Subjects -> SOCIAL SCIENCES (Total: 1761 journals)
    - BIRTH CONTROL (22 journals)
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BIRTH CONTROL (22 journals)

Showing 1 - 22 of 22 Journals sorted alphabetically
Adoption Quarterly     Hybrid Journal   (Followers: 8)
Advances in Contraception     Hybrid Journal   (Followers: 3)
Africa Journal of Nursing and Midwifery     Full-text available via subscription   (Followers: 14)
Biodemography and Social Biology     Hybrid Journal  
Birth     Hybrid Journal   (Followers: 40)
BMJ Sexual & Reproductive Health     Hybrid Journal   (Followers: 2)
Contraception     Hybrid Journal   (Followers: 20)
Contraception : X     Open Access   (Followers: 1)
European Journal of Contraception & Reproductive Health Care     Hybrid Journal   (Followers: 5)
Fetal and Pediatric Pathology     Hybrid Journal   (Followers: 4)
Gynécologie Obstétrique & Fertilité     Full-text available via subscription   (Followers: 1)
Human Fertility     Hybrid Journal   (Followers: 4)
Journal of Family Planning and Reproductive Health Care     Hybrid Journal   (Followers: 12)
Journal of Maternal-Fetal & Neonatal Medicine     Hybrid Journal   (Followers: 40)
Journal of Reproduction and Contraception     Full-text available via subscription   (Followers: 4)
Journal of the American Board of Family Medicine     Open Access   (Followers: 11)
Obstetric Medicine     Hybrid Journal   (Followers: 8)
Perspectives On Sexual and Reproductive Health     Hybrid Journal   (Followers: 7)
Raigal     Open Access  
Revista Chilena de Obstetricia y Ginecologia     Open Access   (Followers: 1)
Studies In Family Planning     Hybrid Journal   (Followers: 6)
Teratology     Hybrid Journal  
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Contraception : X
Number of Followers: 1  

  This is an Open Access Journal Open Access journal
ISSN (Online) 2590-1516
Published by Elsevier Homepage  [3204 journals]
  • The predictive utility of unmet need on time to contraceptive adoption: A
           panel study of non-contracepting Ugandan women

    • Abstract: Publication date: Available online 18 March 2020Source: Contraception: XAuthor(s): Dana Sarnak, Amy Tsui, Fredrick Makumbi, Simon P.S Kibira, Saifuddin Ahmed
  • Experiences of harassment and empowerment after sharing personal abortion
           stories publicly

    • Abstract: Publication date: Available online 14 February 2020Source: Contraception: XAuthor(s): Katie Woodruff, Rosalyn Schroeder, Stephanie Herold, Sarah C.M. Roberts, Nancy F. BerglasAbstractObjectiveIn recent years, in an attempt to counter stigma and increase empathy, public education campaigns have encouraged people to share their personal abortion stories. This exploratory study sought to document negative and positive experiences of those who have shared their abortion stories publicly.Study designWe conducted an anonymous online survey of people who have shared their abortion story publicly (N = 88), recruited via partners affiliated with two abortion story-sharing campaigns. The survey asked about the context in which respondents shared their abortion story, any negative and positive experiences online and in “real life” as a result of story sharing, and any problems or benefits resulting from these experiences. We analyzed survey data using descriptive statistics, bivariate analyses, and categorizing responses to open-ended questions.ResultsSixty percent of respondents reported experiencing harassment and other negative incidents after sharing their story publicly. These experiences contributed to emotional stress, problems with loved ones, and difficulties at work and/or school. These harms were reported even by many respondents who used only a first name or alias when sharing their story. Despite this, positive experiences as a result of story sharing were reported by four out of five respondents and motivated many to continue sharing their story.ConclusionsThis exploratory study indicates that many people who share their abortion story publicly find it to be an empowering, rewarding experience. Yet they also experience harassment and threats at high rates. Future research should explore both positive and negative experiences in more depth.
  • A 1-year prospective, open-label, single-arm, multicenter, phase 3 trial
           of the contraceptive efficacy and safety of the oral progestin-only pill,
           DROSPIRENONE 4 mg, using a 24/4-day regimen

