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Title: Postpartum family planning for healthy pregnancy outcomes. A training manual.
Author: Pathfinder International. Extending Service Delivery Project
Source: Watertown, Massachusetts, Pathfinder, 2009 Feb. 124 p. (USAID Contract No. GPO-A-00-05-00027-00)
Abstract: This manual provides material to conduct a comprehensive two-day training for facility-based health workers (such as health supervisors, nurses and midwives) on providing community-based postpartum family planning education, counseling and referral that enables women and couples to use family planning methods for Healthy Timing and Spacing of Pregnancy (HTSP). The Manual addresses the following content areas: 1. The importance of the postpartum period; 2. HTSP for postpartum women; 3. Postpartum family planning for HTSP; 4. Postpartum family planning counseling and education; 5. Postpartum family planning for HIV positive women. Under each topic, key information for the trainer is provided, as well as a training activity to promote participant learning and skills development for improved community-based postpartum care that includes family planning and HTSP. (excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | MANUAL | RECOMMENDATIONS | EVALUATION | POSTPARTUM WOMEN | PREGNANCY OUTCOMES | FAMILY PLANNING EDUCATION | TRAINING OF TRAINERS | PREGNANCY INTERVALS | POSTPARTUM PROGRAMS | FAMILY PLANNING PROGRAMS | COUNSELING | MEN'S INVOLVEMENT | Puerperium | Reproduction | Pregnancy | Education | Training Programs | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Family Planning | Clinic Activities | Program Activities | Programs | Organization and Administration
Document Number: 325159

Peer Reviewed

Title: Expanding access to intrauterine contraception.
Author: Allen RH; Goldberg AB; Grimes DA
Source: American Journal of Obstetrics and Gynecology. 2009 Jun 13;
Abstract: The intrauterine device is a safe, highly effective, long-lasting, yet reversible method of contraception. Expanding access to intrauterine contraception is an important measure to reduce the rate of unintended pregnancy in the United States. Clinicians should consider intrauterine contraception in appropriate candidates, including women who are nulliparous, adolescent, immediately postpartum or postabortal, and desiring emergency contraception, and as an alternative to permanent sterilization. Barriers to intrauterine contraception such as requiring cervical cancer screening before insertion, routine testing for gonorrhea and chlamydial infection in low-risk women, or scheduling insertion only during menses are unnecessary.
Language: English
Keywords:
UNITED STATES OF AMERICA | CRITIQUE | ADOLESCENTS, FEMALE | IUD | CONTRACEPTIVE AVAILABILITY | MISINFORMATION | CONTRAINDICATIONS | INSERTION | PAIN | IUD EXPULSION | NULLIPARITY | Developed Countries | North America | Americas | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Communication | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Signs and Symptoms | Diseases | Parity | Fertility Measurements | Fertility | Population Dynamics
Document Number: 341709

Title: The role of education level in the intergenerational pattern of adolescent pregnancy in Brazil.
Author: Almeida MC; Aquino EM
Source: International Perspectives on Sexual and Reproductive Health. 2009 Sep;35(3):139-146.
Abstract: Adolescent pregnancy has been associated with the early childbearing experience of the mothers of adolescents, and young people's education level is believed to be an important factor in this phenomenon. In 2002, a representative household survey collected data from 3,050 young men and women ages 20�24 in three Brazilian cities. The main measures were mother's age at first birth, daughter's age at first pregnancy, and son's age when he first impregnated a partner. Ages were dichotomized as younger than 20 and 20 or older. The distribution of respondents, by both their own and their mothers' reproductive experience, was analyzed in relation to various characteristics, and logistic regressions assessed possible associations between these variables and pregnancy experience. Thirty percent of women reported getting pregnant before age 20, and 21% of men said they were younger than 20 when they first impregnated a partner. Of these groups, 34% of women and 31% of men reported that their mothers had first given birth at the same age. Both women and men were more likely to have had an early pregnancy experience if their mother had had a child before age 20. Among women, this positive association disappeared in the final model after adjusting for their education level, whereas among men the association remained after similar adjustment.
Spanish Abstract: Contexto: El embarazo durante la adolescencia se ha asociado con la experiencia de la maternidad temprana de las madres de los y las adolescentes; y se considera el nivel educativo de la gente joven como un factor importante en este fen�meno. M�todos: En 2002, una encuesta representativa de hogares recolect� datos de 3,050 hombres y mujeres j�venes de 20-24 a�os en tres ciudades brasile�as. Las principales medidas fueron la edad de la madre de los encuestados en el momento de su primer parto, la edad de la joven en el primer embarazo y la edad del joven al embarazar por primera vez a una pareja; los grupos de edad se dividieron en menores de 20 y de 20 a�os o mayores. La distribuci�n de las personas encuestadas (tanto por su propia experiencia reproductiva como la de su madre), se analiz� en relaci�n con varias caracter�sticas, y se valor� mediante regresiones log�sticas las posibles asociaciones entre estas variables y la experiencia del embarazo. Resultados: Treinta por ciento de las j�venes reportaron haberse embarazado antes de los 20 a�os; y 21% de los hombres dijeron que eran menores de 20 a�os cuando su pareja se embaraz�. De estos grupos, 34% de las mujeres y 31% de los hombres reportaron que sus madres hab�an dado a luz por primera vez a la misma edad. Tanto las mujeres como los hombres tuvieron mayor probabilidad de experimentar un embarazo temprano si su madre hab�a tenido un hijo antes de los 20 a�os (razones de momios, 2.0 y 2.3, respectivamente). En las mujeres, esta asociaci�n positiva desapareci� en el modelo final, despu�s de ajustar por nivel de educaci�n, mientras que entre los hombres la asociaci�n permaneci� despu�s de un ajuste similar (1.8). Conclusiones: El nivel de educaci�n de las hijas e hijos parece ser un factor importante en la repetici�n de la fecundidad adolescente a trav�s de las generaciones. Se necesita esfuerzos para aumentar el acceso a la educaci�n y para alentar a la gente joven a que permanezca en la escuela.
French Abstract: Contexte: Les grossesses d'adolescentes ont �t� associ�es � l'exp�rience de la maternit� pr�coce des m�res des adolescents concern�s et le niveau d'instruction des jeunes semble jouer un r�le important. M�thodes: En 2002, une enqu�te de m�nages repr�sentative a recueilli des donn�es aupr�s de 3.050 jeunes hommes et femmes de 20 � 24 ans dans trois villes du Br�sil. Les principales mesures ont port� sur l'�ge de la m�re � la premi�re naissance, l'�ge de la fille � la premi�re grossesse et l'�ge du fils au moment de la f�condation d'une partenaire. Les �ges ont �t� dichotomis�s entre moins de 20 ans et 20 ans ou plus. La distribution des r�pondants en fonction de leur propre exp�rience g�n�sique et de celle de leur m�re a �t� analys�e selon diff�rentes caract�ristiques, tandis que les associations possibles entre ces variables et l'exp�rience d'une grossesse �taient �valu�es par r�gressions logistiques. R�sultats: Trente pour cent des femmes ont d�clar� avoir �t� enceintes avant l'�ge de 20 ans, tandis que 21% des hommes d�claraient avoir eu moins de 20 ans au moment de la f�condation de leur partenaire. De ces groupes, 34% des femmes et 31% des hommes ont d�clar� que leur m�re avait accouch� pour la premi�re fois � ce m�me �ge. Tant les femmes que les hommes sont apparus plus susceptibles d'avoir connu une grossesse pr�coce si leur m�re avait eu un enfant avant l'�ge de 20 ans (rapports de probabilit�s, 2,0 et 2,3, respectivement). C�t� f�minin, cette association positive dispara�t dans le mod�le final apr�s correction du niveau d'instruction; c�t� masculin, elle se maintient apr�s correction similaire (1,8). Conclusions: Le niveau d'instruction des filles comme des fils semble jouer un r�le important dans la r�p�tition de la f�condit� adolescente d'une g�n�ration � l'autre. Des efforts sont n�cessaires pour accro�tre l'acc�s � l'�ducation et encourager les jeunes � poursuivre leur scolarisation.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | SURVEYS | MOTHERS | ADOLESCENTS, FEMALE | ADOLESCENT PREGNANCY | AGE FACTORS | FIRST BIRTH | EDUCATIONAL STATUS | REPRODUCTIVE BEHAVIOR | FERTILITY | South America, Eastern | South America | Latin America | Americas | Developing Countries | Sampling Studies | Studies | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Adolescents | Youth | Population Characteristics | Demographic Factors | Population | Population Dynamics | Pregnancy History | Fertility Measurements | Socioeconomic Status | Socioeconomic Factors | Economic Factors
Document Number: 343004

