Unintended Pregnancy Research Articles

Contraception Used by People Assigned Female at Birth With Spinal Cord Injury

ObjectivesThere is limited data on contraception used by people assigned female at birth with spinal cord injury (SCI). Pregnancy in people with SCI can be medically complex, therefore access to contraception to prevent unplanned pregnancies is imperative. This study aimed to assess the availability of contraception from health care providers (HCPs) to people with SCI and the contraception methods used. MethodsAn online international questionnaire was distributed. Demographic data and reproductive histories were recorded. Overall, 780 responses were received from participants in 33 different countries. Most participants lived in North America and self-identified as White. In total, 75% had a traumatic SCI. Most SCIs were at cervical and thoracic levels and American Spinal Injury Association-A and American Spinal Injury Association-B. Descriptive and χ2 statistics were used. ResultsThe recruitment rate was 85.4% and the completion rate was 73.8%. Overall, 93.6% of participants reported ever having been sexually active, while 60.7% reported sexual activity over the past year. Of people who were injured under the age of 50 years and who have been sexually active, 63.6% were offered birth control by an HCP. Condoms were used by 44.5% of participants, withdrawal by 20.1%, the combined oral contraceptive pill by 28.4% and intrauterine device by 20.1% of respondents. ConclusionsThis is the largest known study on SCI and contraception. Most people with SCI are sexually active. The withdrawal method and no contraception are used by many individuals, which may increase the risk of unplanned pregnancy. Increased use of highly effective contraception in this population may be achieved through HCP-initiated conversations about sexual health.

Investigation of factors associated with delayed initiation of breastfeeding in Papua New Guinea: a cross-sectional study

BackgroundBreastfeeding within the first hour of birth is critical for newborn survival. However, in Papua New Guinea (PNG), about 40% of newborns are not breastfed within the first hour of...

Unplanned Pregnancy in Women with Lupus Nephritis Is Common and Is Associated with Poor Fetal Outcomes

Unplanned Pregnancy in Women with Lupus Nephritis Is Common and Is Associated with Poor Fetal Outcomes

Contraception for women over 40: A comprehensive guide.

Women in their 40s experience significant reproductive health changes, requiring personalised contraception to avoid unintended high-risk pregnancies and adapt to changing health conditions. This article examines optimal contraceptive choices for women in their 40s, considering effectiveness, ease of use, non-contraceptive benefits, side effects, contraindications and re-evaluation or discontinuation timings. Contraceptive choices for women in their 40s vary depending on their family planning status, underlying health conditions and risk factors. Long-acting reversible contraceptives, permanent sterilisation and progestogen-only methods (excluding depot medroxyprogesterone acetate) are preferred options for women who have completed their families. Hormonal contraceptives can help manage menstrual disorders and bone health issues while providing endometrial protection during menopause. Regular contraceptive reviews should be conducted, and options adapted asneeded.

Contraception options during pubertal transition: Risks, benefits and considerations.

The age of puberty and sexual maturation has been decreasing, highlighting the importance of providing appropriate contraception to girls and adolescents. However, challenges remain, including legal implications and understanding the effects of hormonal methods on pubertal development. This article aims to equip general practitioners with theknowledge of options, as well as their use and limitations, in young people seeking contraception. No one-size-fits-all approach exists for adolescent contraception. Long-acting reversible contraceptives offer superior contraceptive efficacy, with subdermal implants being the most acceptable regarding the insertion procedure. Condoms should be recommended for protection against sexually transmissible infections. Bone health and mood disorders should be considered when prescribing hormonal contraceptives. Despite the lack of robust evidence regarding harm caused by contraception in adolescents, preventing unintended pregnancies should take precedence, with theoretical risks guiding tailored options for individuals.

Intrauterine device use in adolescence: a narrative review.