    • Abstract: Publication date: Available online 30 January 2020Source: Contraception: XAuthor(s): Thomas Kimble, Anne E. Burke, Kurt T. Barnhart, David F. Archer, Enrico Colli, Carolyn L. WesthoffAbstractObjectivesTo evaluate contraceptive effectiveness and safety of oral drospirenone 4 mg 24/4-day regimen in the United States.Study designWe performed a prospective, single-arm, multicenter Phase 3 trial in sexually active, women for up to thirteen 28-day treatment cycles. Primary outcome was the Pearl index, calculated using confirmed on-drug pregnancies and evaluable cycles in non-breastfeeding women aged ≤ 35 years. We assessed adverse events (AEs) (including hyperkalemia and venous thromboembolism).ResultsOf 1006 women who received at least one dose of drospirenone, 352 women (35.0%) completed the trial and 654 (65.0%) women discontinued before trial end. Most participants (92.2%) were ≤ 35 years; one-third had a body mass index (BMI) ≥ 30 kg/m2. Among non-breastfeeding women aged ≤ 35 years, there were 17 pregnancies (Pearl index: 4.0 (95% confidence interval [CI], 2.3–6.4, n = 953), of which three were unconfirmed and two were from sites excluded from the main analysis for major breaches of FDA regulations. The Pearl index was 2.9 (95% CI: 1.5–5.1) for confirmed pregnancies among 915 non-breastfeeding women aged ≤ 35 years from sites with no protocol violations. Nearly all (95.4%) treatment emergent AEs were mild or moderate in intensity. No cases of venous thromboembolism were reported. The frequency of hyperkalemia was 0.5%. Women with baseline systolic/diastolic blood pressure ≥ 130/85 mmHg had a mean reduction from baseline in blood pressure at exit visit (− 8.5/− 4.9 mmHg; n = 119). No other clinically relevant changes were observed. Participant satisfaction was high.ConclusionDrospirenone 4 mg 24/4 regimen provides effective contraception with a good safety/tolerability profile in a broad group of women, including overweight or obese women.ImplicationsThis new progestin-only contraceptive, drospirenone 4 mg in a 24/4 regimen, provides a contraceptive option for the majority of women regardless of blood pressure or BMI.
  • Transgender abortion patients and the provision of transgender-specific
           care at non-hospital facilities that provide abortions

    • Abstract: Publication date: Available online 18 January 2020Source: Contraception: XAuthor(s): Rachel K. Jones, Elizabeth Witwer, Jenna JermanAbstractObjectiveTo estimate the number of transgender and gender non-binary (TGNB) individuals who obtained abortions in the United States and the extent to which abortion facilities offer transgender-specific health services.Study designWe collected survey data from all known health care facilities that provided abortions in 2017. For the first time, the questionnaire included items about TGNB abortion patients and services.ResultsWe estimate that 462 to 530 TGNB individuals obtained abortions in 2017 and that 23% of clinics provide transgender-specific care.ConclusionSeveral hundred abortions were provided to TGNB individuals in 2017, primarily at facilities that did not provide transgender-specific health services.ImplicationsFindings from this study support efforts to implement and expand gender-inclusive and affirming care at health care facilities that provide abortion.
  • Combined hormonal contraceptive use in Europe before and after the
           European Commission mandated changes in product information

    • Abstract: Publication date: Available online 14 January 2020Source: Contraception: XAuthor(s): Deeksha Khialani, Mary Elizabeth Jones, Szimonetta Komjáthiné Szépligeti, Anne Gulbech Ording, Vera Ehrenstein, Irene Petersen, Astrid van Hylckama VliegAbstractObjectivesWe investigated combined hormonal contraceptives (CHC) prescribing patterns (focussing on combined oral contraceptives; COC) in three countries (Netherlands, Denmark, United Kingdom) in a time period preceding and in a time period following the European Commission's decision to update product information, and we estimated changes in incidence of venous thromboembolism (VTE) between the two periods.Study designWe conducted a drug utilization analysis and a cohort study using routinely collected data. We calculated number, proportion and incidence rate of new users, switchers, and stoppers of COC in both time periods. VTE incidence was calculated in new users of COC and in all women aged 18–49 years.ResultsIn all countries, the largest proportion (> 75%) of new users used COC containing levonorgestrel, norethisterone, or norgestimate, (i.e., indicated by European medicines agency (EMA) as the safest preparations) in both time periods. Switching did not demonstrate a clear pattern towards these types of COC and distribution of stoppers was similar in both time periods. While the proportion of new users initiating COC containing levonorgestrel, norethisterone, or norgestimate increased slightly, this did not translate to a decrease in the overall VTE incidence.ConclusionAll three countries had the greatest proportion of women initiating a COC containing levonorgestrel, norethisterone, or norgestimate, and this proportion increased in the period after the European commission decision albeit the increase was small due to the high percentage of use before the decision. This did not translate into a measureable change in the incidence of VTE.Implications.Both before and after the European Commission's decision, the largest proportion of new users started with combined oral contraceptives containing levonorgestrel, norethisterone, or norgestimate. Earlier studies had already indicated an increased risk of VTE associated with COC containing other progestogens compared with these preparations, so it is possible that physicians were already preferentially prescribing COC containing levonorgestrel, norethisterone, or norgestimate to new users.
  • Abortion patients' preferences for care and experiences accessing services
           in Louisiana

