Contraceptive Side Effects Research Articles

Identifying what contraceptive side effects women are told about during counseling using nationally representative PMA Ethiopia 2019 cross-sectional data.

Despite widespread concerns about contraceptive side effects among contraceptive users, few studies explore the specific side effects women are told about during contraceptive counseling. It is thus unclear whether women receive appropriate and sufficient information on side effects they may experience. The objective of this study is to describe which specific side effects of hormonal contraception or copper IUD users are counseled on and identify relevant user characteristics associated with receipt of counseling, using nationally representative cross-sectional data from Ethiopia. Data were collected from a nationally representative sample of women between October and December 2019. Analyses were restricted to 2,039 current users of hormonal contraception (implant, injectable, pill, or emergency contraception) or the copper IUD. Descriptive analyses identified the types and number of side effects, across all methods and by the injectable, implant, and pill. Multinomial regression identified factors associated with receipt of counseling on bleeding changes only, non-bleeding changes only, or both, relative to no counseling on side effects, adjusting for method type, source, and socio-economic characteristics. Less than 10% of users were told of at least one bleeding and non-bleeding side effect. Relative to implant users, injectable and other method users were less likely to be told about bleeding changes only (aRRR: 0.65, 95% CI: 0.46-0.93 and aRRR: 0.31, 95% CI: 0.16-0.61, respectively) and users of other methods were less likely to be told about both a bleeding and non-bleeding change (aRRR: 0.43, 95% CI: 0.19-0.93). Users who received their method from a non-public source were less likely to receive counseling on any kind of side effect and nulliparous women were less likely to be told about both kinds of side effects. There is need to improve counseling on the method specific side effects on which women are counseled, particularly in the private sector.

Patient-centered or population-centered? How epistemic discrepancies cause harm and sow mistrust

Medical distrust is often conceived of as a problem of misinformation or ignorance. In this paper, I depart from this framework, attributing distrust instead to epistemic divergence between lay people and experts. Using data from a contraceptive side effects Facebook group and in-depth physician interviews, I find that providers employ a “body-as-subject” lens informed by population-health goals, while group members employ a “body-as-agent” lens that privileges individuality and bodily autonomy. Provider epistemologies are privileged, creating epistemic injustice and harm for patients. Ultimately, this erodes trust in providers and the medical community more broadly.

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<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.

The Goals of Medicine: Debate and Disagreements Around Contraceptive Side Effects.

Since the invention of hormonal contraceptives, there has been disagreement between users and providers about the existence of side effects and their implications for care. The lack of consideration for cisgender women, and other people who may become pregnant, has often been explained by sexist bias in the philosophy of medicine. My goal is to contribute additional elements to this discussion. I will argue that there are structurally embedded assumptions about the responsibilities and goals of medicine that open the door to this sexism in the first place. While we tend to accept that contraception is part of medicine for pragmatic reasons, we do not exhibit the same form of pragmatism when it comes to dealing with side effects. This is an unjustified double standard that fails to recognize the goals of contraception and the fact that it relies on medical expertise to achieve them.

Exploring Contraceptive Experiences of Abortion-Fund Clients in the Rocky Mountain Region of the United States from a Reproductive Justice Lens

This study focuses on the contraceptive experiences of abortion-fund applicants to draw attention to various elements that restrict the realization of reproductive justice in the Rocky Mountain Region of the United States. This study uses qualitative data from 830 applications to an abortion fund submitted between 2013 and 2022. Our findings highlight a range of experiences, from contraceptive failure and side effects, to diminished access and reproductive coercion. Abortion-fund applicants described individual, interpersonal, and structural factors that shaped their access to contraception. This study calls for various interventions, including implementing comprehensive sex education, to ensure reproductive justice.

