Pub Date : 2017-01-20DOI: 10.1136/jfprhc-2016-101593
J. Paul, C. Boraas, M. Duvet, Judy C. Chang
Background Since the internet has become an important source of contraceptive information with YouTube.com as the second most visited site, we analysed contraceptive implant YouTube videos for content and clinical accuracy. Methods Using the terms ‘contraceptive implant’, ‘Nexplanon’ and ‘Implanon’, the top 20 results on YouTube by relevance and view count were identified. After excluding duplicates, single-rod implant videos in English were included. Videos were classified as providing a professional or patient perspective. Views, duration and comments were noted. Videos were rated for reliability, global quality scale and whether they were positive or negative about the implant. Inter-rater agreement was measured. Results A total of 120 videos were retrieved; 52 were eligible for review. Less than 23% were professional videos; the majority reported patient experience (46% testimonials, 27% real-time procedure videos, 4% other). Patient videos had been posted a significantly longer duration of time than professional videos (364 vs 188 days, p=0.02), were less reliable (p≤0.0001) and were of lower global quality (p<0.0001). Some 61% of implant testimonial videos were rated as ‘positive experiences’ and inter-rater agreement was very good (κ=0.81). All testimonials mentioned side effects, commonly irregular bleeding and discomfort with insertion. A minority (26%) reported misinformation. Conclusions This study found that most of the information on YouTube pertaining to contraceptive implants is accurate, is presented from the patient's perspective, and promotes the method's use.
{"title":"YouTube and the single-rod contraceptive implant: a content analysis","authors":"J. Paul, C. Boraas, M. Duvet, Judy C. Chang","doi":"10.1136/jfprhc-2016-101593","DOIUrl":"https://doi.org/10.1136/jfprhc-2016-101593","url":null,"abstract":"Background Since the internet has become an important source of contraceptive information with YouTube.com as the second most visited site, we analysed contraceptive implant YouTube videos for content and clinical accuracy. Methods Using the terms ‘contraceptive implant’, ‘Nexplanon’ and ‘Implanon’, the top 20 results on YouTube by relevance and view count were identified. After excluding duplicates, single-rod implant videos in English were included. Videos were classified as providing a professional or patient perspective. Views, duration and comments were noted. Videos were rated for reliability, global quality scale and whether they were positive or negative about the implant. Inter-rater agreement was measured. Results A total of 120 videos were retrieved; 52 were eligible for review. Less than 23% were professional videos; the majority reported patient experience (46% testimonials, 27% real-time procedure videos, 4% other). Patient videos had been posted a significantly longer duration of time than professional videos (364 vs 188 days, p=0.02), were less reliable (p≤0.0001) and were of lower global quality (p<0.0001). Some 61% of implant testimonial videos were rated as ‘positive experiences’ and inter-rater agreement was very good (κ=0.81). All testimonials mentioned side effects, commonly irregular bleeding and discomfort with insertion. A minority (26%) reported misinformation. Conclusions This study found that most of the information on YouTube pertaining to contraceptive implants is accurate, is presented from the patient's perspective, and promotes the method's use.","PeriodicalId":15734,"journal":{"name":"Journal of Family Planning and Reproductive Health Care","volume":"43 1","pages":"195 - 200"},"PeriodicalIF":0.0,"publicationDate":"2017-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jfprhc-2016-101593","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42483497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-13DOI: 10.1136/jfprhc-2016-101561
Suzanne Jewell, K. Campbell, K. Jaffer