    • Abstract: Publication date: Available online 28 November 2019Source: Contraception: XAuthor(s): Erin Carroll, Kari WhiteAbstractObjectiveTo compare abortion patients' expectations and preferences for care with their experiences accessing services in Louisiana where there are numerous restrictive abortion laws.Study designBetween June 2018 and January 2019, we conducted in-depth interviews with 35 English-speaking Louisiana residents who were ≥ 18 years of age and seeking care from the three in-state facilities to explore their perspectives and experiences locating, obtaining and paying for abortion services. We analyzed interview transcripts using a theme-based approach and categorized themes into dimensions of healthcare access: availability/accessibility; accommodation; acceptability; and affordability.ResultsParticipants were surprised to learn that there were so few facilities providing abortion, which required some of them to drive between one and three hours to the nearest clinic. Many were unable to schedule their visits at a convenient time or obtain care as early in pregnancy as desired because the next available appointment was often a week or more away. Protestor activity and congested waiting rooms did not provide most patients their desired level of privacy, but participants expressed diverse views about other approaches to care that would maintain their confidentiality. To pay for an unplanned healthcare expense that was not covered by insurance, many participants deferred paying monthly bills and borrowed money, which contributed to financial hardships and additional delays in care.ConclusionsMany Louisiana abortion patients' expectations and preferences for care are not being met across multiple dimensions of healthcare access assessed in this study, and the state's highly regulated policy environment may limit options for tailoring services to patients' needs.ImplicationsAbortion patients in Louisiana value accessible, timely, private and affordable services, but a constrained network of providers and medically unnecessary requirements make it difficult for them to obtain patient-centered care. Federal- and state-level policy changes, as well as local initiatives, could ensure abortion patients have access to quality, evidence-based services.
  • Using Google ads to recruit and retain a cohort considering abortion in
           the U.S.

    • Abstract: Publication date: Available online 28 November 2019Source: Contraception: XAuthor(s): Ushma D. Upadhyay, Iris J. Jovel, Kevin D. McCuaig, Alice F. CartwrightAbstractObjectiveTo develop and test the feasibility of a methodology to recruit and retain individuals in the United States (U.S.) who were considering abortion at the point of searching for an abortion clinic.Study designWe conducted the Google Ads Abortion Access Study, a national cohort study using a novel recruitment method—recruiting people searching for abortion care on Google. Advertisements for the study were displayed in search results. Users who clicked on the advertisement were directed to a landing page explaining the study and then to a screening form. Participants were eligible if they reported being pregnant and considering abortion. They completed an online baseline survey and 4 weeks later, were invited by email or text message to complete a follow-up survey.ResultsOver the course of 8 months we recruited a racially/ethnically and geographically diverse cohort considering an abortion using Google Ads. After removing fraudulent cases, we recruited 1706 respondents and among these, 1464 (86%) provided contact information for follow-up. Among those providing contact information, 1005 completed the follow-up survey resulting in a 69% follow-up rate. Older age, white race, higher education, difficulty meeting basic needs, being not religious/spiritual, and having no previous births were associated with higher follow-up. Total cost of the ads was $31.99 per completed baseline + follow up survey.ConclusionResearchers can use online advertising to successfully recruit populations early in their abortion-seeking process, to understand the barriers they face and how to improve abortion access. Disadvantages include high cost and a small potential for fraudulent data.ImplicationsGoogle Ads is a feasible tool to recruit and follow a diverse sample of individuals who are considering abortion for studies investigating the barriers they face in obtaining a wanted abortion.
  • Dynamics of contraceptive use among married women in North and South
           Yangon, Myanmar: Findings from a cross-sectional household survey

    • Abstract: Publication date: Available online 25 November 2019Source: Contraception: XAuthor(s): Myint Myint Wai, Espen Bjertness, Thein Thein Htay, Tippawan Liabsuetrakul, Aye Nyein Moe Myint, Hein Stigum, Johanne SundbyAbstractObjectiveTo explore the sociodemographic factors associated with contraceptive use, the variation in prevalence and duration of contraceptive use across the age-groups and parity among 18–49-years-old married women in North and South Yangon.Study designWe conducted a cross-sectional study regarding contraceptive use among married women aged 18–49 in North and South Yangon from September to November 2016. We used a questionnaire based on the Demographic and Health Surveys Program, with additional questions on the duration of contraception along the life-course. Associations between contraceptive prevalence and sociodemographic factors were tested by Chi-square. We describe the percentages of contraceptive use and non-use across the age and parity subgroups, and the mean duration of contraception. We compared the contraceptive prevalence ratios across the parity using logistic regression.ResultsThe contraceptive prevalence of modern methods was 66% (95%CI: 61.5%–69.9%) with better coverage in rural (69.6%) than in urban women (61.5%). Contraceptive use varied by age and parity, demonstrating lower prevalence in the oldest age-group (45–49) and high parity (parity five and above). The mean duration of contraceptive use rose with increased age and parity, except in the oldest age and high parity groups.ConclusionsThe findings called for greater attention to improve the contraceptive coverage of married women living in urban areas around Yangon city (peri-urban women).ImplicationsThe study identified the pockets of low contraceptive coverage in a region with the highest contraceptive prevalence in Myanmar. Women above the age of forty and women who had high parity had low contraceptive prevalence. Women living near the city showed lower contraceptive coverage compared to their rural counterparts.
  • Health insurance coverage and contraceptive use at the state level:
           Findings from the 2017 behavioral risk factor surveillance system

