Reproductive Health Centers Research Articles

Impact of Gender Infertility Diagnosis on Marital Relationship in Infertile Couples: A Couple Based Study

Infertility has a deleterious impact on marital relationships. This study was conducted to determine the effect of a gender-specific infertility diagnosis on the response of infertile couples. A cross sectional analysis of 123 infertile couples (123 wives and 123 husbands) who were visited at three reproductive health centers of Tehran University of Medical Sciences, Tehran, Iran. Couples independently completed three questionnaires before their office appointment. Questionnaires include Demographic characteristics, marital satisfaction questionnaire and sexual satisfaction questionnaire through interviews. Higher scores in questionnaires inspecting marital and sexual satisfaction indicates lower satisfaction. The outcomes, including differences in marital satisfaction and sexual satisfaction in wives and husbands based on infertility diagnosis. In infertile couple, wives expressed less marital and sexual satisfaction than their husbands. Wives with female factor have less marital satisfaction and with male factor have less sexual satisfaction than wives with other factors. Husbands with female factor have less marital satisfaction than husbands with other factors. Husbands with female factor have less marital satisfaction and with male factor husbands show significantly less sexual satisfaction than husbands with other factors (p < 0.05). Infertility diagnosis has a significant impact on infertile couples in marital and sexual satisfaction.

Contraceptive care at the time of medical abortion: experiences of women and health professionals in a hospital or community sexual and reproductive health context

ObjectiveTo examine experiences of contraceptive care from the perspective of health professionals and women seeking abortion, in the contexts of hospital gynaecology departments and a specialist sexual and reproductive health centre (SRHC). Materials and methodsWe conducted in-depth semistructured interviews with 46 women who had received contraceptive care at the time of medical abortion (gestation≤9weeks) from one SRHC and two hospital gynaecology-department-based abortion clinics in Scotland. We also interviewed 25 health professionals (nurses and doctors) involved in abortion and contraceptive care at the same research sites. We analysed interview data thematically using an approach informed by the Framework method, and comparison was made between the two clinical contexts. ResultsMost women and health professionals felt that contraceptive counselling at abortion was acceptable and appropriate, if provided in a sensitive, nonjudgemental way. Participants framed contraceptive provision at abortion as significant primarily as a means of preventing subsequent unintended conceptions. Accounts of contraceptive decision making also presented tensions between the priorities of women and health professionals, around ‘manoeuvring’ women towards contraceptive uptake. Comparison between clinical contexts suggests that women's experiences may have been more positive in the SRHC setting. ConclusionsWhilst abortion may be a theoretically and practically convenient time to address contraception, it is by no means an easy time to do so and requires considerable effort and expertise to be managed effectively. Training for those providing contraceptive care at abortion should explicitly address potential conflicts between the priorities of health professionals and women seeking abortion. ImplicationsThis paper offers unique insight into the detail of women and health professionals' experiences of addressing contraception at the time of medical abortion. The comparison between hospital and community SRHC contexts highlights best practise and areas for improvement relevant to a range of settings.

Are Men's Reproductive Health Problems and Sexual Behavior Predictors of Welfare?

The study examined men's reproductive health problems and sexual behavior and their implications for men's welfare in Nigeria. It used the Nigeria Demographic and Health Survey data set of 2013. The analysis used only male recode files, representing 17,359 males. The dependent variable is the computed wealth index, which was selected as proxy for welfare condition. Analysis involved univariate and multivariate levels. The findings indicated that 49.3% of the respondents currently have more than one sexual partner. The total lifetime sexual partner index identifies 70.2% of the men interviewed have had at least two sexual partners in their lifetime. It revealed that men who experience reproductive health challenges, such as sexually transmitted infections and genital ulcer, are 44% and 93%, respectively, less likely to enjoy good welfare condition. It also indicated that men in urban area are 7.256 times more likely to enjoy good welfare condition compared with their rural counterparts. There is a negative association between total lifetime sexual partnerships and exposure to good welfare. The study concludes that social workers, marriage counselors, other health personnel, and policy makers need to focus on the practice of multiple sexual partnership and reproductive health diseases as major determinants of men's welfare. The authors suggest that the index of welfare should include reproductive health issues and indicators of sexual behavior. Also, there is need for the establishment of specialized reproductive health care services and centers that are accessible to all men for effective servicing of reproductive health needs of men in the country.