Contraceptive use in adolescence remains a challenging issue. Adolescents are at high risk of unintended pregnancies and sexual transmitted infections. During the past few decades intrauterine devices are recommended from global health organization, including the American Academy of Pediatrics, American College of Obstetricians and Gynecologists and World Health Organization as a method of contraception for adolescents. Intrauterine devices are part of the long-acting reversible contraceptives (LARCs) and include the copper bearing device (CU-IUD) and the levonorgestrel intrauterine system (LNG-IUS). IUDs are a safe and effective contraceptive method for adolescents with a failure rate less than 1%. Their use is not limited only in contraception. LNG-IUS 52 mg is approved for treating heavy menstrual bleeding and protection from endometrial hyperplasia in women receiving hormone replacement therapy. It can also be an effective tool in the management of dysmenorrhea, while CU-IUD can provide emergency contraception. Nevertheless, IUDs remain underutilized in this group of population. Adolescents' lack of proper education about contraception and sexual behavior creates myths and misconceptions about the possible side effects and the suitability of IUDs in this age group. Furthermore, health care providers remain skeptical and hesitate to suggest IUDs to adolescents. Other barriers including high cost, concern about confidentiality and difficulties in access contribute to its limited use. It is of high importance to eliminate barriers and offer more accessible contraceptive services to adolescents.

Sexual Health of Young Adults Living with Perinatally Acquired HIV in Paris, France: A Qualitative Study.

We aimed to explore the sexual health of young adults with perinatally acquired human immunodeficiency virus (PHIV). Eighteen to 25 years old PHIV participants were recruited in two tertiary care units in Paris. Sexually transmitted HIV was an exclusion criterion. Individual interviews were conducted. Transcripts were analyzed using a semio-pragmatic phenomenological method. Twenty-five participants were interviewed from March 2022 to September 2022. Some of them renounced being in any romantic relationship. Those who disclosed their HIV status to their romantic partner reported that dating was more complex and those who did not disclose reported that keeping HIV a secret was a significant mental burden. Young men tended to disclose their HIV status to their romantic partner whereas young women did not consider doing so before marriage. Many participants had to educate themselves about sexuality, through school or websites. Identified interlocutors for sexuality varied across participants. All participants were aware of U = U (Undetectable = Untransmittable) slogan. Despite that, participants remained worried about transmitting HIV to their sexual partners. That hindered their sexual satisfaction. In addition, they neglected the risk of unwanted pregnancies or sexually transmitted diseases (STDs). In our study, knowing the U = U slogan did not provide reassurance to PHIV participants regarding the risk of onward HIV transmission. Further, they showed very little concern for protecting themselves from their partner's STD.

Contraceptive Care in the Rheumatic Diseases: A Review.

Contraception can help individuals with rheumatic and musculoskeletal diseases (RMDs) to avoid undesired pregnancies and improve reproductive outcomes. Despite the importance of contraception in the care of females with RMDs, evidence suggests that many of these individuals do not receive consistent or disease-specific counseling regarding contraceptive options. This includes female patients receiving teratogenic prescriptions as part of the management of their RMDs, or who have severe disease activity that might culminate in adverse pregnancy and perinatal outcomes. Contraceptive counseling can help females with RMDs who wish to prevent pregnancy to select a contraceptive method that is best for them.We conducted a narrative review of the primary literature addressing reversible, prescription-based contraception for females with RMDs, framed by published guidelines on contraceptive safety. Many safe and effective contraceptive options are available for females with RMDs. Special considerations must be given to individuals with systemic lupus erythematosus, whose disease activity may be exacerbated by exogenous estrogen. Females with positive antiphospholipid antibodies should avoid estrogen-containing contraception due to an unacceptable risk of thrombosis and should conditionally avoid depot medroxyprogesterone acetate, which appears to have a prothrombotic signature. Limited contraceptive options are available to male patients. Contraceptive care for adolescents with RMDs can be extrapolated from guidelines written for adult patients, with the additional consideration of barrier protection for individuals at risk for sexually transmitted infections. Future research is needed to assess the effects of contraception use on rheumatic disease activity and side effects.