Title: Misoprostol for pregnancy termination in grand multiparous women with three cesarean deliveries.
Author: Alsibiani SA
Source: International Journal of Gynaecology and Obstetrics. 2009 Apr 3;
Abstract: In countries in which women have high parity, pregnancy termination is common in women who have had multiple cesarean deliveries. Although a combination of mifepristone and misoprostol is recommended for late abortion, in Saudi Arabia, mifepristone is not approved or available. There is little information about the safety of misoprostol for the termination of pregnancy or induction of labor in women with scarred uteri and multiple cesarean deliveries. Although there is no recommended dose or mode of administration for misoprostol in patients with scarred uteri and high parity, it is advisable to use a low dose. Misoprostol use in women with scarred uteri can lead to uterine rupture, but few incidences have been reported in the literature. However, caution is advisable. Misoprostol administered orally has a rapid onset of action and increases uterine tone, but contractions are not experienced unless repeated doses are administered. In addition, women usually prefer oral administration. Vaginal administration offers prolonged activity, greatest bioavailability, and a lower incidence of adverse effects. Use of misoprostol for termination of pregnancy in 2 grand multiparous (gravidity N10) women each with 3 previous cesarean deliveries is summarized in Table 1. According to the WHO expert dosage guidelines, the maximum dose was not exceeded in either patient. In patient 1 an intracervical Foley catheter with syntocinon infusion was used to ripen the cervix followed by oral administration of 800 �g of misoprostol. Patient 2 received a single dose of 800 �g of misoprostol vaginally. Favorable results were obtained in both women using a single high dose of misoprostol. The safety of using misoprostol in women with high parity and scarred uteri could not be ascertained from this study. A larger study is needed to confirm the effectiveness and safety of this regimen in patients with high parity who have had more than 2 previous cesarean deliveries. (full-text)
Language: English
Keywords:
SAUDI ARABIA | RESEARCH REPORT | SUMMARY REPORT | CLINICAL RESEARCH | PREGNANT WOMEN | CESAREAN SECTION | ABORTION | MULTIPARITY | MISOPROSTOL | UTERUS | RU-486 | ADMINISTRATION AND DOSAGE | Middle East | Developing Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Fertility Control, Postconception | Family Planning | Parity | Fertility Measurements | Fertility | Population Dynamics | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Genitalia, Female | Genitalia | Urogenital System | Hormone Antagonists | Hormones | Drugs
Document Number: 341466

Title: Socioeconomic determinants of age at first birth in rural areas of Bangladesh.
Author: Aminul Haque M; Sayem AM
Source: Asia-Pacific Journal of Public Health. 2009 Jan;21(1):104-11.
Abstract: The age at first birth is very low under existing rural sociocultural settings in Bangladesh. This study examined the socioeconomic and cultural determinants of age at first birth. The study subjects were married women aged 15 to 29 years in 2 rural areas that were identified through a multistage sampling technique. To collect the relevant information, a semistructured interviewer schedule was applied to the eligible women. This study found that 72.8% women gave first birth at <20 years of age with mean age at first birth 18.74 years. Simple linear regression model explained 30.9% of variance in age at first live birth. Among socioeconomic and cultural determinants, family pressure explained the most significant variance. It is really difficult to reduce fertility in complex sociocultural settings in rural Bangladesh. However, the findings of this study may provide an answer to increase the age at first birth and hence to reduce the high fertility among these group of women.
Language: English
Keywords:
BANGLADESH | RESEARCH REPORT | RURAL AREAS | WOMEN | YOUTH | FIRST BIRTH | AGE FACTORS | SOCIOECONOMIC STATUS | CULTURE | Developing Countries | Asia, Southern | Asia | Geographic Factors | Population | Demographic Factors | Population Characteristics | Pregnancy History | Fertility Measurements | Fertility | Population Dynamics | Socioeconomic Factors | Economic Factors | Sociocultural Factors
Document Number: 330710

10.