Knowledge of HPV and HPV Vaccine among Women Ages 19 to 26

ObjectiveTo describe knowledge about human papillomavirus (HPV) and HPV vaccination among women ages 19 to 26 seeking a variety of services at reproductive health centers. A secondary objective was to identify common sources of HPV information. MethodsTen reproductive health centers enrolled 365 women ages 19 to 26 in a randomized, controlled trial to determine the effect of automated reminder messages on HPV vaccine completion. Using responses from a 61-item self-administered baseline questionnaire completed before initiating the HPV vaccine, this subanalysis assessed participants' knowledge regarding HPV and the HPV vaccine. ResultsKnowledge of HPV prevention, transmission, and disease outcomes among the study population was highly variable. The mean HPV knowledge score was 11.0 of a possible 19 (SD = 3.8). Most participants (77%) had heard of the HPV vaccine before completing the questionnaire and indicated that their primary sources of information about the vaccine were television ads (61%), health care providers (52%), and friends (45%). ConclusionsDespite a relatively high awareness of the vaccine, specific knowledge regarding HPV and the HPV vaccine varied substantially and participant scores highlighted knowledge gaps among vaccine-eligible young women. Media, health care providers, and friends were identified by participants as sources of information and may influence their knowledge of HPV and the HPV vaccine.

The influence of trust in health care systems on postabortion contraceptive choice

ObjectivesThis study investigates whether trust in the health care system or other patient-level characteristics are associated with interest in immediate initiation of long-acting reversible contraception (LARC) after abortion. Study designA structured, self-administered survey was provided to English-speaking women 18years or older presenting to a reproductive health center in the Southeastern United States for first-trimester surgical abortion. The survey collected information about patient characteristics, choice of postabortion contraception, health literacy and trust in the health care system. Trust was measured using a 17-item, previously validated survey and was treated as the primary independent variable. Our primary outcome variable is interest in immediate LARC placement postabortion. Statistical analysis was performed using Chi-square tests, Student’s t tests and logistic regression with SAS® 9.2. ResultsOf 162 respondents who completed the survey, 24% planned to use LARC postabortion, which increased to 37% if LARC placement was available on the day of their abortion. The mean trust score was 59±8 (possible score of 17–85) and did not differ significantly between women who indicated an interest in immediate LARC placement postabortion and those who did not (p=.9). Women with a history of a prior birth were 3.4 times more likely to indicate interest in immediate postabortion LARC than others (adjusted odds ratio 3.42, 95% confidence interval 1.63, 7.18). ConclusionDesire to accept LARC immediately postabortion is associated with history of a prior birth but not with trust in the health care system or other demographic variables. Participant interest in postabortion LARC varied based on immediate device availability. ImplicationsThis research underscores the importance of policies and clinical practices that promote access to LARC methods on the day of an abortion. Further research is needed to elucidate factors that correlate with choice of LARC postabortion.

Obstetric and psychological characteristics of women seeking multiple abortions in the region of Monastir (Tunisia): results of a cross-sectional design.