Factors and consequences of early marriage among women in Jumla

Background: In Nepal, child marriage is seen as a significant obstacle to the country's social and economic growth as well as a significant threat to the health of women. Despite a steady decline in this harmful practice over the past decade, child marriage remains widespread, with approximately one in five girls married in childhood across the globe. The objective of the study was to find out the factors and consequences of early marriage among women in Jumla. Methods: The cross-sectional study was conducted among the residents of Jumla District where 280 married reproductive age group women were taken as subjects. Simple random sampling technique was used. Data was collected by using semi-structured interview schedule. Analysis was done by using descriptive and inferential statistics. Results: Study findings showed that majority (77.9%) of the respondents got early marriage. Early marriage was statistically association with educational status at the time of marriage (p=0.000), occupational status (p=0.000), type of marriage ((p=0.014), educational status of father (p=0.009), occupational status of father (p=0.016), parental income (p=0.000), decision making (p=0.003), husband´s education and occupation (p=0.000). Inadequate education (70.7%) and economic resources (83.9%), customs (66.8%) and unemployment (63.2%) are the main reasons of early marriage. Likewise, increasing responsibility (80.7%), lower abdominal pain (67.5%), uterine prolapse (65.4%), early pregnancy (71.1%), unplanned pregnancy (58.9%) and prolonged labor (51.8%) are the main consequences of early marriage. Therefore, it is concluded that more than three fourth of the respondents were married early which lead to many consequences. Conclusion: The study concluded that more than three fourth of the respondents got early marriage. Early marriage had significant association with educational status at the time of marriage, occupational status, type of marriage, occupational status of father, parental income, decision making at time of marriage, husband´s education and occupation. Inadequate education and economic resources, customs and unemployment are the main reasons of early marriage. Likewise, early pregnancy, unplanned pregnancy, prolonged labor, lower abdominal pain, uterine prolapse, and increasing responsibility are the main consequences of early marriage. Hence, the efforts have to be made to prevent the early marriage through awareness and various educational programs.

Link between pregnancy planning and antenatal care utilization in sub-Saharan Africa: An analysis of DHS data (2010-2023).

This study aims to analyse the relationship between pregnancy planning and antenatal care in sub-Saharan Africa and to identify which categories of mothers are most likely to make inadequate use of antenatal care in the event of a mistimed or unwanted pregnancy. The latest data from the Demographic and Health Surveys of 32 countries were analysed using bivariate and multivariate descriptive methods. The results show that compared with planned births, mistimed and unwanted births are respectively 27% (OR=0.733) and 29% (OR=0.711) less likely to have an antenatal visit in the first three months of pregnancy, and 25% (OR=0.752) and 29% (OR=0.705) less likely to have the four recommended antenatal visits. In addition, the births of the most privileged women (richest, educated and exposed to the media) are the least likely to have an adequate prenatal visit in the event of mistimed or unwanted pregnancies, probably due to an increased psychosocial impact linked to school dropouts, damage to professional projects and a desire to hide the pregnancy from those around her.

Prevalence and Associated Factors of Mental Health Problems Among Peripartum Women During the COVID-19 Pandemic

Objective: This study aimed to determine the prevalence and associated factors of probable depression and probable anxiety in early postpartum women during the COVID-19 pandemic. Methods: This cross-sectional study was conducted with early postpartum women who applied to a maternity hospital to give birth in Turkey between March-June 2021. Women aged 19-45 years, with 23–42 weeks of gestation, with a singleton pregnancy, and negative for the SARSCoV-2 polymerase chain reaction test were included in the study. The Hospital Anxiety and Depression Scale (HADS) was used to assess the presence of probable depression (HADS depression score >7) and probable anxiety (HADS anxiety score >10). The associations between women’s sociodemographic and obstetric characteristics and depression and anxiety were evaluated using univariate and multivariate analyses. Results: A total of 450 women were included in the study. Of these, 50.2% (n=226) had probable depression, and 28% (n=126) had probable anxiety. Multivariate analysis revealed that while perceived poor income level increased the odds for the presence of probable depression, unintended pregnancy, anemia, and SARS-CoV2 infection during pregnancy were associated with probable anxiety. Conclusion: The presence of probable depression and probable anxiety were considerably high among women who had given birth during the pandemic. This study identified the most vulnerable groups in terms of mental health problems among women who were in the early postpartum period during the pandemic. It is essential to develop strategies to prevent and control the mental health problems of these risk groups for future emergency health crises.

A REVIEW STUDY ON ROLE OF CONTRACEPTIVES AND THEIR VARIOUS TYPES.