Title: Reproductive and hormonal factors, and ovarian cancer risk for BRCA1 and BRCA2 mutation carriers: results from the International BRCA1/2 Carrier Cohort Study.
Author: Antoniou AC; Rookus M; Andrieu N; Brohet R; Chang-Claude J
Source: Cancer Epidemiology, Biomarkers and Prevention. 2009 Feb;18(2):601-10.
Abstract: BACKGROUND: Several reproductive and hormonal factors are known to be associated with ovarian cancer risk in the general population, including parity and oral contraceptive (OC) use. However, their effect on ovarian cancer risk for BRCA1 and BRCA2 mutation carriers has only been investigated in a small number of studies. METHODS: We used data on 2,281 BRCA1 carriers and 1,038 BRCA2 carriers from the International BRCA1/2 Carrier Cohort Study to evaluate the effect of reproductive and hormonal factors on ovarian cancer risk for mutation carriers. Data were analyzed within a weighted Cox proportional hazards framework. RESULTS: There were no significant differences in the risk of ovarian cancer between parous and nulliparous carriers. For parous BRCA1 mutation carriers, the risk of ovarian cancer was reduced with each additional full-term pregnancy (P trend = 0.002). BRCA1 carriers who had ever used OC were at a significantly reduced risk of developing ovarian cancer (hazard ratio, 0.52; 95% confidence intervals, 0.37-0.73; P = 0.0002) and increasing duration of OC use was associated with a reduced ovarian cancer risk (P trend = 0.0004). The protective effect of OC use for BRCA1 mutation carriers seemed to be greater among more recent users. Tubal ligation was associated with a reduced risk of ovarian cancer for BRCA1 carriers (hazard ratio, 0.42; 95% confidence intervals, 0.22-0.80; P = 0.008). The number of ovarian cancer cases in BRCA2 mutation carriers was too small to draw definitive conclusions. CONCLUSIONS: The results provide further confirmation that OC use, number of full-term pregnancies, and tubal ligation are associated with ovarian cancer risk in BRCA1 carriers to a similar relative extent as in the general population.
Language: English
Keywords:
DEVELOPED COUNTRIES | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | COHORT ANALYSIS | CROSS-CULTURAL COMPARISONS | CLINICAL RESEARCH | WOMEN | PREVALENCE | RISK ASSESSMENT | OVARIAN CANCER | CHROMOSOME ABNORMALITIES | PARITY | RISK FACTORS | ORAL CONTRACEPTIVES, SIDE EFFECTS | TUBAL LIGATION | Research Methodology | Comparative Studies | Studies | Demographic Factors | Population | Measurement | Evaluation | Cancer | Neoplasms | Diseases | Neonatal Diseases and Abnormalities | Fertility Measurements | Fertility | Population Dynamics | Health | Contraceptive Safety | Safety | Public Health | Female Sterilization | Sterilization, Sexual | Family Planning
Document Number: 331025

11.

Title: Inadequate use of prenatal services among brazilian women: the role of maternal characteristics.
Author: Bassani DG; Surkan PJ; Olinto MT
Source: International Perspectives On Sexual and Reproductive Health. 2009 Mar;35(1):15-20.
Abstract: CONTEXT: To improve the uptake of prenatal care, it is important to know how the use of prenatal care varies by maternal attitudes and social and demographic factors. METHODS: Information about social and demographic variables, prenatal care, parity, pregnancy planning, abortion attempts, satisfaction with pregnancy and satisfaction with the relationship with the child's father was collected from 611 postpartum women in Porto Alegre in southern Brazil. Multinomial logistic regression was used to evaluate associations between these variables and whether the women's use of prenatal care was adequate, partially inadequate or inadequate. RESULTS: About 40% of women had inadequate or partially inadequate prenatal care. After adjustment for other covariates, including satisfaction with the pregnancy, women having an unplanned pregnancy were significantly more likely to have had inadequate care than women who had planned their pregnancy (odds ratio, 2.0). Not living with the child's father (2.8) and dissatisfaction with pregnancy (2.1) were also associated with inadequate use of prenatal care. Women having their second or higher order birth were significantly more likely to report inadequate use of prenatal care than women having their first birth (3.9-9.0). Household income was inversely associated with inadequate use of care. CONCLUSIONS: The study suggests that maternal attitudes may be important for adequate prenatal care. Interventions should be created to encourage women with negative maternal attitudes to use prenatal care and to ensure that they have access to the care they need.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | STATISTICAL REGRESSION | POSTPARTUM WOMEN | ANTENATAL CARE | UTILIZATION OF HEALTH CARE | ATTITUDES | SOCIOECONOMIC STATUS | PARITY | LIVING ARRANGEMENTS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Data Analysis | Research Methodology | Puerperium | Reproduction | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Psychological Factors | Behavior | Socioeconomic Factors | Economic Factors | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Residence Characteristics | Population Distribution | Geographic Factors
Document Number: 341412

12.

Peer Reviewed

Title: How does gestational diabetes affect postpartum contraception in nondiabetic primiparous women?
Author: Beydoun HA; Beydoun MA; Tamim H
Source: Contraception. 2009 Apr;79(4):290-6.
Abstract: BACKGROUND: The aim of the study is to explore the effect of gestational diabetes mellitus (GDM) on postpartum contraception among nondiabetic primiparous women. STUDY DESIGN: Secondary analyses of 2004-2005 Pregnancy Risk Assessment Monitoring System data from Michigan and Oregon. METHODS: Analyses were performed on 2332 women, taking complex survey design into consideration. Crude and adjusted odds ratios (cOR; aOR) and their 95% confidence intervals (CI) were obtained using logistic regression analyses. RESULTS: Postpartum use of hormonal (aOR=1.12, 95% CI: 0.68-1.83) and nonhormonal (aOR=1.18, 95% CI: 0.73-1.92) contraception were not influenced by GDM after controlling for confounders. Female sterilization was more frequently adopted (cOR=4.99, 95% CI: 1.13-22.17) and depomedroxyprogesterone acetate (DMPA) (cOR=0.53, 95% CI: 0.23-1.18), diaphragm/cervical cap/sponge (cOR=0.13, 95% CI: 0.016-0.95) and cervical ring (cOR=0.13, 95% CI: 0.017-0.98) were less frequently adopted by women reporting GDM diagnosis. CONCLUSION: With few exceptions, GDM does not appear to affect postpartum hormonal and nonhormonal contraception.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | EPIDEMIOLOGY | DIABETES | PARITY | CONTRACEPTION | POSTPARTUM | Developed Countries | North America | Americas | Public Health | Health | Diseases | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Family Planning | Puerperium | Reproduction
Document Number: 330558

13.