BackgroundRepeat abortion is a public health concern favored by many obstetric and social factors.The purpose of our study was to identify associated factors to repeated abortion in the region of Monastir (Tunisia). Common mental disorders (CMD) such as anxiety and depression were also evaluated in women seeking voluntary repeated abortion.MethodsWe carried out a cross sectional study between January and April 2013 in the Reproductive Health Center (RHC) of the region of Monastir in Tunisia (This study is part of a prospective design on mental disorders and intimate partner violence among women seeking abortions in the RHC).Among women referred to the RHC we selected those seeking voluntary abortion (medical or surgical method). Data on women’s demographic characters, knowledge and practices about contraceptive methods and abortion were collected the abortion day via a structured questionnaire. Data about anxiety and depression status were evaluated during the post-abortal control visit at 3–4 weeks following pregnancy termination.ResultsOf the 500 interviewed women, 211 (42.2 %; CI95% [37.88 – 46.52]) were seeking repeated abortions. Multivariate analysis showed that increased age, lower level of women school education, single status, poor knowledge about birth control methods and history of conflict/abuse by a male partner, were uniquely associated with undergoing repeat compared with initial abortion.CMD were significantly higher in women undergoing second or subsequent abortion (51.1 %) single and lower educated women. Women relating a history of conflicts/abuse report more CMD than others (30.6 % vs 20.8 %).ConclusionHealth facilities providing abortion services need to pay more attention to women seeking repeat abortion. Further studies are needed to well establish the relation between the number of abortion and the occurrence and the severity of CMD.

Recombinant follicle-stimulating hormone and recombinant luteinizing hormone versus recombinant follicle-stimulating hormone alone during GnRH antagonist ovarian stimulation in patients aged ≥35 years: a randomized controlled trial.

Does luteinizing hormone (LH) supplementation improve live birth rate after in vitro fertilization (IVF) in patients aged ≥35 years receiving a gonadotrophin-releasing hormone (GnRH) antagonist protocol? There was no difference in live birth rate with use of LH during IVF in patients aged ≥35 years undergoing IVF treatment using a GnRH antagonist protocol. Use of GnRH analogues as part of a controlled ovarian hyperstimulation protocol during IVF treatment cycles decreases the amount of LH available to developing follicles. The role of LH supplementation for improving outcomes in patients undergoing controlled ovarian hyperstimulation as part of assisted reproduction treatments, particularly those involving a GnRH antagonist protocol, is unclear. It has been suggested that higher risk patients (e.g. age ≥35 years, poor ovarian reserve) may benefit from LH supplementation. This single-centre, randomized controlled trial was conducted from 1 October 2012 to 30 June 2014. A total of 240 women aged ≥35 years undergoing IVF received ovarian stimulation using a GnRH antagonist protocol, with recombinant follicle-stimulating hormone (r-FSH; Gonal-F(®)) starting from cycle day 2 or 3. GnRH antagonist (Cetrotide(®)) was administered on Day 5 of r-FSH administration. On Day 6, patients in the LH supplementation group were switched to r-FSH/r-LH (Pergoveris(®)) 150/75 IU/day. Randomization to study treatments was performed in blocks of 4 via a computer-generated random number list. Of the 240 patients randomized to treatment, 120 received r-FSH/r-LH and 120 received r-FSH. Patients were recruited from the IVFAS, An Sinh Hospital, Ho Chi Minh City, Vietnam. Live birth rate did not differ significantly (P > 0.05) between r-FSH/r-LH and r-FSH recipients (16.7 versus 17.5%; between-group difference 0.8, 95% confidence interval [CI] -9.5, 11.2). In addition, there were no significant differences between the r-FSH/r-LH and r-FSH groups with respect to the number of oocytes retrieved, implantation rate, miscarriage rate and clinical pregnancy rate. The open-label design could have introduced bias, and the relatively small sample size may have allowed detection of only the most common adverse events. In addition, the study was likely to be underpowered based on differences between the response rate assumptions used in the sample size calculation and the actual response rate during the study. The results of this study found no additional benefit from adding LH supplementation to ovarian stimulation with a GnRH antagonist protocol in women aged ≥35 years, and add to the body of evidence in this area. However, findings across studies are still inconsistent and additional research is needed before any clear recommendations for clinical practice can be made. This study was supported by the Research Center for Genetics and Reproductive Health, School of Medicine, Vietnam National University HCMC. The authors state that they have no financial or commercial conflicts of interest. The trial was registered with clinicaltrials.gov (NCT02244866).