In 2013 the sexual health and contraception services across Birmingham, UK were put out to tender by the commissioning parties Birmingham City Council and Solihull Metropolitan Borough Council. The commissioners' primary focus was to integrate the disparate services managed by different trusts and other associated providers within the region and to bring them under one contract. Another aim was for primary care to play a bigger role in providing sexual health services (SHS). There was also to be greater emphasis on safeguarding and health promotion, and for the service to deliver new ways of working by using media and technology. University Hospitals Birmingham NHS Foundation Trust (UHB) developed a bid based upon the commissioners' vision and created a novel approach to how services could be delivered. UHB were successfully awarded the tender in December 2014, and merging with Solihull-based SHS, the Umbrella service was launched in August 2015. A 5-year contract was agreed, and despite a complete service redesign represented a cost saving. Based on 10 key service outcomes (Table 1) a unique partnership branded Umbrella, with UHB as the lead partner, was launched. Umbrella aspires to be the largest integrated sexual health and contraception service in the world. Umbrella aimed to turn its original service model on its head, focusing on prevention rather than treatment (Figure 1), helping to educate, empower and engage service users in order to better meet the 10 key service outcomes. View this table: Table 1 The 10 key Umbrella service outcomes. Outcomes 1–3 are national public health outcomes.1 Figure 1 Original service model and Umbrella service model (not to scale). GP, general practitioner. UHB already provided SHS in Birmingham …
{"title":"Umbrella: an innovative integrated sexual health service in Birmingham, UK","authors":"Suzanne Jewell, K. Campbell, K. Jaffer","doi":"10.1136/jfprhc-2016-101561","DOIUrl":"https://doi.org/10.1136/jfprhc-2016-101561","url":null,"abstract":"In 2013 the sexual health and contraception services across Birmingham, UK were put out to tender by the commissioning parties Birmingham City Council and Solihull Metropolitan Borough Council. The commissioners' primary focus was to integrate the disparate services managed by different trusts and other associated providers within the region and to bring them under one contract. Another aim was for primary care to play a bigger role in providing sexual health services (SHS). There was also to be greater emphasis on safeguarding and health promotion, and for the service to deliver new ways of working by using media and technology.\u0000\u0000University Hospitals Birmingham NHS Foundation Trust (UHB) developed a bid based upon the commissioners' vision and created a novel approach to how services could be delivered. UHB were successfully awarded the tender in December 2014, and merging with Solihull-based SHS, the Umbrella service was launched in August 2015. A 5-year contract was agreed, and despite a complete service redesign represented a cost saving.\u0000\u0000Based on 10 key service outcomes (Table 1) a unique partnership branded Umbrella, with UHB as the lead partner, was launched. Umbrella aspires to be the largest integrated sexual health and contraception service in the world. Umbrella aimed to turn its original service model on its head, focusing on prevention rather than treatment (Figure 1), helping to educate, empower and engage service users in order to better meet the 10 key service outcomes.\u0000\u0000View this table:\u0000\u0000Table 1 \u0000The 10 key Umbrella service outcomes. Outcomes 1–3 are national public health outcomes.1\u0000\u0000\u0000\u0000\u0000\u0000Figure 1 \u0000Original service model and Umbrella service model (not to scale). GP, general practitioner.\u0000\u0000\u0000\u0000UHB already provided SHS in Birmingham …","PeriodicalId":15734,"journal":{"name":"Journal of Family Planning and Reproductive Health Care","volume":"43 1","pages":"229 - 231"},"PeriodicalIF":0.0,"publicationDate":"2017-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jfprhc-2016-101561","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45200613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01Epub Date: 2016-05-19DOI: 10.1136/jfprhc-2016-101471
Deborah J Lee
There has long been uncertainty as to how the continued use of the contraceptive injection depot medroxyprogesterone acetate (DMPA) affects bone mineral density (BMD). DMPA inhibits ovulation.1 Hence women on long-term DMPA may have relatively low estradiol levels, and some experience estrogen deficiency symptoms. Estrogen is integral to bone health.2 However, low serum levels of estradiol are not reliable indicators of BMD.3 A systematic review by the National Institute of Health and Care Excellence4 concluded that DMPA use is associated with a small loss of BMD, but it appears that this recovers to normal or near normal when DMPA is discontinued. At present clinicians are advised to use DMPA judiciously. A risk–benefit equation should be undertaken for every patient to help them choose the most appropriate method of contraception. For women who are at risk of osteopenia or osteoporosis, methods other than DMPA may be preferable. Two particular groups of patients represent higher risk groups for poor bone health and DMPA. The first are young teenagers who have not yet achieved their peak bone mass, and the second are older women (aged over 40–45 years) who have been using DMPA and who are now approaching menopause. The 2014 Faculty of Sexual & Reproductive Healthcare (FSRH) guidance on the use of progestogen-only injectable contraception states that DMPA can be used in young …