Title: Vasectomy reversal: a seven-year experience.
Author: Busato WF Jr
Source: Urologia Internationalis. 2009;82(2):170-4.
Abstract: INTRODUCTION: Since the demand for vasectomy reversal is increasing and many populations in Brazil and other countries show distinct characteristics, this study was carried out as an effort to determine factors and characteristics associated with the success rate of reversal in a population in Southern Brazil. PATIENTS AND METHODS: We reviewed 29 cases of vasectomy reversal performed over a 7-year period using the single-layer technique under microscopic magnification. RESULTS: Mean patency, pregnancy, and birth rates were 75, 41.7 and 29%, respectively. The patency and pregnancy rates were 92.3 and 38.5%, respectively, for time intervals since vasectomy <10 years and 63.6 and 45.4%, respectively, for intervals >10 years. Patency and pregnancy rates were 87.5 and 50%, respectively, for patients who had their vasectomy performed by a urologist, and 50 and 25%, respectively, for those who had their vasectomy performed by a generalist surgeon (p < 0.05). CONCLUSIONS: High patency and pregnancy rates are associated with time intervals since vasectomy of <10 years and vasectomies performed by urologists. There was no significant difference in the anastomosis time between the first 12 procedures and the next 12 procedures.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | MEN | VASECTOMY | STERILIZATION REVERSAL | PREGNANCY RATE | BIRTH RATE | TIME FACTORS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Demographic Factors | Population | Male Sterilization | Sterilization, Sexual | Family Planning | Reversible Sterilization | Fertility Measurements | Fertility | Population Dynamics
Document Number: 331231

14.

Title: Prenatal origins of undernutrition.
Author: Christian P
Source: Nestle Nutrition Workshop Series. Paediatric Programme. 2009;63:59-73; discussion 74-7, 259-68.
Abstract: Undernutrition continues to be high in many regions of the developing world. Birthweight, a common proxy measure of intrauterine growth, is influenced by nutritional, environmental and lifestyle factors during pregnancy and, in turn, affects immediate survival and function, and is a determinant of later life risk of chronic diseases. Maternal pre-pregnancy weight and height are independently associated with birthweight and also modify the effects of pregnancy weight gain and interventions during pregnancy on birthweight and perinatal mortality. Other prenatal factors commonly known to impact birthweight include maternal age, parity, sex, and birth interval, whereas lifestyle factors such as physical activity and maternal stress, as well as environmental toxicants have variable influences. Tobacco and other substance use and infections, specifically ascending reproductive tract infections, malaria, and HIV, can cause intrauterine growth restriction (IUGR). Few studies have examined the contribution of prenatal factors including low birthweight to childhood wasting and stunting. Studies that have examined this, with adequate adjustment for confounders, have generally found odds ratios associated with low birthweight ranging between 2 and 5. Even fewer studies have examined birth length or maternal nutritional status as risk factors. More research is needed to determine the proportion of childhood under-nutrition attributable to IUGR so that interventions can be targeted to the appropriate life stages.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | ADOLESCENTS, FEMALE | YOUTH | WOMEN | ETHNIC GROUPS | PARITY | REPRODUCTIVE AGE | MALNUTRITION | HEALTH STATUS INDEXES | INTRAUTERINE GROWTH RETARDATION | REPRODUCTIVE TRACT INFECTIONS | MALARIA | HIV INFECTIONS | INTERVENTIONS | Developed Countries | North America | Americas | Adolescents | Age Factors | Population Characteristics | Demographic Factors | Population | Cultural Background | Fertility Measurements | Fertility | Population Dynamics | Reproduction | Nutrition Disorders | Diseases | Health | Congenital Abnormalities | Neonatal Diseases and Abnormalities | Infections | Parasitic Diseases | Viral Diseases | Programs | Organization and Administration
Document Number: 341348

15.

Peer Reviewed

Title: Rate of pregnancy after using drospirenone and other progestin-containing oral contraceptives.
Author: Cronin M; Schellschmidt I; Dinger J
Source: Obstetrics and Gynecology. 2009 Sep;114(3):616-22.
Abstract: OBJECTIVES:: To determine whether prior oral-contraceptive use has a negative effect on the ability of women to conceive in both the short-term and long-term. METHODS:: The European Active Surveillance Study on Oral Contraceptives (EURAS-OC) was a controlled, prospective, noninterventional cohort study of 59,510 users of oral contraceptives containing drospirenone or other progestins in clinical practice in seven European countries. In a planned secondary analysis, pregnancy outcomes were investigated in 2,064 participants in EURAS-OC who stopped oral-contraceptive use after study entry because of planned pregnancy. The influence of age, parity, progestin type, ethinylestradiol dose, duration of oral-contraceptive use, and smoking status on the rate of pregnancy was assessed. RESULTS:: Overall, 21.1% (95% confidence interval [CI] 19.4-23.0%) of the past oral-contraceptive users were pregnant one cycle after oral-contraceptive cessation. This rate increased to 79.4% (95% CI 77.6-81.1%) at 1 year (13 cycles). Progestin type, ethinylestradiol dose, duration of oral-contraceptive use, and parity had no major influence on the rate of pregnancy after oral-contraceptive cessation. Up to age 35 years, age had only a minor influence on the rate of pregnancy. Rates of pregnancy were reduced in women older than 35 years and in current smokers. CONCLUSION:: Previous oral-contraceptive use does not negatively affect initial and 1-year rates of pregnancy after oral-contraceptive cessation. A comparison of these data with data external to this study indicates that the negative effect of aging on fecundity is not amplified by oral-contraceptive use. LEVEL OF EVIDENCE:: II.
Language: English
Keywords:
EUROPE | RESEARCH REPORT | COMPARATIVE STUDIES | PREGNANCY | PREGNANCY OUTCOMES | ORAL CONTRACEPTIVES | LOW-DOSE PROGESTINS | CONTRACEPTION TERMINATION | PREGNANCY RATE | Developed Countries | Studies | Research Methodology | Reproduction | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population
Document Number: 342570

16.

Peer Reviewed

Title: Intrauterine devices for adolescents: a systematic review.
Author: Deans EI; Grimes DA
Source: Contraception. 2009 Jun;79(6):418-23.
Abstract: BACKGROUND: The appropriateness of IUDs for adolescents remains unsettled, as does the definition of the term adolescent. Unplanned pregnancy among teenagers remains epidemic, and long-acting methods, such as IUDs, offer the promise of top-tier effectiveness. STUDY DESIGN: We conducted a systematic review of the literature concerning IUD use in adolescents using MEDLINE, Popline, EMBASE and CINAHL databases. RESULTS: Six cohort studies and seven case-series reports met our inclusion criteria; none included IUDs in current use in the United States. Overall, continuation rates were high and cumulative pregnancy rates low, ranging from 2% at 6 months to 11% at 48 months. Compared with combined oral contraceptives, IUDs had similar or better continuation rates; pregnancy rates were similar at 2 years. IUD expulsion rates may be inversely related to age. CONCLUSIONS: The literature on IUD use among adolescents is scanty and obsolete. Nevertheless, published reports were generally reassuring. Randomized controlled trials and cohort studies comparing contemporary IUDs with other methods are urgently needed.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | COHORT ANALYSIS | ADOLESCENTS | CONTRACEPTION | IUD | PREGNANCY RATE | CONTRACEPTIVE METHODS CHOSEN | Developed Countries | North America | Americas | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Family Planning | Contraceptive Methods | Fertility Measurements | Fertility | Population Dynamics | Contraceptive Usage
Document Number: 342601

17.

