Pub Date : 2019-10-04DOI: 10.1080/13625187.2019.1670346
S. Vodopivec, E. Bokal, B. Pinter
Abstract Objectives: In Slovenia, first-trimester abortion is performed at the woman’s request, either surgically under general anaesthesia or medically with mifepristone and misoprostol, in a public hospital. Our study aimed to evaluate pre-abortion counselling and to reveal differences in acceptability and satisfaction with the two abortion methods. Methods: A cross-sectional study was carried out at Ljubljana University Medical Centre between January and June 2015. Women requesting termination of a pregnancy up to 10 weeks’ gestation voluntarily completed an anonymous questionnaire after the procedure and were divided into a surgical and a medical abortion group. Results: Of the 266 women who were invited to take part, 229 accepted; 16.6% chose a surgical abortion, 83.4% a medical abortion. The most frequent reason cited for requesting an abortion was economic/housing problems. Most women who chose a surgical abortion did so because it was faster, whereas most women who chose a medical abortion did so on the advice of a primary care gynaecologist. Women choosing a surgical abortion had more previous pregnancies and presented with a higher gestational age pregnancy. The choice of method was not related to the woman’s age. There were no differences in acceptability of the two procedures. Pain during the procedure was, however, more severe in the medical abortion group (p = .026), along with bleeding, nausea and chills; there were no differences in severity of vomiting, diarrhoea, dizziness or headache between the groups. Women in the surgical abortion group reported higher satisfaction with the method (p < .001). The study revealed a low frequency of pre-abortion contraceptive counselling. Conclusion: The most common reason given for choosing a surgical abortion was the speed of the procedure; for a medical abortion, it was on the advice of a primary care gynaecologist. Satisfaction was higher with the surgical abortion method. There were no differences in general acceptability of the methods.
{"title":"Counselling before first trimester abortion and acceptability of the procedure: results from a Slovenian cross-sectional study","authors":"S. Vodopivec, E. Bokal, B. Pinter","doi":"10.1080/13625187.2019.1670346","DOIUrl":"https://doi.org/10.1080/13625187.2019.1670346","url":null,"abstract":"Abstract Objectives: In Slovenia, first-trimester abortion is performed at the woman’s request, either surgically under general anaesthesia or medically with mifepristone and misoprostol, in a public hospital. Our study aimed to evaluate pre-abortion counselling and to reveal differences in acceptability and satisfaction with the two abortion methods. Methods: A cross-sectional study was carried out at Ljubljana University Medical Centre between January and June 2015. Women requesting termination of a pregnancy up to 10 weeks’ gestation voluntarily completed an anonymous questionnaire after the procedure and were divided into a surgical and a medical abortion group. Results: Of the 266 women who were invited to take part, 229 accepted; 16.6% chose a surgical abortion, 83.4% a medical abortion. The most frequent reason cited for requesting an abortion was economic/housing problems. Most women who chose a surgical abortion did so because it was faster, whereas most women who chose a medical abortion did so on the advice of a primary care gynaecologist. Women choosing a surgical abortion had more previous pregnancies and presented with a higher gestational age pregnancy. The choice of method was not related to the woman’s age. There were no differences in acceptability of the two procedures. Pain during the procedure was, however, more severe in the medical abortion group (p = .026), along with bleeding, nausea and chills; there were no differences in severity of vomiting, diarrhoea, dizziness or headache between the groups. Women in the surgical abortion group reported higher satisfaction with the method (p < .001). The study revealed a low frequency of pre-abortion contraceptive counselling. Conclusion: The most common reason given for choosing a surgical abortion was the speed of the procedure; for a medical abortion, it was on the advice of a primary care gynaecologist. Satisfaction was higher with the surgical abortion method. There were no differences in general acceptability of the methods.","PeriodicalId":22423,"journal":{"name":"The European Journal of Contraception & Reproductive Health Care","volume":"64 1","pages":"487 - 493"},"PeriodicalIF":0.0,"publicationDate":"2019-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77707748","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 : 2019-09-30DOI: 10.1080/13625187.2019.1670345
I. Mahendra, S. Wilopo, I. E. Putra
