A study of contraception as related to unwanted pregnancy

A study was made of 150 women requesting therapeutic abortion. Mechanical failure of the contraceptive method used accounted for unwanted pregnancy in 89 (59%) women. In the remainder no method of contraception was used by either partner. Among women requesting abortion, failure to use contraceptives was commoner in the younger and unmarried than in older and married women.The data obtained were analyzed in an attempt to explain the failure and avoidance of contraception. Suggestions are made as to how to discourage the use of abortion as a method of contraception.     

Contraceptive practice of Irish married and single first-time mothers

This study surveys 100 married and 100 unmarried primiparous mothers, attending the National Maternity Hospital, Dublin, with regard to their contraceptive practice, their planning of their pregnancy and the timing of their first antenatal visit. Nineteen per cent of the married women, but 64% of the unmarried women, had never used any contraceptive method. The contraceptive pill was the most popular method for both groups, but while three in five of the married women had at some time used the pill, only a little more than one in five of the unmarried women had ever used it. One quarter of the women who had used contraception reported that their pregnancy was the result of a failure in their contraceptive method. Eighty-nine per cent of the single group and 20% of the married had not planned their pregnancy. None of the married women, but almost a quarter of the single, delayed their first antenatal visit until after they were 20 weeks pregnant.     

早期妊娠妇女人工流产的因素调查

目的：了解早期妊娠行人工流产妇女的人群特征,探讨导致妇女人工流产的相关因素,为减少非意愿妊娠提供干预依据。方法：采用整群抽样方法,对丰台区四家二级医院计划生育门诊同期行人工流产的妇女进行问卷调查。结果：共回收调查问卷4381份。调查对象中,平均年龄26岁（16．54岁）,本市户籍占26．8％,外地户籍73．2％;已婚65．33％,未婚34．67％;文化程度初、高中占62．5％;职业列前三位的分别是服务员23．5％、公司职员18．2％、个体工商户10．5％;重复流产为37-3％。非意愿妊娠占83．24％,,非意愿妊娠的原因,39．53％是未避孕,43．71％为避孕失败,而避孕失败的原因中又以避孕套避孕失败居首;意愿妊娠占Ⅲ6．7鹞％,最终选择终止妊娠的原因分别为个人工作因素、情感因素及优生考虑。结论i为降低l妇女非意愿妊娠及重复流产率,对育龄妇女,尤其是流动、未婚人群,需广泛开展性健康教育及避孕方式知情选择,加强避孕知识以及人工流产危害的宣教,指导避孕方法的正确使用,同时,各级医院亟待开展流产后服务。     

Seroepidemiology of Toxoplasma gondii infection in pregnant women in rural Durango, Mexico

The epidemiology of Toxoplasma gondii infection in pregnant women in rural Mexico is largely unknown. The seroepidemiology of T. gondii infection in 439 pregnant women from 9 communities in rural Durango State, Mexico was investigated. Using commercial enzyme-linked immunoassays, sera were tested for T. gondii IgG, IgM, and avidity antibodies. Prevalences of T. gondii IgG antibodies in the communities varied from 0% to 20%. Overall, 36 (8.2%) of the 439 women had IgG T. gondii antibodies. Ten (2.3%) women had also T. gondii IgM antibodies; IgG avidity was high in all IgM-positive women, suggesting chronic infection. None of the women, however, had delivered a known T. gondii-infected child. The seroprevalence was significantly higher (P < 0.05) in women from low socio-economic conditions (14%) than in those with higher socio-economic status (6.6%). Multivariate analysis showed that T. gondii infection was associated with soil floors at home (adjusted OR = 2.89; 95% CI: 1.12-7.49). This is the first epidemiological study of T. gondii infection in pregnant women in rural Mexico.     

Sexual behaviour and contraception among unmarried adolescents and young adults in Greater Accra and Eastern regions of Ghana

A fertility survey of unmarried adolescents and young adults (953 males and 829 females) in Greater Accra and Eastern regions of Ghana revealed that a substantial proportion of the respondents were sexually experienced. Overall, 66.8% of the males and 78.4% of the females were sexually experienced. The mean ages (+/- SD) of the males and females were 15.5 +/- 2.5 and 16.2 +/- 2.0 years, respectively. Most respondents claimed to have received adequate information on reproductive health and sexually transmitted diseases (STDs), including AIDS. However, 20% and 30% of the respondents in peri-urban and rural areas, respectively, did not know that a girl could get pregnant the first time she has sexual intercourse. The incidence of pregnancy among the unmarried female respondents was relatively high (37%), and was higher in urban than in rural areas. Approximately 47% of those who had ever been pregnant reported that they had had an abortion. Levels of contraceptive awareness were high (98.2% among males and 95.5% among females) but many still engaged in unprotected sexual relations. The most commonly used methods were the condom and the pill. The main reasons given for non-use were that they did not think about contraception, were concerned about the safety of contraceptives, and partner objection. These findings point to the need for targeting of unmarried adolescents and young adults with information on reproductive health and family planning to increase their awareness of the risks of pregnancy, STDs and HIV infection.     