Individual and community level factors for modern contraceptives utilization among reproductive aged women in Amhara region, Mixed effect multi-level modeling, Data from Mini-EDHS, 2019

BackgroundModern contraceptive has been identified as a key strategy to control unintended pregnancy, protect the health of the mother and child, and promote women wellbeing. Despite this and increasingly wider availability of modern contraceptives, however, there are still high levels of unmet need for birth interspacing and contraceptive use in Amhara regions. This study aimed to identify factors associated with the enhancing of modern contraceptives utilization among reproductive aged women in Amhara region, using a mixed effects multilevel modeling data from mini-EDHS 2019.MethodsA community-based cross-sectional study was conducted among 711(wt = 100%) samples of reproductive-aged women. The data were interviewed by trained data collectors using a semi-structured questionnaire for the final mini-EDHS 2019 data set. A multilevel binary logistic regression model was fitted to identify the enhancing factors for modern contraceptive utilization Adjusted Odds Ratio (AOR) with 95% Confidence Intervals (CI) was used to identify factors associated with utilization.ResultThe median age of the participants was 31 with (IQR ± 13) years. The overall modern contraceptive utilization was 42.3% (95%CI: 38.7; 46.1). Individual and community factors accounted for 21.4% of the variation in modern contraceptive utilization at the cluster level. Being age 25 years (AOR = 12.99; 95%CI: 4.5–37.2), 26–35 years (AOR = 8.8, 95%CI: 3.25- 24), 36–45 years (AOR = 5.6, 95%CI: 2.2–16.2), being married (AOR = 4.2, 95%CI: 2.21–6.97), educated women (AOR = 11.6, 95%CI: 3.22–40.4), and being middle-economic class (AOR = 3.03; 95%CI: 1.87–4.91) were identified as individual enhancing factors. Whereas, being urban resident (AOR = 5.19; 95%CI: 5.19: 41.7) and having media exposure (AOR = 1.5; 95%CI: 1.58–3.7) were community-level enhancing factors for modern contraceptive utilization.ConclusionCompared to earlier studies, in Amhara region, a lower prevalence rate of modern contraceptive utilization was reported. The variation in utilization at the cluster level, 21.4%, was attributed to individual and community-level factors. Healthcare providers should prioritize raising awareness about contraceptive side effects to encourage new users and decrease the number of individuals who discontinue contraceptive methods.

Sex and Female Empowerment (SAFE): Learning from health care providers, men and women to design a sexual health intervention for women with substance use disorders

BackgroundSubstance Use Disorder (SUD) treatment is a promising setting to provide sexual health education to women. This study examined barriers and possible solutions to effectively providing sexual health education and services during SUD treatment. MethodsTo obtain a full picture of the barriers and solutions, 29 cisgender women and 17 cisgender men in treatment for a SUD and four health care providers in North Carolina were interviewed regarding the domains of pregnancy-planning, barriers to reproductive health services and contraception, selecting a method of contraception and desired aspects and elements of a sexual health intervention. ResultsEight themes and 12 sub-themes emerged that included how addiction impacts pregnancy planning and pregnancy motivations, the stigma and fear regarding accessing health services, the lack of accurate knowledge of the human reproductive cycle and contraceptive methods and worries about contraception side-effects. Recommendations for interventions to reduce unintended pregnancy in this treatment population included the need for simple and focused information given by trusted communicators in a short time frame in accessible locations, and offering incentives for participation such as food and transportation. ConclusionAs SUD treatment providers and programs look to improve access to sexual health and contraceptive options for women with SUD, these eight themes provide helpful guidance in crafting future interventions.

The Effect of Family Planning Education on Knowledge, Attitude and Practice Toward Family Planning Methods Among Married Couples in Kersa and Goma Districts of Jimma Zone, South West Ethiopia.

Individuals with accurate knowledge that goes beyond knowing a few contraceptive methods, such as knowledge of fertility, benefits, and contraceptive side effects, are more likely to use and less likely to discontinue using family planning. The aim of the study was to determine the effect of family planning education on knowledge, attitude, and practice towards family planning among married couples in Jimma Zone, Ethiopia. A quasi-experimental study was done on 766 married couples sampled using a random sampling technique and analyzed using SPSS 23.0. The significance of differences in mean knowledge and attitude between control and experimental couples was measured using the non-parametric 2-independent sample analysis (P < 0.05). The comparison of knowledge score means and significance of their differences between control and experimental women was found to be significant at the posttest (P = 0.001; r = 0.045). Similarly, the experimental men's knowledge score means and their difference was significant at posttest (P = 0.001, r = 0.26). With respect to a comparison of mean score of attitude and the significance of their difference between control and experimental women at posttest was significant with (P < 0.001; r = 0.13). Similarly, the comparison of the male partners in the control and experimental groups was significant at posttest (P = 0.001; r = 0.12). At the posttest, the proportion of experimental couples using each contraceptive method relatively increased, with a shift to relatively effective ones. Two hundred and ninety five (77.6%) of the control and 318 (83.5%) of the experimental men reported supporting their wives in the use of contraceptives, showing more improvement among the experimental men than the control group. Along with routine counseling, a well-structured behavioral model-based family planning education is required for effective and continuous use of contraceptives.