Prevalence of rape-related pregnancy as an indication for abortion at two urban family planning clinics

ObjectiveWe sought to estimate the prevalence of rape-related pregnancy as an indication for abortion at two public Chicago facilities and to describe demographic and clinical correlates of women who terminated rape-related pregnancies. MethodsWe performed a cross-sectional study of women obtaining abortion at the Center for Reproductive Health (CRH) at University of Illinois Health Sciences Center and Reproductive Health Services (RHS) at John H. Stroger, Jr. Hospital between August 2009 and August 2013. Gestational age limits at CRH and RHS were 23+6 and 13+6weeks, respectively. We estimated the prevalence of rape-related pregnancy based on billing code (CRH) or data from an administrative database (RHS), and examined relationships between rape-related pregnancy and demographic and clinical variables. ResultsIncluded were 19,465 visits for abortion. The majority of patients were Black (85.6%). Prevalence of abortion for rape-related pregnancy was 1.9%, and was higher at CRH (6.9%) than RHS (1.5%). Later gestational age was associated with abortion for rape-related pregnancy (median 12days, p<.001). Younger age and Black race were associated with abortion for rape-related pregnancy at CRH only (p<.001 for both). Chlamydia and gonorrhea infection were no more prevalent among women terminating rape-related pregnancy than among those terminating for other indications. ConclusionRape-related pregnancy as an indication for abortion had a low, but clinically significant prevalence at two urban Chicago family planning centers. Later gestational age was associated with abortion for rape-related pregnancy. ImplicationsRape-related pregnancy may occur with higher prevalence among some subgroups of women seeking abortion than others. Efforts to address rape-related pregnancy in the abortion care setting are needed.

Early Sexual Initiation and Associated Factors among Debre Markos University Students, North West Ethiopia

Background: Sexual activities during adolescence have been characterized as dynamic and constantly changing, and it has an impact on reproductive life of young peoples, which is related to the increased susceptibility to HIV transmission, unwanted pregnancy and its complications when the sexual activities are unprotected. So, the objective of this study was to identify the prevalence of early sexual initiation and its associated factors among Debre Markos University students, North West Ethiopia, 2014. Methods: Institution based cross sectional study design was conducted among 273 Debre Markos university students. Study participants were selected by stratified sampling technique and self- administrated questionnaire was distributed to collect information. EpiData version 3.1 was used for data entry and SPSS version 16 was used for analysis. To identify factors associated with sexual initiation, bivariate and multivariate logistic regression with 95 % Confidence interval was used. Results: From 260 respondents, 116(44.6%) had sex prior to the data collection period, while 144(55.4%) had never had sexual intercourse. Almost two third (64.7%) of respondents start sexual intercourse during the age range of 16-19 years old. The mean and standard deviation for the age at first sex was 18.28 and 2.04 years respectively. Factors which were significantly associated with early sexual initiation (< 18 years old) were; being female (AOR=5.7, 95%CI=1.16-27.72), lack of discussion on sexual and reproductive health issues (SRH) with their mother (AOR=, 95%CI= 1.23-41.5) and cigarrate smoking (AOR=7, 95%CI=1.06-46.92). Conclusions: Early sexual initiation was high. Factors which were associated with early sexual initiation were being female, lack of discussion on SRH with mother and cigarrate smoking. So, awareness creation for both male and female young peoples through the use of religious leaders, school teachers and parents on sexual and reproductive health issues is important. Young peoples should be encouraged to discuss with their parents on SRH through the use of reproductive health centers and emphasis should also be given for adolescents who use drugs like cigarrate smoking.

Indications for in vitro fertilization at a public center for reproductive health in Campinas, Brazil

ObjectiveTo assess the sociodemographic profile and gynecologic and obstetric characteristics of women referred to a public reference center in Campinas, Brazil, for in vitro fertilization (IVF). MethodsWomen referred between April 1, 2008, and October 31, 2009, were eligible for inclusion in a cross-sectional study. Participants were interviewed about sociodemographic characteristics, obstetric and gynecologic history, and etiologic factors resulting in the referral. Preliminary clinical examinations performed elsewhere were evaluated. ResultsA total of 176 women were included, of whom 129 (73.3%) presented with tubal factor infertility. Tubal ligation had been performed in 66 (37.5%) women. Overall, 121 (68.8%) women were aged 30years old or less, 110 (62.5%) had received more than 8years of schooling, 123 (69.6%) had had infertility for up to 5years, and 99 (56.3%) did not have any children. Moreover, 25 (14.2%) women had endometriosis and 25 (14.2%) had a male factor issue. A previous ectopic pregnancy was reported for 20 (11.4%) women and pelvic inflammatory disease for 49 (27.8%). ConclusionTubal factor infertility was the most common indication for IVF. Preventive measures are required, in addition to policies that ensure access to high-complexity treatments in the public sector.