Title: Factors influencing the duration of pregnancy termination with vaginal misoprostol for fetal abnormality.
Author: Dickinson JE; Doherty DA
Source: Prenatal Diagnosis. 2009 May;29(5):520-4.
Abstract: OBJECTIVE: Evaluation of factors influencing the duration of second-trimester pregnancy interruption with vaginal misoprostol for fetal abnormality. METHODS: All medical terminations >or=13 weeks of gestation 1/1997 to 12/2007 were prospectively identified. Cases receiving vaginal misoprostol 400 microg 6-hourly were extracted from the database and outcomes reviewed. RESULTS: This consecutive case series comprised 1066 women. Median maternal age was 31 years [interquartile range (IQR) 26, 36] and 15.4% had at least one prior cesarean delivery. Principal indications for termination were aneuploidy (37.6%), neural tube defects (15.9%) and cardiac anomalies (9.4%). Median gestation at termination was 19.5 weeks (IQR 17.9, 21). Median abortion interval was 16.1 h (IQR 12, 23.5). Lower maternal age (median duration 17.6 vs 15.2 vs 13.6 h, age < 30 vs 30-39 vs > 40 years, p < 0.001), nulliparity (median duration 19 vs 14.3 h, nulliparous vs parous, p < 0.001) and increasing gestation (median duration 13 vs 17.8 h, <16 vs >20 weeks, p < 0.001) were associated with abortion prolongation. Controlling for gestation, age and parity, apart from musculoskeletal abnormalities (associated with abortion prolongation, p = 0.03), the specific fetal anomaly did not influence duration. CONCLUSIONS: Three factors: nulliparity, younger maternal age and increasing gestation, were associated with abortion prolongation. Apart from musculoskeletal abnormalities, the fetal anomaly had no impact on abortion duration.
Language: English
Keywords:
AUSTRALIA | RESEARCH REPORT | CONGENITAL ABNORMALITIES | ABORTION | MISOPROSTOL | TIME FACTORS | AGE FACTORS | NULLIPARITY | Oceania | Developed Countries | Neonatal Diseases and Abnormalities | Diseases | Fertility Control, Postconception | Family Planning | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Population Dynamics | Demographic Factors | Population | Population Characteristics | Parity | Fertility Measurements | Fertility
Document Number: 342614 Notification

18.

Title: Is the process of diagnosing and treating incidental medical findings a barrier to contraceptive acceptance and use?
Author: Ekabua JE; Ekabua KJ; Ekanem EI; Iklaki CU
Source: Journal of Obstetrics and Gynaecology. 2009 Apr;29(3):237-9.
Abstract: The objective of this study is to determine the impact of diagnosing and treating incidental medical disorders on contraceptive acceptance/use. The setting was the University of Calabar Teaching Hospital, a tertiary referral centre for the South-South zone of Nigeria and South-west Cameroon. Subjects were apparently healthy women seeking contraceptive counselling at the Teaching Hospital, Calabar (2001-2005). A total of 4,990 women's records were studied for the diagnosis of incidental medical findings. Two levels of missed opportunity for contraceptive uptake were identified. Incidental medical findings were seen in 26.9% of women. Contraceptive acceptance in women with incidental medical findings was 24.8%. Defaults from the screening process and treatment of incidental medical findings were significantly associated with high parity and low social status (p < 0.5). Incidental medical disorders, although uncommon in women desiring contraception were associated with low contraceptive uptake in women with high parity and low social status.
Language: English
Keywords:
NIGERIA | CAMEROON | RESEARCH REPORT | KAP SURVEYS | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | EXAMINATIONS AND DIAGNOSES | SCREENING | PSYCHOSOCIAL FACTORS | CONTRACEPTIVE USAGE | MULTIPARITY | SOCIAL CLASS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Behavior | Contraception | Family Planning | Parity | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Socioeconomic Status | Socioeconomic Factors
Document Number: 330945

19.

Peer Reviewed

Title: What does access to maternal care mean among the urban poor? Factors associated with use of appropriate maternal health services in the slum settlements of Nairobi, Kenya.
Author: Fotso J; Ezeh A; Madise N; Ziraba A; Ogollah R
Source: Maternal and Child Health Journal. 2009 Jan;13(1):130-7.
Abstract: Objectives: The study seeks to improve understanding of maternity health seeking behaviors in resource-deprived urban settings. The objective of this paper is to identify the factors which influence the choice of place of delivery among the urban poor, with a distinction between sub-standard and "appropriate" health facilities. Methods: The data are from a maternal health project carried out in two slums of Nairobi, Kenya. A total of 1,927 women were interviewed, and 25 health facilities where they delivered, were assessed. Facilities were classified as either "inappropriate" or "appropriate". Place of delivery is the dependent variable. Ordered logit models were used to quantify the effects of covariates on the choice of place of delivery, defined as a three-category ordinal variable. Results: Although 70% of women reported that they delivered in a health facility, only 48% delivered in a facility with skilled attendant. Besides education and wealth, the main predictors of place of delivery included being advised during antenatal care to deliver at a health facility, pregnancy "wantedness", and parity. The influence of health promotion (i.e., being advised during antenatal care visits) was significantly higher among the poorest women. Conclusion: Interventions to improve the health of urban poor women should include improvements in the provision of, and access to, quality obstetric health services. Women should be encouraged to attend antenatal care where they can be given advice on delivery care and other pregnancy-related issues. Target groups should include poorest, less educated and higher parity women.
Language: English
Keywords:
KENYA | RESEARCH REPORT | KAP SURVEYS | SLUMS | URBAN POPULATION | WOMEN IN DEVELOPMENT | MATERNAL HEALTH SERVICES | UTILIZATION OF HEALTH CARE | PROGRAM ACCESSIBILITY | QUALITY OF HEALTH CARE | CHILDBIRTH | EDUCATIONAL STATUS | PROMOTION | ANTENATAL CARE | MULTIPARITY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Urbanization | Urban Population Distribution | Population Distribution | Geographic Factors | Population | Population Characteristics | Demographic Factors | Economic Development | Economic Factors | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration | Health Services Evaluation | Pregnancy Outcomes | Pregnancy | Reproduction | Socioeconomic Status | Socioeconomic Factors | Marketing | Parity | Fertility Measurements | Fertility | Population Dynamics
Document Number: 308031

20.