The Impact of Oral Contraceptive Initiation on Young Women’s Condom Use in 3 American Cities: Missed Opportunities for Intervention

Purpose

To describe women’s condom use and assess predictors of consistent condom use and dual method use in the 6 months after the initiation of oral contraception (OC).

Methods

We conducted a planned secondary cohort analysis among women less than 25 years of age initiating oral contraceptives at public family planning clinics in Atlanta, Dallas and New York City, USA, as part of a randomized trial. These clinics provide care to predominantly African American or Hispanic women of low socioeconomic status. Participants completed interviews at enrollment and at 6 months after OC start. We used multivariate logistic regression to assess factors associated with consistent condom and dual method use at 6 months.

Results

1281 participants met the inclusion criteria for this analysis. At enrollment prior to OC start, 28% were consistent condom users. In the six months after initiation of oral contraception, only 14% always used a condom and 4% always used dual methods. In multivariate analysis, receiving basic advice to always use a condom after OC initiation from a provider during the baseline clinic consultation was associated with a 50% increase in the odds of using condoms consistently. Only 28% of participants were given this condom use advice.

Conclusions

This study documents a decline in women’s condom consistent use subsequent to initiation of the oral contraceptive and suggests that opportunities for positive intervention around condom use among women starting hormonal methods are being missed. Basic condom use advice, which is neither time consuming nor resource dependent, was associated with increased consistent use and should be immediately implemented in all family planning services.     

Colonic Crohn's disease and use of oral contraception.

The prevalence of use of oral contraception before the onset of disease was established in 100 consecutive women attending follow up clinics for inflammatory bowel disease. A significant excess of women with Crohn''s disease confined to the colon had taken oral contraceptives in the year before developing symptoms (10/16 (63%] compared with women with small-intestinal Crohn''s disease (12/49 (24%); p less than 0.02) and women with ulcerative colitis (3/35 (9%); p less than 0.0005). When the patient groups were matched for age and year of onset of disease usage of oral contraception before the onset of disease was still more common among women with isolated colonic Crohn''s disease (9/12, 75%) than among those with ulcerative colitis (2/12 (17%); p less than 0.02) and was also more common than would be expected from reported figures for oral contraception in England and Wales (31.4% of women aged under 41; p less than 0.005). A survey of current patient records showed that isolated colonic disease was at least twice as common among women with Crohn''s disease (63/218, 29%) compared with men (25/181, 14%; p less than 0.001). These data support the suggestion made previously that oral contraceptives may predispose to a colitis that resembles colonic Crohn''s disease.     

Plants Used for Reproductive Health by Nahua Women in Northern Veracruz,Mexico

Plants Used for Reproductive Health by Nahua Women in Northern Veracruz, Mexico. This paper reports the use of medicinal plants by Nahua women in the state of Veracruz, Mexico. It documents the women’s plant knowledge for reproductive purposes, which includes uses such as conception, pregnancy, birth, contraception, menstruation, post-partum, and general reproductive health. The concept of equilibrium is very important in regaining health among the Nahua; consequently, many of the medicinal plants have this as their primary purpose. The introduction of biomedical clinics and hospitals in the region has had a significant effect on the loss of knowledge about medicinal plants. Additionally, the midwives are not taking any new apprentices and laywomen are not passing on their knowledge to future generations. This generational gap contributes to the loss of knowledge about medicinal plants. This research contributes to the study of indigenous ethnobotany by (a) creating a record of the plant knowledge possessed by indigenous women, (b) giving voice to some of their health concerns, (c) indicating how the introduction of biomedicine has affected their plant use, and (d) providing a framework for understanding how marginal peoples around the world respond to the impact that globalization and change has on their health needs and local ethnobotanical knowledge.     