The Influence of Trust in Health Care Systems on Postabortion Contraceptive Choice

INTRODUCTION: After recent abortion women are at high risk for unintended pregnancy and repeat abortion. Use of highly effective contraception postabortion may mitigate this risk. Women cannot discontinue long-acting reversible contraception (LARC) without visiting a health care provider. This study investigates whether a womens trust in the health care system is associated with a willingness to consider LARC placement immediately postabortion. METHODS: A structured self-administered survey was provided to English-speaking women older than 18 years old presenting to a reproductive health center in the United States for first-trimester pregnancy termination. The survey collected information about demographics and reproductive history. We measured trust in the health care system with a validated scale. Statistical analysis was performed using chi tests Students t tests and logistic regression with SAS 9.2. RESULTS: One hundred sixty-two respondents completed surveys. Twenty-four percent indicated a plan to use LARC postabortion whereas 37% indicated they would accept LARC if available on the day of their abortion. The mean trust score was 59 (standard deviation 8 range 38-78) and did not differ significantly between women who indicated a willingness to use LARC immediately postabortion and others (P=.9). Demographic variables including education marital status income and prior pregnancy met criteria for inclusion in our multivariable model but none was ultimately predictive of LARC use postabortion. CONCLUSION: More than one third of participants reported that they would accept LARC immediately postabortion if available. In our study neither trust in the health care system nor demographic variables predicted willingness to accept LARC immediately postabortion.

Atención a mujeres inmigrantes en un programa de mediación intercultural en salud

Intercultural Mediation is a strategy for quality health care aimed at reducing inequalities in immigrant population. The aim is to analyse main reasons consultation with the mediation service, women care profile and characteristics of intervention. Cross-sectional study of 339 episodes of care by two intercultural mediators (MI) from February 2008 to October 2011 in Valencia. Variables were analysed individual records of the consultations of the MI: reasons for referral to MI and professionals who refer, motives and problems identified by MI, kind of intervention, kind of derivation of MI and socio-economic variables. To evaluate the differences between countries, X2 test was used for qualitative variables and one-way ANOVA test for quantitative variables. 123 women (36,3%), were referred to the MI by the Sexual and Reproductive Health Centre and 98 (28,9%) by the midwife. 272 women (80,24%) were referred for information and demand for contraception. The MI conducted health education and detected social problems in 67 women (19,7%) and gender violence in 38 (11,21%). The women attending were Latin American immigrants (those of Bolivia showed more vulnerability) and were referred for contraception. The MI provided information, education and facilitated access to reproductive health services. Bolivian women showed more vulnerability factors: irregular situation, precarious work and low residence time.

Staying on track: A cluster randomized controlled trial of automated reminders aimed at increasing human papillomavirus vaccine completion

ObjectivesTo evaluate whether automated reminders increase on-time completion of the three-dose human papillomavirus (HPV) vaccine series. MethodsTen reproductive health centers enrolled 365 women aged 19–26 to receive dose one of the HPV vaccine. Health centers were matched and randomized so that participants received either routine follow-up (control) or automated reminder messages for vaccine doses two and three (intervention). Intervention participants selected their preferred method of reminders – text, e-mail, phone, private Facebook message, or standard mail. We compared vaccine completion rates between groups over a period of 32 weeks. ResultsThe reminder system did not increase completion rates, which overall were low at 17.2% in the intervention group and 18.9% in the control group (p=0.881). Exploratory analyses revealed that participants who completed the series on-time were more likely to be older (OR=1.15, 95% CI 1.01–1.31), report having completed a four-year college degree or more (age-adjusted OR=2.51, 95% CI 1.29–4.90), and report three or more lifetime sexual partners (age-adjusted OR=3.45, 95% CI 1.20–9.92). ConclusionsThe study intervention did not increase HPV vaccine series completion. Despite great public health interest in HPV vaccine completion and reminder technologies, completion rates remain low.