{"title":"Care of patients using progestogen-only injectables.","authors":"Deborah J Lee","doi":"10.1136/jfprhc-2016-101471","DOIUrl":"https://doi.org/10.1136/jfprhc-2016-101471","url":null,"abstract":"There has long been uncertainty as to how the continued use of the contraceptive injection depot medroxyprogesterone acetate (DMPA) affects bone mineral density (BMD). DMPA inhibits ovulation.1 Hence women on long-term DMPA may have relatively low estradiol levels, and some experience estrogen deficiency symptoms. Estrogen is integral to bone health.2 However, low serum levels of estradiol are not reliable indicators of BMD.3\u0000\u0000A systematic review by the National Institute of Health and Care Excellence4 concluded that DMPA use is associated with a small loss of BMD, but it appears that this recovers to normal or near normal when DMPA is discontinued. At present clinicians are advised to use DMPA judiciously. A risk–benefit equation should be undertaken for every patient to help them choose the most appropriate method of contraception. For women who are at risk of osteopenia or osteoporosis, methods other than DMPA may be preferable.\u0000\u0000Two particular groups of patients represent higher risk groups for poor bone health and DMPA. The first are young teenagers who have not yet achieved their peak bone mass, and the second are older women (aged over 40–45 years) who have been using DMPA and who are now approaching menopause.\u0000\u0000The 2014 Faculty of Sexual & Reproductive Healthcare (FSRH) guidance on the use of progestogen-only injectable contraception states that DMPA can be used in young …","PeriodicalId":15734,"journal":{"name":"Journal of Family Planning and Reproductive Health Care","volume":"43 1","pages":"67-69"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jfprhc-2016-101471","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34499743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01Epub Date: 2016-05-12DOI: 10.1136/jfprhc-2015-101427
Amanda Dennis, Kelly Blanchard, Tshego Bessenaar
A systematic review was conducted of 13 peer-reviewed articles and eight reports focused on indicators of quality abortion care. A total of 75 indicators of quality abortion were identified; these indicators address a variety of issues including policy, health systems, trained-provider availability, women's decision making, and morbidity and mortality. There is little agreement about indicators for measuring quality abortion care; more work is needed to ensure efforts to assess quality are informed and coordinated.
{"title":"Identifying indicators for quality abortion care: a systematic literature review.","authors":"Amanda Dennis, Kelly Blanchard, Tshego Bessenaar","doi":"10.1136/jfprhc-2015-101427","DOIUrl":"https://doi.org/10.1136/jfprhc-2015-101427","url":null,"abstract":"A systematic review was conducted of 13 peer-reviewed articles and eight reports focused on indicators of quality abortion care. A total of 75 indicators of quality abortion were identified; these indicators address a variety of issues including policy, health systems, trained-provider availability, women's decision making, and morbidity and mortality. There is little agreement about indicators for measuring quality abortion care; more work is needed to ensure efforts to assess quality are informed and coordinated.","PeriodicalId":15734,"journal":{"name":"Journal of Family Planning and Reproductive Health Care","volume":"43 1","pages":"7-15"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jfprhc-2015-101427","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34380442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-22DOI: 10.1136/jfprhc-2016-101558
R. Lyus