Abstract Objectives: This study aimed to analyse the association between the decision-making pattern and the use of long-acting and permanent methods of contraception (LAPMs) among married and cohabiting women in Indonesia, by controlling for variables at the individual and community or regional level, and geographical area (province). Methods: A cross-sectional survey was conducted using secondary data from Performance Monitoring and Accountability 2020 (PMA2020) which involved 4724 married or cohabitating women aged 15–49 years. Data were analysed using bivariate and multivariate analysis. Multilevel logistic regression was performed to investigate the determinants by taking geographical area into account. Results: The majority of women (63.8%) had made their own decision on current contraceptive use, 30.1% had made a joint decision with their partner or health care provider, and 6.1% had not been involved in the decision-making process. Multilevel analysis showed that the decision-making pattern and individual level factors were significantly associated with LAPM use, and variables at community or regional level were not significant predictors. Compared with women who had made their own decision on contraceptive use, LAPM use was 2.3 times higher in women who had made a joint decision with their partner or health care provider (odds ratio [OR] 2.3; 95% confidence interval [CI] 2.0, 2.7; p < .001) and more than three times higher in women not involved in the decision-making process (OR 3.1; 95% CI 2.3, 4.1; p < .001). Conclusion: Coercion potentially occurs in the contraceptive decision-making process. Our findings suggest that LAPM use may be increased by encouraging joint contraceptive decision making. Increasing women’s participation in the decision-making process is an integral part of respecting women’s reproductive autonomy.
{"title":"The role of decision-making pattern on the use of long-acting and permanent contraceptive methods among married women in Indonesia","authors":"I. Mahendra, S. Wilopo, I. E. Putra","doi":"10.1080/13625187.2019.1670345","DOIUrl":"https://doi.org/10.1080/13625187.2019.1670345","url":null,"abstract":"Abstract Objectives: This study aimed to analyse the association between the decision-making pattern and the use of long-acting and permanent methods of contraception (LAPMs) among married and cohabiting women in Indonesia, by controlling for variables at the individual and community or regional level, and geographical area (province). Methods: A cross-sectional survey was conducted using secondary data from Performance Monitoring and Accountability 2020 (PMA2020) which involved 4724 married or cohabitating women aged 15–49 years. Data were analysed using bivariate and multivariate analysis. Multilevel logistic regression was performed to investigate the determinants by taking geographical area into account. Results: The majority of women (63.8%) had made their own decision on current contraceptive use, 30.1% had made a joint decision with their partner or health care provider, and 6.1% had not been involved in the decision-making process. Multilevel analysis showed that the decision-making pattern and individual level factors were significantly associated with LAPM use, and variables at community or regional level were not significant predictors. Compared with women who had made their own decision on contraceptive use, LAPM use was 2.3 times higher in women who had made a joint decision with their partner or health care provider (odds ratio [OR] 2.3; 95% confidence interval [CI] 2.0, 2.7; p < .001) and more than three times higher in women not involved in the decision-making process (OR 3.1; 95% CI 2.3, 4.1; p < .001). Conclusion: Coercion potentially occurs in the contraceptive decision-making process. Our findings suggest that LAPM use may be increased by encouraging joint contraceptive decision making. Increasing women’s participation in the decision-making process is an integral part of respecting women’s reproductive autonomy.","PeriodicalId":22423,"journal":{"name":"The European Journal of Contraception & Reproductive Health Care","volume":"30 1","pages":"480 - 486"},"PeriodicalIF":0.0,"publicationDate":"2019-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76942525","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 : 2019-09-30DOI: 10.1080/13625187.2019.1670344
Richard Mogeni, J. Mokua, E. Mwaliko, P. Tonui
Abstract Objectives: The aim of the study was to investigate how to improve access to family planning and address unmet contraceptive need in postpartum women, by determining the predictors of contraceptive implant uptake in the immediate postpartum period. Methods: A descriptive cross-sectional study was conducted among women who had given birth up to 6 d earlier at the Riley Mother and Baby Hospital, which is part of the Moi Teaching and Referral Hospital in Eldoret, Kenya. Participants were systematically sampled and data collected using pre-tested interviewer-administered questionnaires. Statistical analyses were performed to determine associations between variables. Logistic regression was used to determine the relationship between variables and contraceptive implant uptake. Results: The study comprised 353 women. Most (92%) were Christians and were married (74%). More than 76% had received secondary education or above; 9% were HIV-positive. Most (87%) had heard of the contraceptive implant and almost half (46%) had ever used it before their current pregnancy. Older women (p = .036), those who had reached their desired family size (p = .003), those who had planned for the current pregnancy (p = .027), those who had used the implant before (p < .001) and those who were HIV-positive (p = .001) were more likely to agree to use the contraceptive implant. Conclusions: Older age, achievement of family size, previous use of the same method, HIV positivity and planned pregnancy positively predicted uptake of the contraceptive implant.