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.

Experiences of pregnancy prevention among youth experiencing homelessness

Youth experiencing homelessness (YEH) are at high risk for unintended pregnancy and face unique challenges to effectively preventing unintended pregnancy. This qualitative study explored the pregnancy prevention experiences of YEH. A total of 81 diverse youth participated in eight focus group discussions that were conducted to explore their perceptions and experiences related to pregnancy prevention. Youth were recruited from shelters, drop-in centers, and homeless-serving organizations in a large metropolitan area in the southern United States. Thematic content analysis of the data revealed that YEH struggle to engage in sexual and reproductive health services owing, in part, to limited accessibility. Lack of knowledge about contraceptives, perceived adverse side effects of contraceptives, and challenges with adherence to contraceptive methods significantly limited the effective use of contraception among YEH. Youths’ decisions to use contraception were influenced by their relationship status with partners, perceptions about the efficacy and side effects of contraceptives, and the stigma associated with contraceptive use. Providing sexual and reproductive health services to YEH requires a collaborative approach. YEH need comprehensive sexual and reproductive health education and counseling that enables and empowers youth to access, navigate, and utilize such services.

Feasibility and acceptability of virtual group contraceptive counseling prior to abortion care

ObjectivesThis study aimed to evaluate the feasibility and acceptability of virtual group contraceptive counseling in the abortion care setting. Study designPatients seeking abortion care at an urban university hospital were invited to participate in this cohort study. Prior to their clinical appointments, groups of two to six patients participated in 45-minute virtual contraceptive counseling visits facilitated by study staff. Contraceptive method use, effectiveness, and side effects were reviewed according to group interest. Participant satisfaction scores were collected immediately following the sessions. After their appointments, providers estimated the time spent on contraceptive counseling during the clinical visit. ResultsOf 195 patients approached, 86 (44%) were enrolled. Fifty-seven (66%) enrolled patients completed a session. The most common reason for declining enrollment was concern about the time commitment. Most (93%) participants reported being “satisfied” or “very satisfied” overall, and 96% would recommend group contraceptive counseling to a friend. Providers reported that compared to typical counseling, participants required a shorter amount of time during the clinical visit than nonparticipants (time spent <5 minutes: 74% vs 54%). ConclusionsVirtual group contraceptive counseling for patients seeking abortion was feasible and acceptable in this study. Group virtual visits may reduce provider time burden, add value when virtual care delivery is desired or required, and deserve further study. ImplicationsFamily planning clinics can consider incorporating virtual group counseling as a person-centered and efficient approach to contraceptive counseling at the time of abortion care.

Exploring Language Used in Posts on r/birthcontrol: Case Study Using Data From Reddit Posts and Natural Language Processing to Advance Contraception Research.

Contraceptive choice is central to reproductive autonomy. The internet, including social networking sites like Reddit, is an important resource for people seeking contraceptive information and support. A subreddit dedicated to contraception, r/birthcontrol, provides a platform for people to post about contraception. This study explored the use of r/birthcontrol, from the inception of the subreddit through the end of 2020. We describe the web-based community, identify distinctive interests and themes based upon the textual content of posts, and explore the content of posts with the most user engagement (ie, "popular" posts). Data were obtained from the PushShift Reddit application programming interface from the establishment of r/birthcontrol to the start date of analysis (July 21, 2011, to December 31, 2020). User interactions within the subreddit were analyzed to describe community use over time, specifically the commonality of use based on the volume of posts, the length of posts (character count), and the proportion of posts with any and each flair applied. "Popular" posts on r/birthcontrol were determined based on the number of comments and "scores," or upvotes minus downvotes; popular posts had 9 comments and a score of ≥3. Term Frequency-Inverse Document Frequency (TF-IDF) analyses were run on all posts with flairs applied, posts within each flair group, and popular posts within each flair group to characterize and compare the distinctive language used in each group. There were 105,485 posts to r/birthcontrol during the study period, with the volume of posts increasing over time. Within the time frame for which flairs were available on r/birthcontrol (after February 4, 2016), users applied flairs to 78% (n=73,426) of posts. Most posts contained exclusively textual content (n=66,071, 96%), had comments (n=59,189, 86%), and had a score (n=66,071, 96%). Posts averaged 731 characters in length (median 555). "SideEffects!?" was the most frequently used flair overall (n=27,530, 40%), while "Experience" (n=719, 31%) and "SideEffects!?" (n=672, 29%) were most common among popular posts. TF-IDF analyses of all posts showed interest in contraceptive methods, menstrual experiences, timing, feelings, and unprotected sex. While TF-IDF results for posts with each flair varied, the contraceptive pill, menstrual experiences, and timing were discussed across flair groups. Among popular posts, intrauterine devices and contraceptive use experiences were often discussed. People commonly wrote about contraceptive side effects and experiences using methods, highlighting the value of r/birthcontrol as a space to post about aspects of contraceptive use that are not well addressed by clinical contraceptive counseling. The value of real-time, open-access data on contraceptive users' interests is especially high given the shifting landscape of and increasing constraints on reproductive health care in the United States.