Contraception is the process used to stop unwanted pregnancy and control birth rate. Contraceptives reduces the chances of pregnancy after sexual intercourse. Contraceptives prevent pregnancies by interfering with the procedure of fertilization. Contraceptives reduces the chances of abortion by preventing unintended pregnancies on their partners, in which 842 million (44%) are modern using modern methods of Contraceptives are accessible in huge varieties and types . Numerous contraceptives are available, 790 million (42%) are traditional method users according the statistical data of 2019. The most common contraceptive techniques that are use of contraceptives are increasing day by day, 922 million of women of reproductive age used worldwide are female sterilization and male condoms, female sterilization are used in 219 million users (24%), male condoms are used in 189 million users (21%) according the data of 2019. The use of traditional methods and IUDs has reduced worldwide since 1994. According to WHO, The only form of birth control is a condom,that can prevent both unintended pregnancies and sexually transmitted diseases. The need of family planning is increased globally up to 77% from 2015 to 2020.. Over the past 20 years, the number of women using family planning methods has grown, rising from 900 million in 2020 to 2000 million. Use of modern contraceptive methods is also increased from 663 million to 851 million with the prevalence rate of 47.7% to 49.0%. Numerous contraceptive methods exist, including hormonal methods like CHC vaginal ring, CHC transdermal patch, and combination hormonal contraceptives. Progestin-only techniques include hormonal male contraceptives, progestin-only pills, DMPA injections, implants, and progestin-only IUDs. The other approach is non-hormonal and consists of vaginal pH modulators, barrier techniques like condoms, and copper IUDs. Traditional methods, such as the LAM method, the fertile cycle method, and the withdrawal approach, comprise the third type of contraception. Herbal contraceptives, which use a variety of herbs and plant preparations, are the fourth technique of birth control.

Pola Komunikasi Keluarga dalam Penerimaan Diri Perempuan dengan Kehamilan Tidak Diinginkan

The facts show that Self-Acceptance of Unwanted Pregnancy occurs a lot, especially because sexual relations are increasingly considered normalized by today's teenagers. Among the factors that encourage unwanted pregnancies to occur is communication between the couple and their environment. Therefore, this research aims to determine the Communication Patterns in the Family and Environment in Self-Acceptance of Unwanted Pregnancy Decisions in Premarital Relationships. This research is qualitative research with a phenomological approach. As informants for this research were 3 people who were perpetrators of unwanted pregnancies, 1 person from the perpetrator's family, and 1 child and adolescent psychology counselor in the city of Bandung. The results of the research state that in making decisions in conditions of Unwanted Pregnancy, everything happens in conditions that can cause good or bad thinking. The communication that occurs starts from the woman's side to ask her partner for responsibility and then tells the woman's family. So in this action, there were several different responses that the female perpetrators received from their partners. So with the differences in responses that occur, in the end the decisions and conditions that occur are also different.

Assessment of Sexual Violence against Girls and Young Women with Disabilities in Sub-Saharan Africa: A Review

This review looks into the prevalence of sexual violence against disabled girls and young women in Sub-Saharan Africa. Understanding this issue is vital for meeting the Sustainable Development Goals (SDGs), which seek to eliminate all forms of violence in the region. The research specifically examines the nature of sexual violence faced by girls and young women with disabilities in Sub-Saharan Africa. To achieve the desired outcomes, a comprehensive desk review was carried out on the subject of sexual violence against this demographic. The study highlights factors that contribute to vulnerability, the environments where offenders operate, the repercussions of sexual abuse, and the coping strategies employed by victims. The findings indicate that girls and young women with disabilities are at a heightened risk of sexual abuse due to perceptions of weakness and a lack of adequate protection. Additionally, disability and poverty further exacerbate the risk of gender-based violence. It was found that many women with disabilities experienced sexual abuse due to circumstances such as limited mobility, financial hardship, familial rejection, and unemployment, which often confined them to their homes and made them easy targets. In terms of repercussions, sexual violence has been linked to unintended pregnancies, homelessness, divorce, and challenges in finding marriage partners. There is a pressing need for further research to guide policymakers in implementing effective multi-sectoral strategies that support the Sustainable Development Goals (SDGs) aimed at reducing all forms of violence in Sub-Saharan Africa.