{"title":"Predictors of contraceptive implant uptake in the immediate postpartum period: a cross-sectional study","authors":"Richard Mogeni, J. Mokua, E. Mwaliko, P. Tonui","doi":"10.1080/13625187.2019.1670344","DOIUrl":"https://doi.org/10.1080/13625187.2019.1670344","url":null,"abstract":"Abstract Objectives: The aim of the study was to investigate how to improve access to family planning and address unmet contraceptive need in postpartum women, by determining the predictors of contraceptive implant uptake in the immediate postpartum period. Methods: A descriptive cross-sectional study was conducted among women who had given birth up to 6 d earlier at the Riley Mother and Baby Hospital, which is part of the Moi Teaching and Referral Hospital in Eldoret, Kenya. Participants were systematically sampled and data collected using pre-tested interviewer-administered questionnaires. Statistical analyses were performed to determine associations between variables. Logistic regression was used to determine the relationship between variables and contraceptive implant uptake. Results: The study comprised 353 women. Most (92%) were Christians and were married (74%). More than 76% had received secondary education or above; 9% were HIV-positive. Most (87%) had heard of the contraceptive implant and almost half (46%) had ever used it before their current pregnancy. Older women (p = .036), those who had reached their desired family size (p = .003), those who had planned for the current pregnancy (p = .027), those who had used the implant before (p < .001) and those who were HIV-positive (p = .001) were more likely to agree to use the contraceptive implant. Conclusions: Older age, achievement of family size, previous use of the same method, HIV positivity and planned pregnancy positively predicted uptake of the contraceptive implant.","PeriodicalId":22423,"journal":{"name":"The European Journal of Contraception & Reproductive Health Care","volume":"1 1","pages":"438 - 443"},"PeriodicalIF":0.0,"publicationDate":"2019-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83068235","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 : 2019-09-27DOI: 10.1080/13625187.2019.1666362
T. Faustmann, J. Crocker, C. Moeller, Yvonne Engler, C. Caetano, K. Buhling
Abstract Purpose: Evidence from real-world settings is important to provide an accurate picture of health care delivery. We investigated use of long-acting reversible contraception (LARC) in women aged 15–49 years. Materials and methods: Two surveys, one of women and one of health care professionals (HCPs), were conducted in parallel across seven countries. Participating women completed an online survey to assess contraceptive awareness, current method of contraception, age, and experience with current contraceptive method. HCPs participated in an online survey to provide practice-level information and three anonymous charts of hormonal LARC users. Results: Of 6903 women who completed the survey, 3225 provided information about their current primary contraception method. Overall, 16% used LARC methods, while 52% used oral contraceptives (OCs). Of hormonal intrauterine system users, 72% described their experience as ‘very favourable’, compared with only 53% of women using OCs. Anonymous patient records (n = 1605) were provided by 550 HCPs who completed the online survey. Most women (64%) had used short-acting reversible contraception before switching to LARC. Physicians perceived 56–84% of LARC users to be highly satisfied with their current form of contraception. Conclusions: Although usage of LARC was low, most women using LARC were highly satisfied with their method of contraception.