To compare the clinical efficacy and side effects of implant (Jadelle) and IUCD (Copper T)

This study aims to compare the performance and side effects of the subdermal implant JADELLE and intrauterine contraceptive device Copper-T as long-acting reversible contraceptive methods. The study design involved a comparative analysis of Jadelle and Copper-T contraceptives, assessing clinical performance and side effects. Sample data from 336 participants was collected using stratified random sampling, with standardized instruments for demographic information, clinical assessment, and contraceptive side effects. Inclusion criteria were reproductive-age multipara women, while exclusion criteria included primary para, preexisting medical disorders, nullipara, and other contraceptive use. Ethical guidelines were followed, ensuring informed consent, privacy, and the right to withdraw. Statistical analysis employed descriptive statistics, chi-square test, independent samples t-test, and Kaplan-Meier survival analysis. SPSS (version 23.0) was used for analysis. The comparison between Group A (Jadelle) and Group B (Copper-T) reveals interesting findings. Group A has a higher mean age, but no significant differences in parity, blood pressure, or weight. Group B has more total and ongoing pregnancies. Group A experiences higher prevalence of side effects, including expulsion, infection, severe menstrual changes, pain or discomfort, and mood swings. Blood parameters show no significant differences. Variations exist in follow-up rates, informed consent, and privacy maintenance.

Compare the clinical efficacy and side effects of implant (JADELLE) and IUCD (COPPER T)

This study aims to compare the performance and side effects of the subdermal implant JADELLE and intrauterine contraceptive device Copper-T as long-acting reversible contraceptive methods. The study design involved a comparative analysis of Jadelle and Copper-T contraceptives, assessing clinical performance and side effects. Sample data from 336 participants was collected using stratified random sampling, with standardized instruments for demographic information, clinical assessment, and contraceptive side effects. Inclusion criteria were reproductive-age multipara women, while exclusion criteria included primary para, preexisting medical disorders, nullipara, and other contraceptive use. Ethical guidelines were followed, ensuring informed consent, privacy, and the right to withdraw. Statistical analysis employed descriptive statistics, chi-square test, independent samples t-test, and Kaplan-Meier survival analysis. SPSS (version 23.0) was used for analysis. The comparison between Group A (Jadelle) and Group B (Copper-T) reveals interesting findings. Group A has a higher mean age, but no significant differences in parity, blood pressure, or weight. Group B has more total and ongoing pregnancies. Group A experiences higher prevalence of side effects, including expulsion, infection, severe menstrual changes, pain or discomfort, and mood swings. Blood parameters show no significant differences. Variations exist in follow-up rates, informed consent, and privacy maintenance.

Hubungan Jenis Dan Lama Penggunaan Kontrasepsi Hormonal Terhadap Gangguan Menstruasi Pada Wanita Usia Subur Di Klinik Pratama Vina Kecamatan Medan Baru Kota Medan Tahun 2023