    • Abstract: Publication date: Available online 15 November 2019Source: Contraception: XAuthor(s): Megan L. Kavanaugh, Ayana Douglas-Hall, Sean FinnAbstractObjectiveTo examine associations between health insurance coverage, income level and contraceptive use – overall and most/moderately effective method use – among women ages 18–44 at risk of pregnancy, within and across 41 United States jurisdictions in 2017.Study designUsing data from the 2017 BRFSS, we calculated the proportions of women using any contraceptive method and using a most or moderately effective method for each state/territory and across all jurisdictions, categorized by health insurance coverage and income groups. For both contraceptive use outcomes, we ran simple and multivariable logistic regression models to test for significant differences in outcomes between insured and uninsured individuals.ResultsAcross jurisdictions, compared to uninsured women, those who had health care coverage had higher levels of contraceptive use (65% versus 59%; p 
  • Trends in Subcutaneous Depot Medroxyprogesterone Acetate (DMPA-SC) Use in
           Burkina Faso, the Democratic Republic of Congo, and Uganda

    • Abstract: Publication date: Available online 9 November 2019Source: Contraception: XAuthor(s): Philip Anglewicz, Pierre Akilimali, Georges Guiella, Patrick Kayembe, Simon P.S. Kibira, Fredrick Makumbi, Amy Tsui, Scott RadloffAbstractObjectivesDMPA-SC is seen as a valuable innovation in family planning, but little is known about trends in DMPA-SC use or characteristics of users. Using data from Burkina Faso, the Democratic Republic of Congo (DRC), and Uganda, we measured trends in DMPA-SC; and identified characteristics associated with DMPA-SC use.Study DesignWe used repeated cross-sectional representative data, collected between 2016 and 2019. First, we plotted trends in DMPA-SC use for all women and married women. Next, we presented the sociodemographic and family planning-related characteristics of DMPA-SC users. Finally, we conducted weighted multivariate logistic regression analysis to examine how DMPA-SC users were different from women (1) using all other modern methods combined, and (2) not using any modern method.ResultsDMPA-SC use increased monotonically in all three countries. Many DMPA-SC users were first-time users of modern contraception (54.5% in Burkina Faso, 34.6% in DRC, 50.7% in Uganda). Never-married women had lower odds than married women of using DMPA-SC (compared to other modern methods) in all three countries (Burkina Faso adjusted odds ratio (AOR) 0.40, 95% confidence interval (95% CI) 0.20-0.80; DRC AOR 0.31 95% CI 0.10-0.93; Uganda AOR 0.24; 95% CI 0.08-0.71). Level of education was positively associated with DMPA-SC use (compared to no use) (Burkina Faso AOR 1.79; 95% CI 1.03-3.14; Uganda AOR 3.23; 95% CI 1.33-7.84).ConclusionsDMPA-SC is a rapidly growing method in these settings. Despite the comparable levels of and increases in use for all three countries, the characteristics associated with DMPA-SC use generally differed across countries.ImplicationsThis is the first analysis of patterns of DMPA-SC use with representative data for African countries. Our results confirm that DMPA-SC is increasingly popular, although the profile of users varies across settings.
  • Cost-effectiveness of self-injected DMPA-SC compared with health
           worker-injected DMPA-IM in Senegal

    • Abstract: Publication date: Available online 23 October 2019Source: Contraception: XAuthor(s): Mercy Mvundura, Laura Di Giorgio, Chloe Morozoff, Jane Cover, Marguerite Ndour, Jennifer Kidwell DrakeAbstractObjectivesTo evaluate the cost-effectiveness of self-injected subcutaneous depot medroxyprogesterone acetate (DMPA-SC) compared to health worker-administered intramuscular DMPA (DMPA-IM) in Senegal and to assess how including practice or demonstration injections in client self-injection training affects estimates.Study designWe developed a decision-tree model with a 12-month time horizon for a hypothetical cohort of 100,000 injectable contraceptive users in Senegal. We used the model to estimate incremental costs per disability-adjusted life year (DALY) averted. The analysis derived model inputs from DMPA-SC self-injection continuation and costing research studies and peer-reviewed literature. We evaluated the cost-effectiveness from societal and health system perspectives and conducted one-way and probabilistic sensitivity analyses to test the robustness of results.ResultsCompared to health worker-administered DMPA-IM, self-injected DMPA-SC could prevent 1402 additional unintended pregnancies and avert 204 maternal DALYs per year for this hypothetical cohort. From a societal perspective, self-injection costs less than health worker administration regardless of the training approach, and is therefore dominant. From the health system perspective, self-injection is dominant compared to health worker administration if a one-page instruction sheet is used and one additional DMPA-SC unit is used for training and is cost-effective at $208 per DALY averted when two additional DMPA-SC units are used. Sensitivity analysis showed estimates were robust.ConclusionsSelf-injected DMPA-SC averted more pregnancies and DALYs and cost less from the societal perspective compared to health worker-administered DMPA-IM and hence is dominant. Using fewer DMPA-SC units for practice or demonstration improves cost-effectiveness of self-injection from the health system perspective.ImplicationsEvidence from Senegal shows that self-injection of DMPA-SC can be dominant or cost-effective from both health system and societal perspectives relative to DMPA-IM from health workers, even if women practice injecting or health workers demonstrate with one or two DMPA-SC units. Evidence on whether practice or demonstration is required for client training would be useful.
  • Reproductive Autonomy and Contraceptive Use among Women in Hanoi, Vietnam