{"title":"How do women and health care professionals view hormonal long-acting reversible contraception? Results from an international survey","authors":"T. Faustmann, J. Crocker, C. Moeller, Yvonne Engler, C. Caetano, K. Buhling","doi":"10.1080/13625187.2019.1666362","DOIUrl":"https://doi.org/10.1080/13625187.2019.1666362","url":null,"abstract":"Abstract Purpose: Evidence from real-world settings is important to provide an accurate picture of health care delivery. We investigated use of long-acting reversible contraception (LARC) in women aged 15–49 years. Materials and methods: Two surveys, one of women and one of health care professionals (HCPs), were conducted in parallel across seven countries. Participating women completed an online survey to assess contraceptive awareness, current method of contraception, age, and experience with current contraceptive method. HCPs participated in an online survey to provide practice-level information and three anonymous charts of hormonal LARC users. Results: Of 6903 women who completed the survey, 3225 provided information about their current primary contraception method. Overall, 16% used LARC methods, while 52% used oral contraceptives (OCs). Of hormonal intrauterine system users, 72% described their experience as ‘very favourable’, compared with only 53% of women using OCs. Anonymous patient records (n = 1605) were provided by 550 HCPs who completed the online survey. Most women (64%) had used short-acting reversible contraception before switching to LARC. Physicians perceived 56–84% of LARC users to be highly satisfied with their current form of contraception. Conclusions: Although usage of LARC was low, most women using LARC were highly satisfied with their method of contraception.","PeriodicalId":22423,"journal":{"name":"The European Journal of Contraception & Reproductive Health Care","volume":"37 1","pages":"422 - 429"},"PeriodicalIF":0.0,"publicationDate":"2019-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86869192","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 : 2019-09-25DOI: 10.1080/13625187.2019.1662391
M. Ceccaroni, V. Bounous, R. Clarizia, D. Mautone, M. Mabrouk
Abstract Recurrence of endometriosis after conservative surgery is not an uncommon finding. There is no uniformity, however, on what the term ‘recurrence’ means. Recurrence is variously defined in the literature as the relapse of pain, clinical or instrumental detection of an endometriotic lesion, repeat rise in CA 125 levels, or evidence of recurrence found during repeat surgery. Consequently, the reported recurrence rate varies widely (0–89%) in the different series, depending on its definition and the type of study performed. As endometriosis recurrence seems to be an indeterminate enemy, we set out to examine exactly what we were fighting in our everyday battle. In this narrative review, we aimed to seek an answer to questions related to endometriosis recurrence, some of which are often asked by our patients.
{"title":"Recurrent endometriosis: a battle against an unknown enemy","authors":"M. Ceccaroni, V. Bounous, R. Clarizia, D. Mautone, M. Mabrouk","doi":"10.1080/13625187.2019.1662391","DOIUrl":"https://doi.org/10.1080/13625187.2019.1662391","url":null,"abstract":"Abstract Recurrence of endometriosis after conservative surgery is not an uncommon finding. There is no uniformity, however, on what the term ‘recurrence’ means. Recurrence is variously defined in the literature as the relapse of pain, clinical or instrumental detection of an endometriotic lesion, repeat rise in CA 125 levels, or evidence of recurrence found during repeat surgery. Consequently, the reported recurrence rate varies widely (0–89%) in the different series, depending on its definition and the type of study performed. As endometriosis recurrence seems to be an indeterminate enemy, we set out to examine exactly what we were fighting in our everyday battle. In this narrative review, we aimed to seek an answer to questions related to endometriosis recurrence, some of which are often asked by our patients.","PeriodicalId":22423,"journal":{"name":"The European Journal of Contraception & Reproductive Health Care","volume":"26 1","pages":"464 - 474"},"PeriodicalIF":0.0,"publicationDate":"2019-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73457632","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 : 2019-09-23DOI: 10.1080/13625187.2019.1663500
M. Guida, J. Troisi, G. Saccone, L. Sarno, M. Caiazza, I. Vivone, C. Cinque, C. I. Aquino
Abstract Objectives: The aims of the study were to understand how education relates to contraceptive choice and how sexual function can vary in relation to the use of a contraceptive method. Methods: We surveyed female medical students and women attending a family planning service (FPS) in Italy. Participants completed an online questionnaire which asked for information on sociodemographics, lifestyle, sexuality and contraceptive use and also included items of the Female Sexual Function Index (FSFI). Results: The questionnaire was completed by 413 women (362 students and 51 women attending the FPS) between the ages of 18 and 30 years. FSFI scores revealed a lower risk of sexual dysfunction among women in the control group who did not use oral hormonal contraception. The differences in FSFI total scores between the two study groups, when subdivided by the primary contraceptive method used, was statistically significant (p < 0.005). Women using the vaginal ring had the lowest risk of sexual dysfunction, compared with all other women, and had a positive sexual function profile. In particular, the highest FSFI domain scores were lubrication, orgasm and satisfaction, also among the control group. Expensive contraception, such as long-acting reversible contraception, was not preferred by this young population, even though such methods are more contemporary and manageable. Compared with controls, students had lower compliance with contraception and a negative attitude towards voluntary termination of pregnancy. Conclusion: Despite their scientific knowledge, Italian female medical students were found to need sexual and contraceptive assistance. A woman’s sexual function responds to her awareness of her body and varies in relation to how she is guided in her contraceptive choice. Contraceptive counselling is an excellent means to improve female sexuality.