According to the World Health Organization (WHO) in 2017 contraceptive use has increased in many parts of the world, especially in Asia and Latin America and is lowest in Sub-Saharan Africa. Globally, users of modern contraception have increased significantly from 35% in 1970 to 63% in 2017. The 2019 Indonesia Health Profile data shows that most active family planning participants choose injections and pills as contraceptives and are even very dominant (more than 80 %) compared to other methods; inject (63.7%), Pill (17.0%), Implant (7.4%), IUD/IUD (7.4%), Condom (1.2%), MOW (Women's Operative Method) (2 .7%), MOP (Male Operative Method) (0.5%). (RI Ministry of Health, 2020). The side effect of hormonal contraception is disruption of menstruation. The main side effects of DMPA (Depot Medroxyprogesterone Acetate) contraception and implants are menstrual disorders in the form of amenorrhea, spotting, changes in cycles, frequency, length of menstruation and amount of blood loss. The side effects of a contraceptive method are a factor that needs to be considered in determining the decision to continue using the contraceptive method (Hartanto, 2013). The type of research used in this research is analytic with a cross sectional approach. Cross sectional is a research approach that emphasizes the time of measurement/observation of independent variable data and depends only once at a time. The research sampling technique is total sampling. This research will be conducted at the Pratama Vina Clinic, Medan Baru District, Medan City in 2023. The results of the chi-squere test d. There is a significant relationship between the type of hormonal contraception and menstrual disorders in women of childbearing age at the Pratama Vina Clinic, Medan Baru District, Medan City, in 2023 (p= 0.013) and there is a significant relationship between the length of use of hormonal contraception and menstrual disorders in women of childbearing age at the Pratama Vina Clinic, Medan Baru District, Medan City in 2023 (p=0.031).

"She should support me, she's my doctor:" Patient perceptions of agency in contraceptive decision-making in the clinical encounter in Northern California.

Agency in contraceptive decision-making is an essential aspect of reproductive autonomy. We conducted qualitative research to investigate what agency means to patients seeking contraceptive care to inform the development of a validated measure of this construct. We held four focus group discussions and seven interviews with sexually-active individuals assigned female at birth, ages 16-29 years, recruited from reproductive health clinics in Northern California. We explored experiences in contraceptive decision-making during the clinic visit. We coded data in ATLAS.ti and by hand, compared codes across three coders, and used thematic analysis to identify salient themes. The sample mean age was 21 years, with 17% of participants identifying as Asian, 23% as Black, 27% as Latinx, 17% as Multiracial/other, and 27% as white. Overall, participants reported active and engaged decision-making in their recent contraceptive visit but noted experiences that had undermined their agency in the past. They described how non-judgmental care allowed them to communicate openly, affirming their ability to make their own decisions. However, several mentioned how unexpected contraceptive side effects after the visit had reduced their sense of agency over their decision in retrospect. Several participants, including those who identified as Black, Latinx, and/or Asian, described prior experiences where pressure to use a contraceptive method had undermined their agency and where they had switched providers to regain agency over their contraceptive decisions. Most participants were aware of their agency during contraceptive visits and how it varied in different experiences with providers and the healthcare system. Patient perspectives can help to inform measurement development and ultimately the delivery of care that supports contraceptive agency.

One-year discontinuation among users of the contraceptive pill and injection in South East Tigray region, Ethiopia.

The aim of this study is to determine the 12 months' discontinuation rate and associated factors among family planning clients using pills and injection. A follow-up study was initiated to collect data from 845 family planning users between November 2017 and December 2018. An interviewer administered questionnaire was used to collect data from participants. Data were entered into EpiData version 3.1 and analyzed using SPSS version 20, where both are open-source systems. A Cox proportional-hazards model was used to estimate the hazard ratios (HR) for the rate of discontinuation among participants. At 12 months, 63.5% of women discontinued the use of their baseline method. For the individual methods, 84% of women that chose the pill discontinued its use and for those using the injectable, 60.7% of women discontinued its use. Using the adjusted Cox proportional-hazards model, pills users (HR = 1.77; 95%CI = [1.4-2.3]), users receiving family planning services in the same room as other maternal health clinic services (HR 1.58; 95%CI = [1.16-2.2]), users served by health officers (HR = 3.7; 95%CI = [1.66-8.2]), and users not intending to use the baseline method continuously (HR = 1.6; 95%CI = [1.16-2.24]) were significantly more likely to discontinue using the baseline method. The main reason cited for discontinuation was side effects of contraception. The discontinuation rate of the baseline contraceptive method after 12 months was very high. To increase the continuity of contraceptive use, family planning services should be given in a separate room with effective counseling on potential side effects, provided by midwives or nurses who have good counseling skills.

Reasons for Having Unprotected Sex Among Adolescents and Young Adults Accessing Reproductive Health Services.