Dilatation and evacuation, or D&E, is the safest method of second-trimester surgical abortion. It has a lower rate of immediate complications than the alternative of medical induction, causes less pain and bleeding, and is also faster, cheaper, and preferred by the majority of women.1 In addition to elective pregnancy termination, D&E has a role to play in the effective management of second-trimester miscarriage and pre-viable preterm pre-labour rupture of membranes. However, access to D&E in the British National Health Service (NHS) is inadequate. Although no recent published data is available, it is common knowledge amongst abortion service providers that only one hospital in the country provides D&E to 24 weeks’ gestation, and only a very small minority of hospitals provide any D&E service at all. As a result, many women are not offered this option for termination, particularly women choosing a termination because of a seriously abnormal antenatal fetal diagnosis,2 or those with complex medical problems that require inpatient care.3 There are probably multiple barriers to improved access to D&E in the NHS, but in my experience many doctors are concerned about the potential for damage to the cervix, which could result in reduced cervical integrity for subsequent pregnancies. D&E requires …
{"title":"Cervical preparation prior to second-trimester surgical abortion and risk of subsequent preterm birth","authors":"R. Lyus","doi":"10.1136/jfprhc-2016-101558","DOIUrl":"https://doi.org/10.1136/jfprhc-2016-101558","url":null,"abstract":"Dilatation and evacuation, or D&E, is the safest method of second-trimester surgical abortion. It has a lower rate of immediate complications than the alternative of medical induction, causes less pain and bleeding, and is also faster, cheaper, and preferred by the majority of women.1 In addition to elective pregnancy termination, D&E has a role to play in the effective management of second-trimester miscarriage and pre-viable preterm pre-labour rupture of membranes.\u0000\u0000However, access to D&E in the British National Health Service (NHS) is inadequate. Although no recent published data is available, it is common knowledge amongst abortion service providers that only one hospital in the country provides D&E to 24 weeks’ gestation, and only a very small minority of hospitals provide any D&E service at all. As a result, many women are not offered this option for termination, particularly women choosing a termination because of a seriously abnormal antenatal fetal diagnosis,2 or those with complex medical problems that require inpatient care.3\u0000\u0000There are probably multiple barriers to improved access to D&E in the NHS, but in my experience many doctors are concerned about the potential for damage to the cervix, which could result in reduced cervical integrity for subsequent pregnancies. D&E requires …","PeriodicalId":15734,"journal":{"name":"Journal of Family Planning and Reproductive Health Care","volume":"43 1","pages":"70 - 71"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jfprhc-2016-101558","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63793849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-22DOI: 10.1136/jfprhc-2016-101690
S. Goldbeck-Wood
Ann Furedi. London, UK: Palgrave Macmillan, 2016. ISBN-13: 978-1-137-41118-1. Price: £19.99. Pages: 165 (hardcover) The cover is shabby – like a wrinkled, stained, smudged and mended plain wrapper – signalling the abjection and dirtiness with which abortion has often been associated. But Ann Furedi’s The Moral Case for Abortion is an attempt to rehabilitate abortion, as an idea and a practice, from the ethical, philosophical gutter. It is, in the author’s words, an “assault on the moral high ground.” Going beyond familiar, utilitarian justifications for abortion as an unavoidable fact of life better performed safely than dangerously, Furedi builds a careful and largely convincing moral philosophical arguments for abortion as an actively humanitarian service. Drawing on relevant philosophical and theological argument, alongside medical and cultural ones, she places herself in a “strong, post-enlightenment philosophical tradition”, refusing the “attractive certainties” …