{"title":"Contraceptive use and sexual function: a comparison of Italian female medical students and women attending family planning services","authors":"M. Guida, J. Troisi, G. Saccone, L. Sarno, M. Caiazza, I. Vivone, C. Cinque, C. I. Aquino","doi":"10.1080/13625187.2019.1663500","DOIUrl":"https://doi.org/10.1080/13625187.2019.1663500","url":null,"abstract":"Abstract Objectives: The aims of the study were to understand how education relates to contraceptive choice and how sexual function can vary in relation to the use of a contraceptive method. Methods: We surveyed female medical students and women attending a family planning service (FPS) in Italy. Participants completed an online questionnaire which asked for information on sociodemographics, lifestyle, sexuality and contraceptive use and also included items of the Female Sexual Function Index (FSFI). Results: The questionnaire was completed by 413 women (362 students and 51 women attending the FPS) between the ages of 18 and 30 years. FSFI scores revealed a lower risk of sexual dysfunction among women in the control group who did not use oral hormonal contraception. The differences in FSFI total scores between the two study groups, when subdivided by the primary contraceptive method used, was statistically significant (p < 0.005). Women using the vaginal ring had the lowest risk of sexual dysfunction, compared with all other women, and had a positive sexual function profile. In particular, the highest FSFI domain scores were lubrication, orgasm and satisfaction, also among the control group. Expensive contraception, such as long-acting reversible contraception, was not preferred by this young population, even though such methods are more contemporary and manageable. Compared with controls, students had lower compliance with contraception and a negative attitude towards voluntary termination of pregnancy. Conclusion: Despite their scientific knowledge, Italian female medical students were found to need sexual and contraceptive assistance. A woman’s sexual function responds to her awareness of her body and varies in relation to how she is guided in her contraceptive choice. Contraceptive counselling is an excellent means to improve female sexuality.","PeriodicalId":22423,"journal":{"name":"The European Journal of Contraception & Reproductive Health Care","volume":"1 1","pages":"430 - 437"},"PeriodicalIF":0.0,"publicationDate":"2019-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87406163","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 : 2019-09-23DOI: 10.1080/13625187.2019.1666361
A. Peterson, Amy Brown, Ashlyn H. Savage, A. Dempsey
Abstract Purpose: To characterise the frequency of and predictors of contraceptive implant discontinuation within 12 months of insertion in our clinical setting. Materials and methods: This retrospective cohort study included women receiving the etonogestrel contraceptive implant at our hospital between May 2007 and May 2012. We abstracted data from charts including implant removal date, bleeding complaints, reproductive and demographic characteristics, prior contraceptive use, tobacco use and implant insertion timing. Our primary outcome was implant discontinuation within 12 months following insertion. SAS 9.4 (SAS Institute Inc., Cary, NC, USA) was used to generate frequencies, bivariate analyses and multivariate logistic regression models. Results: Implant discontinuation was documented in 16% of implant users prior to 12 months (89/544). Women with documented bleeding complaints in the medical record were more likely to discontinue within 12 months (OR: 4.36, CI: 2.71, 7.00). No other demographic or clinical characteristics were associated with premature discontinuation. Having less than two prior pregnancies and tobacco use were associated with documented bleeding complaints. Conclusions: Discontinuation of the implant is associated with bleeding complaints. Women with lower parity and tobacco users may be more likely to experience bleeding or to find it intolerable.