Contraceptive History, Unintended Pregnancy, and Contraceptive Method Choice Among Urban Low-Income Women

Nearly half of pregnancies in the United States are unintended, a proportion that has remained constant in the last decade. Half of unintended pregnancies occur among women not using any contraception, but little is known about how contraceptive history and contraceptive priorities predict contraceptive method choice. Among 1454 women not currently seeking pregnancy who completed a computer-based contraceptive assessment module at an urban reproductive health center, factors associated with not obtaining a contraceptive method were assessed. The 1454 participants were low-income (98% had incomes <200% federal poverty level), predominantly Hispanic (71%), and foreign-born (76%). None were seeking to become pregnant, but 15% did not obtain a method of contraception. In adjusted analyses, women who had ever had an unintended pregnancy-41% of the sample-were significantly more likely to leave their visit without receiving a method (adjusted odds ratio [AOR]=1.67, 95% confidence interval [CI]: 1.21-2.30), as were women who were not using contraception at the start of their visit (AOR=3.82, 95% CI: 2.73-5.35). In an adjusted model, prioritizing no hormones or the preference of not wanting to interrupt sex to use a method was not a significant predictor of obtaining a method. Analyses revealed that women at higher risk of unintended pregnancy identified by their contraceptive histories were significantly more likely to leave their healthcare visit without a method of contraception. Additional research is needed on ways to help women obtain effective, medically indicated contraceptive methods that fit their reproductive life goals, priorities, and preferences.

Are all skilled birth attendants created equal? A cluster randomised controlled study of non-physician based obstetric care in primary health care clinics in Mexico

Backgroundthe great majority of births in Mexico are attended by physicians. Non-physician health professionals have never been evaluated or compared to the medical model of obstetric care. This study evaluates the relative strengths of adding an obstetric nurse or professional midwife to the physician based team in rural clinics. Methodswe undertook a cluster-randomised trial in 27 clinics in 2 states with high maternal mortality. Twelve non-physician providers (obstetric nurses (4) and professional midwives (8)) were randomly assigned to clinics; 15 clinics served as control sites. Over an 18-month period in 2009–2010, we evaluated quality of care through chart review and monthly interviews with providers about last three deliveries performed. We analysed practices by creating indices using WHO care guidelines for normal labour and childbirth. Volume of care was assessed using administrative reporting forms. Findingstwo thousand two hundred fifty-four pregnancies were followed, and a total of 461 deliveries occurred in study sites. Intervention clinics were more likely to score highly on the index for favourable practices on admission (OR=3.6, 95% CI 2.3–5.8), and during labour, childbirth, and immediately post partum (OR=8.6, 95% CI 2.9–25.6) and less likely to use excessively used or harmful practices during labour, childbirth and immediately post partum (OR=0.2, 95% CI 0.1–0.4). There was a significant increase in volume of care in intervention clinics for antenatal visits (incidence rate ratio (IRR) 1.3, 95% CI 1.2–1.4), deliveries (IRR=2.5, 95% CI 1.7–3.7) and for postpartum visits (IRR=1.4, 95% CI 1.1–1.7). Interpretationthe addition of non-physician skilled birth attendants to rural clinics in Mexico where they independently provided basic obstetric services led to improved care and higher coverage than clinics without. The potential value of including a professional midwife or obstetric nurse in all rural clinics providing obstetric care should be considered. FundingMexican National Institute for Women, Mexican National Center for Gender Equity and Reproductive Health, MacArthur Foundation, Bill and Melinda Gates Foundation.

