies, abortions and their complications is one of the major problems of healthcare. The most effective method of unwanted pregnancies prevention is family planning with highly effective contraceptive methods. Currently number of unwanted pregnancies cases is still numerous. Problem of unwanted pregnancy cannot be solved completely with any method of contraception. Every fourth pregnancy in the world is considered as unplanned, more than half of them end in abortion, which can pose a threat to health of the patient. Overall, more than 90% of abortions are performed due to unwanted pregnancies. Emergency contraception continues to play an important role in family planning today. It is known that the effectiveness of emergency contraception decreases with the time after unprotected sex. Today a variety of emergency contraception methods exists, which allows individual approach to specific patient. The article presents the results of randomized clinical trials and meta-analyses evaluating all currently used methods of emergency contraception from the evidence-based point of view. The article also describes drugs specifics, features, and effects on the reproductive system.