    • Abstract: Publication date: Available online 5 October 2019Source: Contraception: XAuthor(s): Nghia Nguyen, Jessica Londeree, Linh H Nguyen, Dung H Tran, Maria F. GalloAbstractObjectiveReproductive autonomy (i.e., power to control and decide about contraceptive use, pregnancy and childbearing) could determine a woman’s capacity to use contraception. Although the Reproductive Autonomy Scale was developed to quantitatively assess women’s reproductive autonomy, it has not been validated in any population outside the U.S.Study designWe conducted a cross-sectional study of reproductive-age, sexually-active women in Hanoi, Vietnam who did not desire pregnancy. We administered a questionnaire containing the Reproductive Autonomy Scale and calculated composite scores of the measure’s three subscales: (1) decision-making power, (2) freedom from coercion, and (3) communication ability. To assess internal consistency, we calculated Cronbach’s alpha score for each subscale. We used logistic regression to evaluate differences in subscale scores between women who did and did not engage in unprotected sex in the past month.ResultsAnalysis is based on 500 participants; of these women, 17% (n = 85) engaged in unprotected sex in the past month. Subscales had moderate to high internal consistency (Cronbach’s alpha: 0.65-0.87). Mean subscale scores did not vary between women who did and did not engage in recent unprotected sex. Unprotected sex in the past month was not associated with decision-making power (adjusted odds ratio [aOR], 0.77; 95% confidence interval [CI], 0.49-1.20); freedom from coercion (aOR, 0.94; 95% CI, 0.52-1.67), or communication ability (aOR, 1.69; 95% CI, 0.92-3.09).ConclusionFindings highlight the need to develop and validate a new measure for reproductive autonomy for populations outside the United States, or to adapt the existing measure for these contexts.
  • Miscarriage information available on the internet: A content analysis of
           leading consumer websites

    • Abstract: Publication date: Available online 5 October 2019Source: Contraception: XAuthor(s): Katherine Ehrenreich, Rebecca Kriz, Daniel GrossmanAbstractObjectiveThe objective of this content analysis was to explore the accuracy and completeness of information provided about miscarriage on consumer-facing websites.Study designWe identified the most popular consumer websites for health information and the leading medical and nursing professional association websites. We reviewed each website for content on miscarriage aimed at consumers, and compared the website content to the information contained in the American College of Obstetricians and Gynecologists (ACOG) Practice Bulletin on Early Pregnancy Loss (EPL).We used a simple scoring method to compare the accuracy and completeness of the content on each website with the ACOG Practice Bulletin.Results60% (n = 9) of the top 15 consumer websites for health information had dedicated webpages on miscarriage. Of the nine leading professional association websites, two had dedicated pages on miscarriage. On average, each site provided information on 64% of the key messages from the ACOG Practice Bulletin. Sites commonly emphasized and provided overall accurate and complete information on risk factors of miscarriage. The key messages with the most limited or inaccurate information pertained to diagnosis of miscarriage; treatment, including medical management with mifepristone and misoprostol; instructions post-miscarriage; and prevention of miscarriage.ConclusionsThe majority of popular health websites include consumer-facing content on miscarriage, and the information presented is a mostly complete and accurate representation of the ACOG Practice Bulletin. The lack of information on treatment options may affect patients' ability to make informed choices about their care. The missing information points to areas that patients may feel under-prepared to discuss with healthcare providers.ImplicationsMore effort is needed to ensure that internet-based consumer information about miscarriage reflects the best scientific evidence.
  • Knowledge of contraceptive effectiveness and method use among women in
           Hanoi, Vietnam