Title: Breastfeeding and breast cancer risk in India: a multicenter case-control study.
Author: Gajalakshmi V; Mathew A; Brennan P; Rajan B; Kanimozhi VC; Mathews A; Mathew BS; Boffetta P
Source: International Journal of Cancer. 2009 Aug 1;125(3):662-5.
Abstract: Breast cancer incidence is low in India compared with high-income countries, but it has increased in recent decades, particularly among urban women. The reasons for this pattern are not known although they are likely related to reproductive and lifestyle factors. Here, we report the results of a large case-control study on the association between breastfeeding and breast cancer risk. The study was conducted in 2 areas in South India during 2002-2005 and included 1,866 cases and 1,873 controls. Detailed information regarding menstruation, reproduction, breastfeeding and physical activity was collected through in-person interview. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by unconditional logistic regression models. Breastfeeding for long duration was common in the study population. Lifetime duration of breastfeeding was inversely associated with breast cancer risk among premenopausal women (p-value of linear trend, 0.02). No such protective effect was observed in postmenopausal women, among whom a protective effect of parity was suggested. A reduction of breast cancer risk with prolonged breastfeeding was shown among premenopausal women. Health campaign focusing on breastfeeding behavior by appropriately educating women would contribute to reduce breast cancer burden.
Language: English
Keywords:
INDIA | RESEARCH REPORT | CONTROL GROUPS | WOMEN | BREAST CANCER | RISK FACTORS | BREASTFEEDING | TIME FACTORS | MENOPAUSE | PARITY | Asia, Southern | Asia | Developing Countries | Research Methodology | Demographic Factors | Population | Cancer | Neoplasms | Diseases | Health | Infant Nutrition | Nutrition | Population Dynamics | Reproduction | Fertility Measurements | Fertility
Document Number: 342166

21.

Title: Early motherhood, high mortality, and HIV/AIDS rates in Sub-Saharan Africa.
Author: Gant L; Heath KM; Ejikeme GG
Source: Social Work In Public Health. 2009 Jan-Apr;24(1-2):39-46.
Abstract: Despite billions of dollars devoted to HIV/AIDS prevention since 1990, rates of infection continue to climb worldwide, primarily through heterosexual contact, and Sub-Saharan Africa is the worst case scenario (UNAIDS, 2004). Traditional intervention programs based on the ABCs (abstinence, being faithful, and condom use) of safe sex practices have shown mixed success. Engaging in risky sexual behavior (behaviors not adhering to the ABCs of safe sex practices) continues to escalate the HIV/AIDS epidemic. Although research abounds with correlates to HIV/AIDS rates, few studies have addressed the basis of sexual behavior. Here we show that not only are HIV/AIDS rates significantly higher in Sub-Saharan Africa than in the rest of the world but also infant mortality rates and teenage birth rates are higher as well. Based on these findings, we argue that engaging in risky sexual behavior, in many circumstances associated with deplorable living conditions and high mortality, is the only viable option for avoiding reproductive failure: dying without leaving surviving descendents. We suggest that initiatives that improve overall health and living conditions in the at-risk populations are necessary before traditional intervention programs can effectively combat the spread of HIV/AIDS in Sub-Saharan Africa.
Language: English
Keywords:
AFRICA, SUB SAHARAN | RESEARCH REPORT | STATISTICAL STUDIES | HIV INFECTIONS | AIDS | PREVALENCE | MORTALITY | LIFE EXPECTANCY | INFANT MORTALITY | AGE SPECIFIC FERTILITY RATE | ADOLESCENT PREGNANCY | SEX BEHAVIOR | Africa | Developing Countries | Studies | Research Methodology | Viral Diseases | Diseases | Measurement | Population Dynamics | Demographic Factors | Population | Length of Life | Fertility Rate | Birth Rate | Fertility Measurements | Fertility | Reproductive Behavior | Behavior
Document Number: 341955

22.

Peer Reviewed

Title: Sex ratio at birth and family composition in sub-saharan Africa: inter-couple variations.
Author: Garenne M
Source: Journal of Biosocial Science. 2009 May;41(3):399-407.
Abstract: In this study, sex ratios at birth (male/female births) were found to vary according to family composition. Using Demographic and Health Survey (DHS) maternity histories from sub-Saharan Africa, the study shows that the sex ratio at birth increases with the number of previous male births and decreases with the number of previous female births. For families with only males, the sex ratio increases from 1.046 for the first birth to 1.083 for the 8th birth. For families with only females, the sex ratio decreases from 1.046 for the first birth to 0.942 for the 8th birth. The differences were highly significant when tested with a linear logistic model (p=0.018 for males; p=1.85 x 10(-11) for females). The effect was not symmetrical, and was found to be significantly stronger for females. These effects could be reproduced assuming a strong heterogeneity between couples. The distribution of sex ratios was fitted with an asymmetrical log-gamma function, which revealed a wide range of variation in the sex ratio between 0.50 and 1.30, and a peak around 1.14. The results and their implications are discussed in the light of former findings in France and in the United States of America.
Language: English
Keywords:
AFRICA, SUB SAHARAN | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | STATISTICAL STUDIES | COUPLES | SEX RATIO | FAMILY CHARACTERISTICS | BIRTH HISTORY | Africa | Developing Countries | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Studies | Research Methodology | Family and Household | Sociocultural Factors | Sex Distribution | Sex Factors | Population Characteristics | Pregnancy History | Fertility Measurements | Fertility
Document Number: 341403

23.

Peer Reviewed

Title: Power over parity: intimate partner violence and issues of fertility control.
Author: Gee RE; Mitra N; Wan F; Chavkin DE; Long JA
Source: American Journal of Obstetrics and Gynecology. 2009 Aug;201(2):148.e1-7.
Abstract: OBJECTIVE: The purpose of this study was to examine the association between intimate partner violence (IPV), abortion, parity, and contraception use. STUDY DESIGN: We recruited 1463 women for this written questionnaire study of IPV. Patient demographics, contraceptive history, and reproductive history were obtained in the waiting room from patients presenting for gynecologic care. RESULTS: Seventy percent of those eligible participated. Twenty-one percent reported a history of IPV. Partner unwillingness to use birth control, partner desirous of conception, partner creating difficulty for subject's use of birth control, and subjects expressing inability to afford contraception were all positively associated with report of IPV. Each additional pregnancy was associated with 10% greater odds of IPV (95% confidence interval, 1.03-1.17). CONCLUSION: Contraception is more difficult to navigate for women experiencing IPV. Providers should consider prescribing contraceptive methods for IPV victims that are not partner dependent.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | COUPLES | DOMESTIC VIOLENCE | MULTIPARITY | ABORTION | CONTRACEPTION | Developed Countries | North America | Americas | Family Characteristics | Family and Household | Sociocultural Factors | Crime | Social Problems | Parity | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Fertility Control, Postconception | Family Planning
Document Number: 342608 Notification

24.