Attitude of Post-Graduate Students towards Family Planning in Ilorin Metropolis, Kwara State

Family planning can be considered beneficial to an extent and it involves the use of contraceptives to stop unwanted pregnancies. Thus, this study investigated attitude of post-graduate students towards family planning in Ilorin metropolis, Kwara state. Descriptive research design of survey type was adopted for this study. The population for this study consisted of post graduates in Ilorin, Kwara state. The sample of two hundred were randomly selected. The sampling technique that was used in this study was purposive sampling technique. The instrument that was used for this study is a researcher-developed questionnaire tagged “Attitude of Post-graduate Students Towards Family Planning Question (APSTFPQ)". In analyzing the data collected for this study, both descriptive and inferential statistical analyses were employed. The demographic data collected was analyzed using percentages and ranking order. In testing the hypotheses generated, t-test and Analysis of variance (ANOVA) statistics were used to analyze the hypotheses generated for the study at 0.05 level of significance. The study revealed that the attitude of post graduate students towards family planning in Ilorin metropolis was positive. There was no significant difference in the attitude of post graduate students towards family planning based on age, course of study and number of children while significant difference was observed on level of educational attainment. Based on the findings of this study, it was recommended that awareness should be created among post graduate students about family planning to improve the attitude of the students towards family planning, Counsellors in tertiary institutions should organize seminars and workshops on family planning and its importance, post graduate students irrespective of age, course of study and number of children should make it as a habit to engage in family planning.

FREQUENCY OFANXIETY AND DEPRESSION AND ITS PSYCHOSOCIAL CORRELATES AMONG WOMEN RECEIVING ANTENATAL CARE IN A TERTIARY CARE HOSPITAL IN KARACHI

Objective: To determine the proportion of women suffering from antenatal depression and anxiety visiting a tertiary care hospital for routine antenatal visits to evaluate the psychosocial factors associated with their depression and anxiety. Study Design: A descriptive cross-sectional study Place and Duration Department of Gynaecology & Obstetrics Ward 9B, Jinnah Postgraduate Medical Center (JPMC), Karachi from January 2024 to May 2024. Top of FormMethods: This study was conducted with 249 pregnant women via non-probability, consecutive sampling. Anxiety and depression were assessed using Urdu validated version of Hospital Anxiety and Depression Scale. Psychosocial stressors were also recorded. Data was entered and analyzed using SPSS for Windows version 23.0. Results: In this study, 20% of women in their second and third trimesters of pregnancies were anxious and 5% were depressed. Critical psychosocial factors included low education, marital stressors such as low social support from husband and/or in-laws, living separately from husband, and intimate partner violence, financial stressors such as husband unemployment and pregnancy-related factors such as unplanned pregnancy and narrow birth spacing. Conclusion: The study provides a significant burden of antenatal mental health issues in our region and their specific associated psychosocial factors. The study emphasizes upon the need for Biopsychosocial support systems and interventions to mitigate the risk of antenatal depression and safeguard maternal well-being during this critical period.

Structural Inequality and the Social Determinants of Unintended Pregnancy

Structural Inequality and the Social Determinants of Unintended Pregnancy

Modern contraceptive utilization among women of reproductive age in Ghana: a multilevel mixed-effect logistic regression model