    • Abstract: Publication date: Available online 11 July 2019Source: Contraception: XAuthor(s): Maria F. Gallo, Nghia Nguyen, Chuong Nguyen, Markus J. SteinerAbstractObjectiveTo evaluate the association between contraceptive knowledge and type of method used.MethodsWe analyzed data from a cross-sectional study of sexually-active women in Hanoi, Vietnam not desiring pregnancy. We used linear and logistic regression to evaluate contraceptive knowledge of users of the intrauterine device (IUD), combination oral contraception (COC), and male condoms. We measured contraceptive knowledge with seven questions on relative effectiveness of methods, reversibility, covert use, contraindications and side effects.ResultsRespondents used IUD (n = 128), COC (n = 126), or condoms (n = 167). Summary knowledge scores did not differ by current type of method used. Only one knowledge domain, contraceptive effectiveness, varied by method. Compared to condom users, IUD users had higher odds of correctly identifying the IUD as more effective than COC, condoms and withdrawal (adjusted odds ratio [aOR], 4.8; 95% confidence interval [CI], 2.7–8.3). Higher proportions of condom users (49.7%) mistakenly identified condoms as the most effective of listed methods compared to IUD (20.3%) and COC users (23.0%). On the other hand, IUD and COC users had lower odds (aOR, 0.5; 95% CI, 0.2–1.0 and aOR, 0.3; 95% CI, 0.1–0.6, respectively) of identifying consistent condom use as better for pregnancy prevention than other practices (e.g., withdrawal and post-coital douching).ConclusionsIUD users more often recognized that the IUD is highly effective while condom users appeared to overestimate condom effectiveness. Contraceptive counseling should ensure that women understand the relative effectiveness of methods. We found no evidence that other types of contraceptive knowledge differed by type of method used.ImplicationsKnowledge of contraceptive effectiveness was the sole difference detected in contraceptive knowledge between women in Hanoi, Vietnam using the IUD, COC or male condoms.
  • Cohort study to evaluate efficacy, safety and acceptability of a two rod
           contraceptive implant during 3rd, 4th and 5th year of product use in China

    • Abstract: Publication date: Available online 20 June 2019Source: Contraception: XAuthor(s): Y Che, D Taylor, D Luo, LY Maldonado, M Wang, S Wevill, H Vahdat, X Han, V Halpern, L Dorflinger, MJ SteinerAbstractObjectiveSino-implant (II) is a contraceptive implant approved for four years of use in China. We evaluated the contraceptive efficacy during the third, fourth, and fifth year, and assessed additional pharmacokinetics (PK), safety, and acceptability endpoints.Study designWe enrolled a cohort of 255 current Sino-Implant (II) users entering their third year and a second cohort of 243 users entering their fourth year. We followed these two cohorts for 12 and 24 months, respectively. To characterize PK endpoints (i.e. levonorgestrel (LNG), sex hormone binding globulin and free LNG index) over five years, we collected blood samples in a subset of 50 participants we followed during the third, fourth and fifth year. We also enrolled small cohorts (n = 20) of Sino-implant (II) users entering their sixth month and second year and followed them each for up to six months. Our primary efficacy measures were the pregnancy Pearl Indices during Year 3 and 4. Secondary objectives included assessments of PK, safety, acceptability and efficacy in the fifth year.ResultsWe recorded four pregnancies, with a higher pregnancy rate during Year 3 [1.34 (95% CI: 0.28–3.93)] than Year 4 [0.44 (95% CI: 0.01–2.47)] or Year 5 [0.00 (95% CI: 0.00–2.02)]. The overall pregnancy rate for the third, fourth and fifth years of product use was 0.63 per 100 WY; 95% CI: (0.17–1.62). Mean LNG concentrations remained well above 200 pg/mL (Year 3 = 280.9; Year 4 = 233.6; Year 5 = 270.6). Most participants (93.7%) described their bleeding pattern as acceptable.ConclusionSino-implant (II) is a highly effective contraceptive method in this population of Chinese women over five years.IMPLICATIONS.Sino-implant (II) is a highly effective contraceptive method with an estimated Pearl Index of less than 1% over the third, fourth and fifth years of use in a population of Chinese women of reproductive age.
  • Randomized trial to evaluate contraceptive efficacy, safety and
           acceptability of a two rod contraceptive implant over four years in the
           Dominican Republic

    • Abstract: Publication date: Available online 18 March 2019Source: Contraception: XAuthor(s): MJ Steiner, V Brache, D Taylor, R Callahan, V Halpern, A Jorge, S Wevill, J Sergison, L Venkatasubramanian, L DorflingerAbstractObjectiveSino-implant (II) is a contraceptive implant that had a commodity price one-third of the competing products a decade ago. To make Sino-implant (II) more widely available, we conducted a trial to collect safety and efficacy data required for WHO prequalification, a quality standard allowing global donors to procure a pharmaceutical product.Study designThis was a randomized controlled trial allocating 650 participants to either Sino-implant (II) or Jadelle®. Participants were seen at one and six months, and then semi-annually. The primary efficacy measure was the pregnancy Pearl Index (number of pregnancies per 100 women-years of follow-up) in the Sino-implant (II) group during up to four years of implant use.ResultsFor the primary outcome, Sino-implant (II) had a four-year Pearl Index of 0.74 (95% CI: 0.36–1.37), compared to 0.00 (95% CI: 0.00–1.04) for Jadelle®. The Sino-implant (II) pregnancy rate was significantly higher in the fourth year (3.54 per 100 WY) than in the first three years combined (0.18 per 100 WY; p 
  • Patterns and trends in contraceptive use among women attending Title X
           clinics and a national sample of low-income women