Peer Reviewed

Title: Tackling health inequities in Chile: maternal, newborn, infant, and child mortality between 1990 and 2004.
Author: Gonzalez R; Requejo JH; Nien JK; Merialdi M; Bustreo F; Betran AP
Author: Chile Maternal, Newborn, and Child Health Writing Group
Source: American Journal of Public Health. 2009 Jul;99(7):1220-6.
Abstract: OBJECTIVES: We analyzed trends in maternal, newborn, and child mortality in Chile between 1990 and 2004, after the introduction of national interventions and reforms, and examined associations between trends and interventions. METHODS: Data were provided by the Chilean Ministry of Health on all pregnancies between 1990 and 2004 (approximately 4,000,000). We calculated yearly maternal mortality ratios, stillbirth rates, and mortality rates for neonates, infants (aged > 28 days and < 1 year), and children aged 1 to 4 years. We also calculated these statistics by 5-year intervals for Chile's poorest to richest district quintiles. RESULTS: During the study period, the maternal mortality ratio decreased from 42.1 to 18.5 per 100,000 live births. The mortality rate for neonates decreased from 9.0 to 5.7 per 1000 births, for infants from 7.8 to 3.1 per 1000 births, and for young children from 3.1 to 1.7 per 1000 live births. The stillbirth rate declined from 6.0 to 5.0 per 1000 births. Disparities in these mortality statistics between the poorest and richest district quintiles also decreased, with the largest mortality reductions in the poorest quintile. CONCLUSIONS: During a period of socioeconomic development and health sector reforms, Chile experienced significant mortality and inequity reductions.
Language: English
Keywords:
CHILE | RESEARCH REPORT | DATA ANALYSIS | INFANT | CHILDREN | CHILD MORTALITY | MATERNAL MORTALITY | DEATH RATE | PARITY SPECIFIC BIRTH RATE | INEQUALITIES | PREVENTION AND CONTROL | Developing Countries | South America, Southern | South America | Latin America | Americas | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Mortality | Population Dynamics | Fertility Rate | Birth Rate | Fertility Measurements | Fertility | Socioeconomic Factors | Economic Factors | Diseases
Document Number: 342239

25.

Title: Reconsidering childhood undernutrition: can birth spacing make a difference? An analysis of the 2002-2003 El Salvador National Family Health Survey.
Author: Gribble JN; Murray NJ; Menotti EP
Source: Maternal and Child Nutrition. 2009 Jan;5(1):49-63.
Abstract: It is well understood that undernutrition underpins much of child morbidity and mortality in less developed countries, but the causes of undernutrition are complex and interrelated, requiring a multipronged approach for intervention. This paper uses a subsample of 3853 children under age 5 from the most recent family health survey in El Salvador to examine the relationship between birth spacing and childhood undernutrition (stunting and underweight). While recent research and guidance suggest that birth spacing of three to five years contributes to lower levels of infant and childhood mortality, little attention has been given to the possibility that short birth intervals have longer-term effects on childhood nutrition status. The analysis controls for clustering effects arising from siblings being included in the subsample, as well as variables that are associated with household resources, household structure, reproductive history and outcomes, and household social environment. The results of the multiple regression analyses find that in comparison to intervals of 36-59 months, birth intervals of less than 24 months and intervals of 24-35 months significantly increase the odds of stunting (<24 months Odds Ratio (OR) = 1.52; 95% confidence interval (CI): 1.21-1.92; 25-36 months OR = 1.30; 95% CI: 1.05-1.64). Other factors related to stunting and underweight include standard of living index quintile, child's age, mother's education, low birthweight, use of prenatal care, and region of the country where the child lives. Policy and program implications include more effective use of health services and outreach programs to counsel mothers on family planning, breastfeeding, and well child care.
Language: English
Keywords:
EL SALVADOR | RESEARCH REPORT | ANTHROPOMETRY | CHILDREN | CHILD HEALTH | CHILD DEVELOPMENT | CHILD NUTRITION | BIRTH SPACING | BIRTH INTERVALS | LOW BIRTH WEIGHT | FAMILY PLANNING | BREASTFEEDING | NEEDS | PROGRAM EVALUATION | Developing Countries | Central America | Latin America | Americas | Measurement | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Biology | Nutrition | Fertility Measurements | Fertility | Population Dynamics | Birth Weight | Body Weight | Physiology | Infant Nutrition | Economic Factors | Programs | Organization and Administration
Document Number: 329593

26.

Title: Use of family planning services in Darfur, Sudan.
Author: Haggaz A; Ahmed S; Adam I
Source: International Journal of Gynaecology and Obstetrics. 2009 Mar;104(3):247-8.
Abstract: High fertility rates and inadequate spacing between births can lead to high maternal and infant mortality. An estimated 600 000 maternal deaths occur worldwide each year, and the vast majority take place in low-income countries. The World Health Organization estimates that 13% of these deaths are due to unsafe abortions. Worldwide, where approximately 50 million women resort to induced abortion, this frequently results in high rates of maternal morbidity and mortality. Family planning and adequate spacing between births are important methods to help avoid these deaths. Little published data are available regarding the use of family planning services in Sudan-the largest country in Africa, with 40 million inhabitants-although high maternal mortality and inadequate utilization of prenatal care in Darfur have been reported previously. In Alfasher, the area considered in the present study, the Sudanese Family Planning Association has an office that provides services such as contraceptive pills and intrauterine contraceptive devices free of charge. A community-based cross-sectional household survey was conducted in Alfashar, in April and June 2008, to investigate the use of and factors associated with family planning services. (excerpt)
Language: English
Keywords:
SUDAN | RESEARCH REPORT | STATISTICAL STUDIES | WOMEN | FAMILY PLANNING PROGRAMS | UTILIZATION OF HEALTH CARE | AGE FACTORS | EDUCATIONAL STATUS | PARITY | FAMILY PLANNING EDUCATION | Developing Countries | Africa, North | Africa | Studies | Research Methodology | Demographic Factors | Population | Family Planning | Health Services | Delivery of Health Care | Health | Population Characteristics | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Fertility Measurements | Fertility | Population Dynamics | Education
Document Number: 341389

27.