{"title":"Prevalence of early discontinuation and associated factors among a retrospective cohort of etonogestrel contraceptive implant users","authors":"A. Peterson, Amy Brown, Ashlyn H. Savage, A. Dempsey","doi":"10.1080/13625187.2019.1666361","DOIUrl":"https://doi.org/10.1080/13625187.2019.1666361","url":null,"abstract":"Abstract Purpose: To characterise the frequency of and predictors of contraceptive implant discontinuation within 12 months of insertion in our clinical setting. Materials and methods: This retrospective cohort study included women receiving the etonogestrel contraceptive implant at our hospital between May 2007 and May 2012. We abstracted data from charts including implant removal date, bleeding complaints, reproductive and demographic characteristics, prior contraceptive use, tobacco use and implant insertion timing. Our primary outcome was implant discontinuation within 12 months following insertion. SAS 9.4 (SAS Institute Inc., Cary, NC, USA) was used to generate frequencies, bivariate analyses and multivariate logistic regression models. Results: Implant discontinuation was documented in 16% of implant users prior to 12 months (89/544). Women with documented bleeding complaints in the medical record were more likely to discontinue within 12 months (OR: 4.36, CI: 2.71, 7.00). No other demographic or clinical characteristics were associated with premature discontinuation. Having less than two prior pregnancies and tobacco use were associated with documented bleeding complaints. Conclusions: Discontinuation of the implant is associated with bleeding complaints. Women with lower parity and tobacco users may be more likely to experience bleeding or to find it intolerable.","PeriodicalId":22423,"journal":{"name":"The European Journal of Contraception & Reproductive Health Care","volume":"23 1","pages":"475 - 479"},"PeriodicalIF":0.0,"publicationDate":"2019-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81239571","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 : 2019-09-16DOI: 10.1080/13625187.2019.1662392
A. Moura, S. Silva, C. de Freitas, L. Abreu, I. Baía, C. Samorinha
Educating the public about donating and receiving gametes (i.e., oocytes and sperm) is needed to increase public awareness, decrease stigmatisation, improve donor recruitment and ensure the continuous replenishment of public banks of gametes [1]. Why is it relevant? Because demand for assisted reproductive technology (ART) treatments with donated gametes has increased in many countries, while huge shortages in gametes supply persist. But how to educate the public? Using people-centred communication campaigns. Communication campaigns are strategies to inform, influence or shape attitudes, decisions or behaviours among patients or the public in a certain period of time [2]. They have been acknowledged to enable systems facing transitions (e.g., shortage of gamete donors, prevention of age-related fertility decline and shift from anonymous to open donation) to prompt public and patient involvement in health governance and to improve the responsiveness of the care provided. However, some public communication campaigns have been criticised for failing to give due consideration to the perceptions and needs of the populations targeted, and for lacking adequate evaluation of their implementation and effectiveness. Do these concerns impact on gamete donation? Yes. There is a scarcity of guidelines to help develop people-centred communication campaigns, i.e., campaigns that are responsive to key stakeholders’ values, preferences and needs. To help fill this gap, we assessed gamete donors’ and recipients’ perceptions about and experiences with publicly funded communication campaigns on gamete donation implemented over the last three years in Portugal (e.g., launch of the first web page about gamete donation hosted by the National Health Service website; dissemination of flyers and posters appealing to the donation) through a mixed-methods study [3]. Portugal is in a transition phase from anonymous donation to an open-identity regime, and gamete donors are recompensed for loss of earnings and inconvenience through a fixed sum of money. Between July 2017 and June 2018, 72 gamete donors and 177 recipients recruited at the Portuguese Public Bank of Gametes completed self-report questionnaires, and semistructured qualitative interviews were later conducted with a subsample of 16 donors and 13 recipients. Our study results offer several insights that can be used to overcome existing concerns with public campaigns about gamete donation that may apply across different jurisdictions. First, there is a need to invest in campaign dissemination through diverse and accessible settings and channels that go beyond health-related sites or universities. Communication campaigns about gamete donation are mostly targeted at specific populations (e.g., health care users or college students). This can alienate the general public who may feel the issue as a distant and unrelated concern. The implementation of a joint communication campaign strategy would thus benefit from being m