    • Abstract: Publication date: 2019Source: Contraception: X, Volume 1Author(s): Christina I. Fowler, Katherine A. Ahrens, Emily Decker, Julia Gable, Jiantong Wang, Brittni Frederiksen, Ana Carolina Loyola Briceño, Susan B. MoskoskyAbstractObjectivesTo describe the types of contraception used by women attending Title X-funded clinics and a comparable group of low-income reproductive-age women at risk of unintended pregnancy.Study designWe estimated the percentage of reproductive aged (15–44 years) women using contraception, by method type and level of effectiveness in preventing pregnancy (i.e., most, moderately, and less effective), using Title X Family Planning Annual Report (2006–2016) and National Survey of Family Growth (2006–2015) data. We divided most effective methods into permanent (female and male sterilization) and reversible (long-acting reversible contraceptives [LARCs]) methods.ResultsAmong Title X clients during 2006–2016, use of LARCs increased (3–14%); use of moderately effective methods decreased (64–54%); and use of sterilization (~ 2%), less effective methods (21–20%), and no method (8–7%) was unchanged. These same trends in contraceptive use were observed in a comparable group of women nationally during 2006–2015, during which LARC use increased (5–19%, p 
  • Continuous vs. cyclic combined hormonal contraceptives for treatment of
           dysmenorrhea: a systematic review

    • Abstract: Publication date: 2019Source: Contraception: X, Volume 1Author(s): Tiffany Damm, Georgine Lamvu, Jorge Carrillo, Chensi Ouyang, Jessica FeranecObjectiveThis systematic review aims to evaluate the benefits of oral continuous combined hormonal contraceptives (CHCs) in managing dysmenorrhea by comparing randomized controlled trials (RCTs) evaluating the efficacy of continuous vs. cyclic CHC use for the following outcomes: (a) reducing dysmenorrhea duration and frequency, (b) severity, (c) recurrence and (d) interference with daily activity.Study designCochrane, PUBMED and Popline databases were searched from 1934 to 2018 for all relevant studies evaluating CHC for treatment of dysmenorrhea. A study was selected if it (a) compared continuous regimen vs. cyclic regimen of oral CHC, (b) measured dysmenorrhea as a primary or secondary outcome, (c) was an RCT and (d) was published in English. Due to differences in CHC used and outcome measurement, a systematic analysis of individual study results and a limited meta-analysis were conducted.ResultsOf 780 studies that were screened by title and abstract, 8 were included in the final analysis; 6 evaluated cyclic vs. continuous CHC, and 2 evaluated cyclic vs. extended/flexible CHC use. Quality of evidence was low for all outcome measures. Overall, compared to cyclic use, flexible/extended CHC resulted in 4 fewer days of dysmenorrhea. Studies revealed conflicting results for interference with daily activity, pain severity and pain recurrence. Side effects were few in both comparison groups.ConclusionsContinuous or extended/flexible CHC use may reduce dysmenorrhea duration compared to cyclic regimen; however, more rigorous research is needed.ImplicationsThis systematic review shows that continuous CHC use may reduce dysmenorrhea duration compared to cyclic regimen, although the quality of evidence is low. Future double-blinded RCTs with more rigorous study design, consistent outcome measures and comprehensive outcome reporting are needed.
  • Tideglusib, a prospective alternative to nonoxynol-9 contraceptive

    • Abstract: Publication date: 2019Source: Contraception: X, Volume 1Author(s): Zhiting Chen, Niyan Shu, Yuzhu Wang, Yiting Yang, Zhiyu Shao, Fang Tian, Minjie Xia, Zhikai Wang, Xin Wang, Xing Feng, Xianliang Huang, Weihua Li, Heguo Yu, Hua DiaoAbstractObjectivesWe aimed to evaluate the antifertility activity and vaginal irritation effects of tideglusib in vivo using rabbit models and to evaluate the cytotoxical effects of tideglusib to sperm, vaginal cells and vaginal bacteria (L. acidophilus) in vitro.Study designWe treated female rabbits with vaginal tideglusib 1 mM, nonoxynol-9 (N-9) or vehicle control (Poloxamer 407). In experiment 1, we sacrificed females (n = 6 each) after 10 days of daily administration and assessed vaginal histological changes using Eckstein irritation score. In experiment 2, females (n = 9 each) received estradiol benzoate to induce ovulation 24 h prior to vaginal treatment followed by introduction of a fertile male. These females underwent necropsy at the 21st day to assess pregnancy status. In experiment 3, we used an HTM-TOX IVOS sperm motility analyzer and scanning electron microscopy (SEM) to evaluate the effect of tideglusib on human sperm samples. In experiment 4, we evaluated the effect of tideglusib on lactobacillus and vaginal cell growth in vitro.ResultsThe total irritation score of tideglusib vs. N-9 was 3.4 ± 2.07 vs. 7.8 ± 3.82, p 
  • Sexual and reproductive health content in nurse practitioner transition to
           practice training programs