Peer Reviewed

Title: Profile of long-acting reversible contraception users in Europe.
Author: Haimovich S
Source: European Journal of Contraception and Reproductive Health Care. 2009 Jun;14(3):187-95.
Abstract: OBJECTIVES: To assess the profile of long-acting reversible contraceptives (LARCs) users in Europe. METHODS: A random sample of women aged 15-49 years in 14 European countries (Germany, France, UK, Spain, Italy, Russian Federation, Estonia, Latvia, Lithuania, Austria, Czech Republic, Denmark, Norway, and Sweden) underwent web-based or computer-aided face-to-face interviews in June 2006. In this paper data pertaining to a subgroup of women using LARCs are presented. RESULTS: A total of 11,490 women participated in the full study. Of these, 1,188 (10%) women were LARC (hormonal implant, injectables, levonorgestrel-releasing intrauterine system [LNG-IUS], copper intrauterine device [Cu-IUD]) users. The age of the LARC users exceeded 30 years for 57-91% of them. Furthermore, more than half of them found convenience an extremely important factor when selecting the LARC as a contraceptive method. As compared to those wearing a Cu-IUD, women using hormonal LARCs experienced fewer physical and emotional symptoms that appeared or worsened during menstruation. CONCLUSIONS: LARCs have their place in the contraceptive market in Europe. The most popular LARCs among European women were the LNG-IUS and the Cu-IUD; both were mainly used by women who had children and had no wish to have more in the future.
Language: English
Keywords:
EUROPE | RESEARCH REPORT | SAMPLING STUDIES | WOMEN | CONTRACEPTIVE USAGE | CONTRACEPTIVE IMPLANTS | INJECTABLES | IUD | CONTRACEPTIVE METHODS CHOSEN | AGE FACTORS | PARITY | SATISFACTION | CONTRACEPTIVE AGENTS, SIDE EFFECTS | Developed Countries | Studies | Research Methodology | Demographic Factors | Population | Contraception | Family Planning | Contraceptive Methods | Population Characteristics | Fertility Measurements | Fertility | Population Dynamics | Psychological Factors | Behavior | Contraceptive Agents
Document Number: 341802

28.

Peer Reviewed

Title: Reproductive and family planning history, knowledge, and needs: A community survey of low-income women in Beijing, China.
Author: He H; Ostbye T; Daltveit AK
Source: BMC Women's Health. 2009 Aug 10;9(1):23.
Abstract: ABSTRACT: BACKGROUND: The reproductive health status of China's low-income urban women is believed to be poor. Therefore, understanding their reproductive history and needs and improving services provision is very important. However, few studies have been done to assess reproductive health status, knowledge and needs in this low-income population. The purpose of this study is to broadly assess reproductive and family planning history, knowledge and health needs among low income urban women with an aim to informing health services interventions. METHODS: 1642 low-income women age 18-49 from Haidian district, Beijing were selected. All were interviewed via a standardized questionnaire in 2006. RESULTS: Most women reported at least one pregnancy and delivery (97.7%, 98.3%). Deliveries in hospitals (97.3%) by medical personnel (98.5%) were commonplace, as was receipt of antenatal care (86.0%). Nearly half had at least one abortion, with most (56.0%) performed in district hospitals, by physicians (95.6%), and paid for out-of-pocket (64.4%). Almost all (97.4%) used contraception, typically IUDs or condoms. Reproductive knowledge was limited. Health needs emphasized by the participants included popularizing reproductive health information, being able to discuss their reproductive health concerns, free reproductive health insurance, examination and treatment. CONCLUSIONS: Among poor urban women in Beijing, antenatal care and contraceptive use were common. However, abortions were also common. Knowledge about reproductive health was limited. There is a need for better reproductive health education, free medical care and social support.
Language: English
Keywords:
CHINA | RESEARCH REPORT | SAMPLING STUDIES | FAMILY PLANNING SURVEYS | LOW INCOME POPULATION | URBAN POPULATION | WOMEN | REPRODUCTIVE HEALTH | PREGNANCY HISTORY | KNOWLEDGE | NEEDS | Asia, Eastern | Asia | Developing Countries | Studies | Research Methodology | Family Planning | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Population Characteristics | Demographic Factors | Population | Health | Fertility Measurements | Fertility | Population Dynamics | Sociocultural Factors
Document Number: 342493

29.

Peer Reviewed

Title: Parity and subfertility effects of continuous oral contraceptive on fertility are important.
Author: Hitchcock CL; Prior JC
Source: Fertility and Sterility. 2009 Aug 21;
Abstract: This letter to the editor discusses parity and subfertility effects of continuous oral contraceptive on fertility and states concerns related to recent articles by Barnhart and colleagues. It expresses issues about the role of parity in the time to conception and concerns that an uncritical acceptance of this conclusion may cause harm.
Language: English
Keywords:
CANADA | CRITIQUE | DATA ANALYSIS | CONTRACEPTION CONTINUATION | PARITY | ORAL CONTRACEPTIVES | Developed Countries | North America, Northern | Americas | Research Methodology | Contraceptive Usage | Contraception | Family Planning | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Contraceptive Methods
Document Number: 342593

30.

Peer Reviewed

Title: Fragile, threatened, and still urgently needed: family planning programs in Sub-Saharan Africa.
Author: Jacobstein R; Bakamjian L; Pile JM; Wickstrom J
Source: Studies in Family Planning. 2009 Jun;40(2):147-154.
Abstract: Many family planning (FP) programs in sub-Saharan Africa are fragile; recent performance has fallen off and future performance is challenged. Yet robust and wellfunctioning FP programs are still urgently needed if countries are to meet their health, equity, poverty-alleviation, and economic development goals. In support of these observations, we present data on FP parameters in sub- Saharan Africa overall and in eight of its countries, including Nigeria, the most populous African country; Kenya, a long-time leader in FP in the region; and Uganda, with fertility among the highest in Africa and a population projected to more than triple in the next 40 years to become sub-Saharan Africa's fourth-most-populous country. We also draw upon findings of individual case studies of the contraceptive programs of Ghana (Solo et al. 2005c), Malawi (Solo et al. 2005a), Senegal (Wickstrom et al. 2006), Tanzania (Pile and Simbakalia 2006), and Zambia (Solo et al. 2005b), as well as a synthesis of some of these case studies (ACQUIRE Project 2005). All eight of these countries, which together comprise 40 percent of the population of sub-Saharan Africa, are facing the same difficult dynamics in terms of threat and need.
Language: English
Keywords:
AFRICA, SUB SAHARAN | CRITIQUE | DEMOGRAPHIC AND HEALTH SURVEYS | FAMILY PLANNING PROGRAMS | NEEDS | CONTRACEPTIVE USAGE | TOTAL FERTILITY RATE | FERTILITY PREFERENCES | DECENTRALIZATION | FUNDS | URBANIZATION | POVERTY | FOOD SECURITY | Africa | Developing Countries | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Family Planning | Economic Factors | Contraception | Fertility Rate | Birth Rate | Fertility Measurements | Fertility | Political Factors | Sociocultural Factors | Financial Activities | Urban Population Distribution | Population Distribution | Geographic Factors | Socioeconomic Factors | Food Supply | Natural Resources | Environment
Document Number: 341898


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