Population structure and anthropometric variation in rural western Ireland: Isolation by distance and analysis of the residuals

The study of human population structure allows the assessment of cultural and historical influences on mating probabilities, and, hence, genetic variation. A commonly used model is isolation by distance, which predicts a negative exponential relationship between genetic similarity and geographic distance. Anthropometric data collected during the 1930's for 261 adult women in 12 towns of rural western Ireland were used to test the isolation by distance model and to assess the influence of cultural factors upon the fit of the model. The effects of recent migration were tested by using two additional data subsets, one excluding known intercounty migrants and the other consisting of unmarried women, only in an attempt to control partially for local migration upon marriage. Deviations from the expected isolation by distance model were analyzed using rotational fitting and regression analysis. Estimates of the isolation by distance parameters agree closely with independent estimates from isonymy and with estimates obtained in other studies of rural European population structure. Analysis of the residuals indicates three major factors which contribute to deviations from the expected model: recent migration upon marriage, age variation among groups, and variation in population size and/or transportation opportunities. Variation in population size was tested using the gravity model of economic geography by regressing the residuals from the isolation by distance model for each pair of towns on the product of their population sizes. The best fit occurred for the unmarried sample, as expected from ethnographic evidence, since rural–urban migration was most common among unmarried women.     

Declining Odds: Kinship, Women's Employment, and Political Economy in Rural Mexico

Some women in San Cosme Mazatecochco, a rural community in central Mexico, whose families have more diverse networks and a slight economic advantage, use the community's flexible kinship system to get more secure employment. But their ability to do so is limited by the larger political economy. As the Mexican economy deteriorates for working-class Mexicans and the class system becomes more closed, more women participate in the labor force and more women have marginal employment, [political economy, kinship, women, class, Mexico]     

Determinants of the sex ratio at birth: Review of recent literature

Abstract

Use of contraception by rural Egyptian women who desire no more children is examined within a modified microeconomic framework. Four sets of factors are hypothesized to influence current use of contraception: (1) costs of contraception, ‘(2) factors influencing the slope of the desired family size function, (3) anticipated costs of child rearing and (4) strength of motivation for fertility regulation. Women's education and two measures of psychic costs were found to be important predictors of contraceptive use. Factors affecting the demand for children and thus indirectly influencing the motivation for fertility regulation were also important. Land ownership, cultivating status of the household, and educational expectations for children were significantly related to current use. Strength of motivation, although significant, was less strongly related to use of contraception. The findings suggest women who want no more children, but who are not practicing contraception, are affected by factors influencing both the costs of contraception and the costs of an unwanted child.     

Cervical cancer incidence and mortality in New Mexico's Hispanics,American Indians,and non-Hispanic whites.

High rates of cervical cancer were reported in New Mexico in the early 1970s, with especially high rates for minority women. We examined data collected from 1970 to 1987 for invasive cervical cancer and cervical carcinoma in situ for New Mexico''s Hispanic, American Indian, and non-Hispanic white women to determine whether changes had occurred in cervical cancer rates since earlier reports. To further characterize the epidemiology of cervical cancer in New Mexico, we reviewed state vital statistics for cervical cancer deaths occurring between 1958 and 1987. From 1970 to 1987, the incidence for invasive cervical cancer among Hispanic (18.9 per 100,000 person-years) and American Indian women (22.0 per 100,000 person-years) was about double that for non-Hispanic white women (10.3 per 100,000). The incidence in each ethnic group decreased over time for both invasive cancer and carcinoma in situ when the data were examined by 2 time periods (1970 to 1978 and 1979 to 1987). These decreases were most dramatic for invasive cervical cancer. Cervical cancer-related death rates for Hispanics and non-Hispanic whites also decreased from 1958 to 1987. Although our data reflect declines in cervical cancer rates during the study period, further rate decreases, especially for minority women, remain an important public health goal in New Mexico.     

Pet companionship and depression: Results from a United States Internet sample

Abstract

Using Internet survey data from 2,291 respondents from the United States, we examined socio-demographic predictors of living with a cat or dog. Logistic regressions showed that, for men, being married, living with children, being Midwestern and non-urban increased odds of living with a pet. For women, being White, having a high income, living with children, and living in a rural setting increased odds for pet ownership. Multivariate analyses examining influences of gender, marital status, and pet ownership on depression (CES-D) scores, adjusting for potential confounders, revealed that unmarried women who live with a pet have the fewest depressive symptoms, and unmarried men who live with a pet have the most. These findings suggest that single women benefit from pet companionship, whereas single men may be burdened by it.     

Paraguayan pharmacies and the sale of pseudo-abortifacients

This study was conducted in 1985 in Asunción, Paraguay, 6 years after the closure of the state supported family planning services. Data from national surveys in 1977 and 1987 permit a comparison of sources of contraceptive supplies before and after the elimination of government support for family planning. The purchase of pseudo-abortifacients from private pharmacies was used as an indication of induced abortion. After the loss of government clinics, it is suggested that some women turned to pharmacists to obtain pseudo-abortifacients when faced with unwanted pregnancy. There is an indication of increased pseudo-abortifacient use, particularly among unmarried women and those from poorer neighbourhoods.     

Breast-feeding promotion in Manitoba. Committee on Breast-feeding,Manitoba Pediatric Society.