Continuing Medical Education Credits for 45th Annual Meeting of the Society for the Study of Reproduction & 18th Ovarian Workshop Hosted by the Center for Reproductive Biology and Health The Pennsylvania State University State College, Pennsylvania 12–15 August 2012. “Applied Reproductive Biology: Making It Relevant”

Continuing Medical Education Credits for 45th Annual Meeting of the Society for the Study of Reproduction & 18th Ovarian Workshop Hosted by the Center for Reproductive Biology and Health The Pennsylvania State University State College, Pennsylvania 12–15 August 2012. “Applied Reproductive Biology: Making It Relevant”

Back to the Future of Regulating Abortion in the First Term

Abortion and women's reproductive rights have reemerged as front-page news. As popular culture grapples with election rhetoric, states continue to engage in aggressive anti-abortion regulation of first-term abortions. In the first half of 2011, more abortion bills have passed to restrict abortion than ever before. The 162 new abortion bills passed by 19 states in the first six months of the year dwarf the average number of abortion bills for the last three decades of 15 per year. Even more, these bills propose significantly more stringent limits on abortion than in the past, including mandatory ultrasound viewings, intensive counseling, and bans after the first fetal heartbeat at six weeks. These restrictions seem blatantly to defy the holding of Roe v. Wade permitting abortion in the first trimester, yet they continue to proliferate.This Article provides the historical context for the current onslaught of proposed abortion bills by returning to two of the earliest Supreme Court cases of indirect regulation of abortion in the first term. It offers a legal history of the case, City of Akron v. Akron Center for Reproductive Health, and its follow-on case, Ohio v. Akron Center for Reproductive Health. For before the dust had even settled in the Supreme Court’s 1973 landmark decision in Roe v. Wade, legislators had moved to restrict its impact by passing laws to 'protect women’s health and voluntary and informed consent.' In the Akron cases, the Court first rejected such attempts to limit abortion in the first term, but then subsequently upheld a first-term regulation, casting doubt upon its continued commitment to Roe. This legal history offers insights and analyses into the legislation of abortion gleaned from a review of the historical record in the Akron cases found in archives and long-forgotten files in dusty basements. It relies on interviews with key players in the cases to provide a fuller explanation of the political and social motivations behind the legal disputes. Revisiting the legal and factual details of these foundational cases of first-term abortion regulation offers a more nuanced understanding of the opposition to abortion and the unsatisfactory nature of the judicial compromises. For only one thing is clear: “The decision in Roe v. Wade neither started nor ended the debate over abortion.”

GnRH agonist protocol versus GnRH antagonist protocol in assisted reproduction

GnRH agonist protocol versus GnRH antagonist protocol in assisted reproduction

SP4-34 Factors associated with qualified medical care for sick neonates among urban poor in Lucknow, northern India

IntroductionThis study assessed factors associated with qualified medical care-seeking (QMC) for sick neonates among urban poor.MethodsThe study was conducted at an urban Reproductive and Child Health (RCH) center and free...

TERMINATION OF PREGNANCY LESS THAN 49 DAYS USING MIFEPRISTONE AND MISOPROSTOL

Objectives: 1.To evaluate the effectiveness and safety of Mifepristone and Misoprostol in termination of pregnancy less than 49 days. 2. To evaluate the acceptability and side effects of that treatment scheme. Materials &amp; Methods: 169 pregnant women less than &lt;49 days demanding medical abortion at Can Tho Reproductive Health Center during the period of June 1st 2009 to May 30th 2010. Mifepristone 200mg was administered orally, followed by onsite monitoring during 30 minutes; Misoprostol 400 µg were administered orally 48 hours later by th facility at the center. Follow-up visit for 2 weeks was made after using Mifepristone. Results and Discussion: Rate of successful pregnancy termination was 95.3%. Mean duration between Mifepristone and Misoprostol use and abortion is 4.3 ± 3.7 hours. Satisfaction rate is 89.4%. Observed Mifepristone’s side effects include abdominal pain (35.8%), nausea (20.3%), and vomit (4.8%); Misoprostol’s side effects include abdominal pain (86.6%), nausea (33,7%), vomit (8,6%), fever/child, fatigue and diarrhea (7.5%). Conclusions: Mifepristone and Misoprostol are safe and highly effective for termination of pregnancy less than 49 days.