{"title":"The Moral Case for Abortion","authors":"S. Goldbeck-Wood","doi":"10.1136/jfprhc-2016-101690","DOIUrl":"https://doi.org/10.1136/jfprhc-2016-101690","url":null,"abstract":"Ann Furedi. London, UK: Palgrave Macmillan, 2016. ISBN-13: 978-1-137-41118-1. Price: £19.99. Pages: 165 (hardcover)\u0000\u0000The cover is shabby – like a wrinkled, stained, smudged and mended plain wrapper – signalling the abjection and dirtiness with which abortion has often been associated. But Ann Furedi’s The Moral Case for Abortion is an attempt to rehabilitate abortion, as an idea and a practice, from the ethical, philosophical gutter. It is, in the author’s words, an “assault on the moral high ground.”\u0000\u0000Going beyond familiar, utilitarian justifications for abortion as an unavoidable fact of life better performed safely than dangerously, Furedi builds a careful and largely convincing moral philosophical arguments for abortion as an actively humanitarian service. Drawing on relevant philosophical and theological argument, alongside medical and cultural ones, she places herself in a “strong, post-enlightenment philosophical tradition”, refusing the “attractive certainties” …","PeriodicalId":15734,"journal":{"name":"Journal of Family Planning and Reproductive Health Care","volume":"43 1","pages":"69 - 69"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jfprhc-2016-101690","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63794095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-22DOI: 10.1136/jfprhc-2016-101696
S. Goldbeck-Wood
A moment when the world′s most powerful country has just elected one of its most anti-abortion presidents might seem an odd time for UK abortion care providers to be seeking the liberalisation of Britain′s abortion law. But 50 years on from the passing of the 1967 Abortion Act, abortion care in the UK is heading towards a crisis, and practitioners are undeterred by the political climate. This is reflected in the founding of a new support organisation for service providers, the British Society for Abortion Care Providers (BSACP),1 a new campaign for legal reform by the UK′s largest service provider, the British Pregnancy Advisory Service (BPAS),2 active consultation processes on abortion care quality and legal reform within the Royal College of Obstetricians and Gynaecologists (RCOG) and the Faculty of Sexual & Reproductive Healthcare (FSRH), and a constant stream of material submitted to this journal.3–13 Among many challenges women seeking abortion face, inequitable access, inadequate numbers of appropriately trained staff, stigmatisation, and a culture of exceptionalism, or ghettoisation, have often been highlighted.14 ,15 Much abortion care in the UK is provided outside the National Health Service in specialist organisations, excluding students …
{"title":"Reforming abortion services in the UK: less hypocrisy, more acknowledgment of complexity","authors":"S. Goldbeck-Wood","doi":"10.1136/jfprhc-2016-101696","DOIUrl":"https://doi.org/10.1136/jfprhc-2016-101696","url":null,"abstract":"A moment when the world′s most powerful country has just elected one of its most anti-abortion presidents might seem an odd time for UK abortion care providers to be seeking the liberalisation of Britain′s abortion law. But 50 years on from the passing of the 1967 Abortion Act, abortion care in the UK is heading towards a crisis, and practitioners are undeterred by the political climate. This is reflected in the founding of a new support organisation for service providers, the British Society for Abortion Care Providers (BSACP),1 a new campaign for legal reform by the UK′s largest service provider, the British Pregnancy Advisory Service (BPAS),2 active consultation processes on abortion care quality and legal reform within the Royal College of Obstetricians and Gynaecologists (RCOG) and the Faculty of Sexual & Reproductive Healthcare (FSRH), and a constant stream of material submitted to this journal.3–13\u0000\u0000Among many challenges women seeking abortion face, inequitable access, inadequate numbers of appropriately trained staff, stigmatisation, and a culture of exceptionalism, or ghettoisation, have often been highlighted.14 ,15 Much abortion care in the UK is provided outside the National Health Service in specialist organisations, excluding students …","PeriodicalId":15734,"journal":{"name":"Journal of Family Planning and Reproductive Health Care","volume":"72 1","pages":"3 - 4"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jfprhc-2016-101696","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63794251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-22DOI: 10.1136/jfprhc-2016-101676
S. Sheldon
The decriminalisation of abortion in Victoria was greeted by one commentator as changing both nothing and everything: “[n]othing, because the number, rate and incidence of abortion will not change. And everything, because for the first time women will be recognised as the authors of our own lives. With that comes our full citizenship”.1 Victoria does not collect data regarding the incidence of abortion and, until now, the only evidence against which to assess these predictions has been anecdotal. Keogh et al. 's2 study in this issue provides the first robust …