During the International Year of the Child the Manitoba Pediatric Society undertook professional and public education activities to promote breast-feeding in that province. The objective was a 100% increase in the proportion of mothers who breast-fed their infants for 2 months or longer. Surveys conducted before and after the campaign showed no significant increase in the rate of breast-feeding either at the time of hospital discharge or 2 months later. The infants of Winnipeg residents were more likely to be breast-fed than those of women living on Indian reservations or in any other part of the province (termed "rural"). The rate of bottle-feeding was significantly greater among infants of young unmarried mothers. Future programs to promote breast-feeding should be longer and more intensive, should be directed to the young, to rural residents and to Indian women, and should focus on social and emotional factors as well as nutrition and health benefits.     

Contraception and Unintended Pregnancy among Unmarried Female University Students: A Cross-sectional Study from China

This study aims to understand the level of contraceptive knowledge and attitudes towards contraception, and then to explore the association between the contraceptive behavior and unintended pregnancy in unmarried female university students in China. A cross-sectional study was conducted of university students in 49 universities across 7 cities in China from September 2007 to January 2008. We distributed 74,800 questionnaires, of which 69,842 were returned. In this paper, the data from 35,383 unmarried female university students were analyzed. The prevalence of sexual intercourse in unmarried female university students was 10.2%. The prevalence of unintended pregnancy in those sexually active female university students, was 31.8%. Among students with pregnancy, 53.5% experienced two or more pregnancies. 28.3% of the students with sexual intercourse reported that they always adopted contraceptive methods, and of those 82.9% chose to use male condoms. The majority (83.9%) of students with unintended pregnancy chose to terminate the latest pregnancy by surgical abortion or medical abortion. The contraceptive knowledge level of students who experienced unintended pregnancy was lower than those who did not. In China, about one third of unmarried female students with sexual intercourse experience unintended pregnancy. A variety of contraceptive methods are adopted, but the frequency of contraceptive use is low. Most of unmarried female students who experienced unintended pregnancy would choose to terminate the pregnancy with surgical or medical abortion. University students, especially the ones who have experienced unintended pregnancy, lack contraceptive and reproductive health knowledge.     

Anaemia of pregnancy: the changing postwar pattern.

A popluation survey covering over a quarter of a century has shown clearly the improvement in haemoglobin levels in women attending antenatal clinics at the Glasgow Royal Maternity Hospital. Various influences have helped to bring this about, foremost among these being routine early prophylaxis with combined iron and folate supplements. Indeed, a time-space relationship between changes in prophylactic therapy, rates of improvement, and the incidence of megaloblastic anaemia can be shown. The women at risk are still essentially the same except for a new group of young, unmarried girls, who must be watched. In our view the withdrawal of routine prophylactic therapy in pregnancy would be retrograde step.     

Why is the number of pregnancies among teenagers decreasing?

The issue of pregnancy among adolescent women has received considerable attention from the media. Contrary to common belief, both the numbers and the rates of such pregnancies, even when data on abortion are included, have been declining. Patterns of contraception may account for some of the decrease; however, more study is required. In the past, unmarried teenagers who became pregnant either got married or put the baby up for adoption. Now they can either have an abortion or keep the baby. Solutions to the problems of pregnancy among teenagers must therefore be addressed to these altered social consequences rather than to misleading comments about "epidemics", with their suggestion of increased rates of pregnancy.     

Implications of inflammatory changes on cervical cytology.

OBJECTIVE--To assess premenopausal women with inflammatory changes on cervical cytology for genital infections and cervical abnormalities. DESIGN--Prospective study of women attending general practice and family planning clinics who had a recent cervical cytology result with inflammatory changes. SETTING--Department of genitourinary medicine. PATIENTS--102 Premenopausal women with recent cytology result showing inflammatory changes and with no history of antibiotic or antifungal treatment since their smear. INVESTIGATIONS--Genital examination and microbiological screening for genital infections; colposcopic examination about six weeks later. MAIN OUTCOME MEASURES--Detection of genital infections, particularly those sexually acquired, and abnormalities on colposcopy. RESULTS--Genital infections were isolated in 77 patients, and one or more sexually acquired infections were found in 22. Prevalence of sexually acquired infections was significantly correlated with younger age (particularly being under 25), being single, separated, or divorced; using non-barrier contraception; and recent change of sexual partner. An abnormality on colposcopy was found in 36 women. There was a strong correlation of a sexually acquired infection with an abnormality at colposcopy; hence younger women were more likely to have a colposcopic abnormality. CONCLUSIONS--Inflammatory changes on cytology are often associated with the presence of a sexually acquired infection and premalignant disease of the cervix, particularly in younger, single women using non-barrier contraception.