Although research suggests that young people are more likely to have unprotected sex than adults, their reasons for doing so are not well-understood. Among a sample of young people accessing no-cost contraceptive services, we explored their reported reasons for having unprotected sex and their willingness to have unprotected sex in the future. We recruited sexually active assigned female at birth youth at 10 family planning clinics in the San Francisco Bay Area (n=212). Participants completed a self-administered survey reporting their reasons for having unprotected sex and willingness to do so in the future. We used bivariate analyses to assess associations between reasons for unprotected sex and age group (adolescents ages 14-19 vs. young adults ages 20-25) and willingness to have unprotected sex in the future. Most young people (69%) had recently engaged in unprotected sex and 41% were willing to in the future. The most common reported reasons for having unprotected sex included not planning to have sex, a preference for unprotected sex, and difficulty using contraception. Worrying about contraceptive side effects and a preference for unprotected sex were significantly associated with a willingness to have unprotected sex in the future (p<.01). Age group was not associated with most reasons for having unprotected sex. Person-centered care should give attention to the range of reasons that may influence young people's sexual and contraceptive decision-making.

The burden of unintended pregnancies among Indian adolescent girls in Bihar and Uttar Pradesh: findings from the UDAYA survey (2015–16 & 2018–19)

BackgroundUnintended pregnancy severely affects the health and welfare of women and children, specifically if women are young and vulnerable. This study aims to determine the prevalence of unintended pregnancy and its determinants among adolescent girls and young adult females in Bihar and Uttar Pradesh. We believe the present study is unique as it examines the association between unintended pregnancy and sociodemographic factors among young female population in two states of India from 2015–19.MethodsThe data for the present study is derived from the two-wave longitudinal survey “Understanding the lives of adolescents and young adults” (UDAYA) conducted in 2015–16 (Wave 1) and 2018–19 (Wave 2). Univariate, bivariate analysis along with logistic regression models were employed.ResultsThe results revealed that 40.1 per cent of all currently pregnant adolescents and young adult females reported their pregnancy as unintended (mistimed and unwanted) in Uttar Pradesh at Wave 1 of the survey, which decreased to 34.2 per cent at Wave 2. On the contrary, almost 99 per cent of all currently pregnant adolescents in Bihar reported their pregnancy as unintended at Wave 1, which decreased to 44.8 per cent at Wave 2. The sociodemographic factors like age, caste, religion, education, wealth, media and internet use, knowledge and effective contraception highly impacted unintended pregnancy in Bihar and Uttar Pradesh. The longitudinal results of the study revealed that place of residence, internet use, number of wanted children, heard about contraception and SATHIYA, use of contraception, side effects of contraception, and the confidence in getting contraceptives from ASHA/ANM did not appear significant predictors at Wave 1. However, they emerge significant over time (Wave 2).ConclusionsDespite many recently launched policies for adolescents and the youth population, this study comprehended that the level of unintended pregnancies in Bihar and Uttar Pradesh stands worrisome. Therefore, adolescents and young females need more comprehensive family planning services to improve their awareness and knowledge about contraceptive methods and use.

Acceptability and continuation of use of the subdermal contraceptive implant among adolescents and young women in Argentina: a retrospective cohort study

A new public policy was instituted in Argentina for free distribution of subdermal contraceptive implants to women aged 15–24 years old in the public healthcare system. The objective of this study is to determine the extent to which this population adhered to the implant, as well as predictors of continuation. The retrospective cohort study was based on a telephone survey of a random sample of 1101 Ministry of Health-registered implant users concerning the continuation of use, satisfaction with the method and side-effects, and reasons for removal. Descriptive statistics and multivariate regression analysis were used to explore the association between adherence and having received contraceptive counselling, satisfaction, and side effects. We found high levels of adherence (87%) and satisfaction (94%). Common reported side effects were amenorrhoea or infrequent bleeding, perceived weight gain, increased menstrual bleeding and headaches. Multivariate regression analysis indicates that, among adolescents, having received contraceptive counselling increased comfort, while frequent bleeding at six months hindered trust. Participants who had a history of a prior delivery or who had themselves primarily chosen the method were less likely to request the removal of the implant. Our results support the public policy of free implant distribution in the public health sector. This is a sustainable public policy that contributes to equity and access to effective contraception. It is appropriate for adolescents and young women and will also reduce unintended pregnancies. Our results suggest that counselling patients is key prior to insertion of the implant, as it improves acceptability and continuation.