BackgroundWorldwide, sexual and reproductive health remains a prominent public health concern for women of reproductive age. Modern contraceptive methods play a crucial role in enabling individuals and families to regulate fertility, thereby reducing unintended pregnancies, abortions, pregnancy-related complications, and mortality. Due to the scarcity of reliable and current data regarding the factors affecting the adoption of modern contraceptives among women of reproductive age at the national level in Ghana, this research aimed to explore the determinants of modern contraceptive usage among reproductive age women.MethodsThe study analyzed data from the 2022 Ghana Demographic and Health Survey, including a weighted sample of 6,839 reproductive-age women. By employing a multilevel logistic regression model, the study sought to determine factors associated with the utilization of modern contraceptives. Associations between explanatory variables and the outcome were evaluated using adjusted odds ratios (AORs) along with 95% confidence intervals (CIs). Statistical significance was established using a p-value threshold of less than 0.05. All statistical analyses were conducted using STATA version 17 software.ResultsThe study found that 26.36% (95% CI: 25.33-27.34%) of women of reproductive age in Ghana used modern contraceptives. Secondary education (AOR = 1.26, 95% CI = 1.03–1.53), poorer household (AOR = 1.30, 95% CI = 1.05–1.61), women’s marital status, i.e. married (AOR = 1.46, 95% CI = 1.16–1.83), living with a partner (AOR = 1.65, 95% CI = 1.32–2.06), divorced (AOR = 2.53, 95% CI = 1.48–4.31), and separated (AOR = 1.70, 95% CI = 1.21–2.37), multipara (AOR = 1.39, 95% CI = 1.04–1.87), were the factors that promote modern contraceptive utilization. Women’s age in years, i.e. 35–39 (AOR = 0.71, 95% CI = 0.52–0.97), 40–44 (AOR = 0.63, 95% CI = 0.44–0.90), and 45–49 (AOR = 0.45, 95% CI = 0.25–0.79), history of pregnancy loss (AOR = 0.86, 95% CI = 0.76–0.98), region, i.e. Greater Accra (95% CI = 0.42–0.92), Bono East (95% CI = 0.32–0.81), Northern (95% CI = 0.28–0.67), Savannah (95% CI = 0.28–0.81), and North East (95% CI = 0.20–0.63), were all associated with a lower use of modern contraceptives.ConclusionsModern contraceptive utilization was low in this study. Factors such as women’s education, socioeconomic status, and marital status were associated with increased modern contraceptive utilization, whereas women’s age and regional disparities were linked to lower usage rates. These findings emphasize the need for targeted interventions to address socioeconomic barriers and regional disparities in access to family planning services across Ghana.

Family Planning and Health of Users: A Case Study of Owan Community in Edo State Nigeria

Background: This study investigated the relationship between family planning and health of women in Owan West Local Government Area of Edo State. Materials and Methods: the population of the study was 280,000 inhabitants with sample size of 140, Taro Yamane formula was used in determining the sample size with a significant level of 0.05%. The data analysis technique used for this study is simple percentage for questions by the respondents. Results & Discussion: This study has succeeded in identifying the impact of family planning on woman. The process of family planning prevents unwanted pregnancy and reverses the complications of pregnancy. Family planning has positive impact on the health of women. In view of the research and importance of family planning on women. Conclusion & Recommendation: The following recommendations were made, that government should encourage the use of contraceptives for the good of it involving reduction in population growth as well as its positive impacts and roles in the society. It is also recommended that seminars or public lectures be organized to educate the public on the significance of contraceptive use and its application effectiveness.

Effects of structured contraceptive counseling in young women: Secondary analyses of a cluster randomized controlledtrial (the LOWE trial).

Unwanted pregnancy constitutes a huge health issue. Long-acting reversible contraception (LARC) are the most effective methods for preventing unwanted pregnancy, especially among young women. This study evaluates the intervention effect of structured contraceptive counseling on the choice, initiation, and use of LARC in young women. This is a secondary analysis of women aged 18-25, enrolled in a multicenter cluster randomized controlled trial performed in abortion, youth, and maternal health clinics across the Stockholm County in Sweden. Clinics were randomized (1:1) to provide structured contraceptive counseling (intervention) or standard counseling (control). Surveys were administered at the clinic visit and follow-ups at 3, 6, and 12 months. Primary outcome focused on the choice of LARC among women 18-25 years of age. Secondary outcomes included initiation, and use of LARC at 3 and 12 months, satisfaction with the counseling received and information on extended use of combined hormonal contraceptives. The study was registered at Clinicaltrials.gov (NCT03269357). From September 2017 to May 2019, 770 women aged 18-25 years from 28 clinics/clusters were recruited. There was a significant intervention effect on LARC choice (aOR 5.96, 95% CI 3.25-10.94), initiation (aOR 4.43, 95% CI 2.32-8.46), and use at 12 months (aOR 2.21, 95% CI 1.31-3.73). The odds of LARC choice at pre-booked visits were higher and more women received information about extended-use regimen for short-acting reversible contraception in the intervention group compared to the control group. The intervention package was well received, but with higher satisfaction at pre-booked compared to drop-in visits. Our study demonstrates that comprehensive structured contraceptive counseling significantly increases LARC choice, initiation and use, with high satisfaction among young participants, especially at pre-booked visits. The results highlight an approach that merits implementation to increase quality of care in contraceptive services, to enhance reproductive health for adolescents and young adults.