{"title":"Abortion law reform in Victoria: lessons for the UK","authors":"S. Sheldon","doi":"10.1136/jfprhc-2016-101676","DOIUrl":"https://doi.org/10.1136/jfprhc-2016-101676","url":null,"abstract":"The decriminalisation of abortion in Victoria was greeted by one commentator as changing both nothing and everything: “[n]othing, because the number, rate and incidence of abortion will not change. And everything, because for the first time women will be recognised as the authors of our own lives. With that comes our full citizenship”.1\u0000\u0000Victoria does not collect data regarding the incidence of abortion and, until now, the only evidence against which to assess these predictions has been anecdotal. Keogh et al. 's2 study in this issue provides the first robust …","PeriodicalId":15734,"journal":{"name":"Journal of Family Planning and Reproductive Health Care","volume":"43 1","pages":"25 - 25"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jfprhc-2016-101676","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63794470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-22DOI: 10.1136/jfprhc-2016-101619
Mary Hernon
The inaugural article written by Dr Abi Berger in the new ‘Person in Practice’ series was published in the July 2016 issue of the journal.1 In it, Dr Berger discusses attracting patients with similar conditions to her own. She ‘admits’ to suffering from anxiety and epiretinal membranes in the past and, more recently, to symptoms of menopause including disturbed sleep, night sweats and low mood, which she describes as an abyss. She …
Abi Berger博士在2016年7月的杂志上发表了新的“实践中的人”系列的第一篇文章在这篇文章中，伯杰博士讨论了如何吸引与自己病情相似的病人。她“承认”自己过去患有焦虑症和视网膜前膜症，最近还出现了一些更年期症状，包括睡眠不安、盗汗和情绪低落，她形容这些症状就像一个深渊。她……
{"title":"Comments on the first ‘Person in Practice’ article","authors":"Mary Hernon","doi":"10.1136/jfprhc-2016-101619","DOIUrl":"https://doi.org/10.1136/jfprhc-2016-101619","url":null,"abstract":"The inaugural article written by Dr Abi Berger in the new ‘Person in Practice’ series was published in the July 2016 issue of the journal.1 In it, Dr Berger discusses attracting patients with similar conditions to her own. She ‘admits’ to suffering from anxiety and epiretinal membranes in the past and, more recently, to symptoms of menopause including disturbed sleep, night sweats and low mood, which she describes as an abyss. She …","PeriodicalId":15734,"journal":{"name":"Journal of Family Planning and Reproductive Health Care","volume":"43 1","pages":"78 - 79"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jfprhc-2016-101619","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63794159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-22DOI: 10.1136/jfprhc-2016-101692
R. D’souza
We all bring our personal views to our practice, as this journal's new section, ‘Person in Practice’, highlights.1 My position on abortion is challenging to hold as a consultant in sexual and reproductive health (SRH) and I have spent much time reflecting on this. The following is an edited transcript of a talk I was invited to give at a recent meeting convened by the Faculty of Sexual and Reproductive Healthcare at which abortion law reform was being considered. One of the main purposes of the law is to protect the concerns and interests of the community as a whole, especially its vulnerable members. We have laws which protect newborn babies against abuse and maltreatment, and animals from being neglected or tortured in our own homes. We have laws governing the way animals are used in research. Similarly, we are concerned about the rights and interests of fetuses. The law against procuring an abortion except under the terms of the 1967 Abortion Act reflects these concerns. We are also, as a community, concerned about the rights and interests of a woman who is pregnant but doesn't want to be, respecting her desire to abort her pregnancy, often for intensely personal and understandable reasons. It is important to acknowledge these, as well as the fact that women who choose to discontinue their pregnancy will use whatever means it takes to procure an abortion, even, if necessary, in ways that are unsafe. Surveys carried out by the Guttmacher Institute2 suggest that worldwide levels of abortion are more strongly linked to the incidence of unintended pregnancy than to the legal status of abortion, and that high abortion rates are directly correlated to high levels of unmet contraceptive need, often in countries where abortion is highly restricted. In England, Wales and Scotland …
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