    • Abstract: Publication date: 2019Source: Contraception: X, Volume 1Author(s): Katherine Simmonds, Joyce Cappiello, Alex HoytAbstractObjectiveTo describe the sexual and reproductive health (SRH) offerings of transition to practice training programs for certified primary care nurse practitioners in the United States.Study designProgram Directors from all identified primary care training programs (n = 51) were invited to participate in an online survey to assess the SRH didactic and clinical offerings based on competencies developed by the World Health Organization and adapted for the US across 15 domains and 15 related procedures.ResultsTwenty-two (43%) surveys were completed. There was considerable variation in offerings, with no single domain required by all programs, nor any program requiring trainees to complete didactic and clinical offerings in all domains. On average, programs required didactic and clinical training for approximately a third of the competencies in the Reproductive Tract Cancers domain (the most required domain) and for approximately a quarter of the competencies in the Contraceptive domain. Infertility/Fertility and Environmental Risks to Reproductive Health were the least commonly required domains. Clinical training tended to be more frequently required or offered than didactic instruction in almost all domains.Regarding procedures, both didactic and clinical training on insertion and removal of intrauterine devices were required by one third of programs. No-scalpel vasectomy was the procedure in which programs were least likely to offer trainees either didactic or clinical training, followed by uterine aspiration for missed or elective abortion or heavy menstrual bleeding.ConclusionAlthough SRH is recognized as an essential component of primary care, its inclusion in transition to practice primary care training programs for NPs is low and inconsistent.Implications statementPreparing primary care NPs to deliver competent SRH care is important for workforce development and patient care. Our study highlights a need for additional research to determine the baseline competency in SRH care among primary care NPs in order to further enhance education, training and policies with this aim.
  • Do young men's reports of hormonal and long-acting contraceptive method
           use match their female partner's reports'

    • Abstract: Publication date: 2019Source: Contraception: X, Volume 1Author(s): Elizabeth Karberg, Elizabeth Wildsmith, Jennifer Manlove, Makedah JohnsonAbstractObjectiveTo assess whether young men's reports of hormonal and long-acting contraceptive methods match their female partner's reports.Study designWe analyzed a sample of 1096 heterosexual couples (aged 18–26) from the National Longitudinal Study of Adolescent to Adult Health Romantic Pair subsample. We compared male and female partner reports of hormonal/long-acting method use using class of method (hormonal/long-acting) rather than type (e.g., intrauterine device). Regression analyses linked men's reports of individual and relationship characteristics with alignment of reporting.ResultsSixteen percent of young men reported hormonal/long-acting method use at last sex differently than their female partner, that is, had a mismatched report. Men who had fewer lifetime sexual partners, had greater relationship satisfaction, believed their partner was monogamous and had a matched report of condom use at last sex were more likely to match their partner's report of hormonal/long-acting contraceptive use. Men living with children (from either partner) were less likely to have a matched report. Hispanic men were more likely to have a matched report than black men.ConclusionsMen are an increasingly important part of pregnancy prevention efforts. Pregnancy prevention and healthy relationship programs that incorporate communication skills may also indirectly improve young men's knowledge of their partner's contraceptive use and engagement in contraceptive decision making.ImplicationsAnalyses showed that nearly two thirds of the 16% of young men that did not accurately report their partner's hormonal/long-acting method use at last sex underreport method use. Men at increased risk of misreporting may benefit the most from targeted pregnancy prevention programs.
  • Can we safely stop testing for Rh status and immunizing Rh-negative women
           having early abortions' A comparison of Rh alloimmunization in Canada
           and the Netherlands

    • Abstract: Publication date: 2019Source: Contraception: X, Volume 1Author(s): Ellen R. Wiebe, Mackenzie Campbell, Abigail R.A. Aiken, Arianne AlbertAbstractObjectiveThe objective of this study was to compare Rh alloimmunization rates in two countries (Canada and the Netherlands) with completely different policies regarding abortion-related use of anti-D immunoglobulin to ultimately determine any benefit in use. In the Netherlands, the policy is to offer anti-D immunoglobulin to Rh-negative women having spontaneous abortions over 10 weeks 0 days gestation and induced abortions over 7 weeks 0 days. In Canada, it is recommended to offer all Rh-negative women having induced or spontaneous abortions anti-D immunoglobulin.MethodsWe used public databases to obtain the population data, the number of births, the abortion rates (the percentage of women having induced abortions in one year) and the Rh-negativity rates (percentage of Rh negative women) in Canada and the Netherlands. Both countries do routine prenatal blood screening and we obtained the rates of clinically significant antibodies from public databases.ResultsIn nearly 2 million blood samples from pregnant women in both Canada and the Netherlands, the prevalence of clinically significant antibodies was statistically lower in the Netherlands: 4.21 (95% CI: 4.12 to 4.30) and 4.03 (95% CI: 3.93 to 4.12) per 1000, respectively. Canada and the Netherlands had small differences in rates of abortion (1.9 per 100 vs 1.2 per 100) and of Rh negativity (13.0% vs 14.5%).ConclusionDespite different anti-D Ig treatment policies, we found a similar prevalence of clinically significant perinatal antibodies among women in Canada and the Netherlands.ImplicationsOur findings suggest that The Dutch policy of not treating Rh-negative women having spontaneous abortions under 10 weeks’ or induced abortions under 7 weeks’ gestation can be safely adopted by other countries.
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Tel: +00 44 (0)131 4513762

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