{"title":"Concerns with educating the public about donating and receiving gametes","authors":"A. Moura, S. Silva, C. de Freitas, L. Abreu, I. Baía, C. Samorinha","doi":"10.1080/13625187.2019.1662392","DOIUrl":"https://doi.org/10.1080/13625187.2019.1662392","url":null,"abstract":"Educating the public about donating and receiving gametes (i.e., oocytes and sperm) is needed to increase public awareness, decrease stigmatisation, improve donor recruitment and ensure the continuous replenishment of public banks of gametes [1]. Why is it relevant? Because demand for assisted reproductive technology (ART) treatments with donated gametes has increased in many countries, while huge shortages in gametes supply persist. But how to educate the public? Using people-centred communication campaigns. Communication campaigns are strategies to inform, influence or shape attitudes, decisions or behaviours among patients or the public in a certain period of time [2]. They have been acknowledged to enable systems facing transitions (e.g., shortage of gamete donors, prevention of age-related fertility decline and shift from anonymous to open donation) to prompt public and patient involvement in health governance and to improve the responsiveness of the care provided. However, some public communication campaigns have been criticised for failing to give due consideration to the perceptions and needs of the populations targeted, and for lacking adequate evaluation of their implementation and effectiveness. Do these concerns impact on gamete donation? Yes. There is a scarcity of guidelines to help develop people-centred communication campaigns, i.e., campaigns that are responsive to key stakeholders’ values, preferences and needs. To help fill this gap, we assessed gamete donors’ and recipients’ perceptions about and experiences with publicly funded communication campaigns on gamete donation implemented over the last three years in Portugal (e.g., launch of the first web page about gamete donation hosted by the National Health Service website; dissemination of flyers and posters appealing to the donation) through a mixed-methods study [3]. Portugal is in a transition phase from anonymous donation to an open-identity regime, and gamete donors are recompensed for loss of earnings and inconvenience through a fixed sum of money. Between July 2017 and June 2018, 72 gamete donors and 177 recipients recruited at the Portuguese Public Bank of Gametes completed self-report questionnaires, and semistructured qualitative interviews were later conducted with a subsample of 16 donors and 13 recipients. Our study results offer several insights that can be used to overcome existing concerns with public campaigns about gamete donation that may apply across different jurisdictions. First, there is a need to invest in campaign dissemination through diverse and accessible settings and channels that go beyond health-related sites or universities. Communication campaigns about gamete donation are mostly targeted at specific populations (e.g., health care users or college students). This can alienate the general public who may feel the issue as a distant and unrelated concern. The implementation of a joint communication campaign strategy would thus benefit from being m","PeriodicalId":22423,"journal":{"name":"The European Journal of Contraception & Reproductive Health Care","volume":"11 1","pages":"420 - 421"},"PeriodicalIF":0.0,"publicationDate":"2019-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90267290","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 : 2019-09-03DOI: 10.1080/13625187.2019.1665175
A. Abdelhakim, Mohammad Sunoqrot, A. H. Amin, H. Nabil, Ayman N. Raslan, A. Samy
Abstract Objective: The aim of the study was to compare early vs. delayed postpartum insertion of the 52 mg levonorgestrel intrauterine system (LNG-IUS). Methods: The databases of PubMed, Scopus, Web of Science and CENTRAL were searched to February 2019. The search comprised randomised controlled trials (RCTs) comparing early vs. delayed postpartum insertion of the LNG-IUS. Data were extracted and combined in a meta-analysis. Pooled results were expressed as the relative risk (RR) with 95% confidence interval (CI). The main outcome measures were breastfeeding continuation, LNG-IUS expulsion, uterine perforation, LNG-IUS use, satisfaction and number of pregnancies. Results: Twelve RCTs were included, comprising 1006 women in total. Our analysis indicated no significant difference between early and delayed insertion of the LNG-IUS in terms of any breastfeeding continuation (RR 0.99; 95% CI 0.84, 1.16; p = 0.88). After removal of heterogeneity, there was a statistically significant superiority in LNG-IUS use at the endpoint in the early insertion group compared with the delayed insertion group (RR 1.27; 95% CI 1.07, 1.51; p = 0.006). LNG-IUS expulsion was significantly less in the delayed insertion group in comparison with the early insertion group (RR 5.32; 95% CI 2.68, 10.53; p = 0.00001). No significant differences were found between the groups in satisfaction, number of pregnancies and risk of uterine perforation. Conclusion: Early postpartum insertion of the LNG-IUS has no negative effects on breastfeeding continuation. Early postpartum insertion may be used as an alternative to delayed postpartum insertion.
摘要目的:比较52 mg左炔诺孕酮宫内系统(LNG-IUS)在产后早期与延迟置入的效果。方法:检索PubMed、Scopus、Web of Science和CENTRAL数据库至2019年2月。该研究包括随机对照试验(rct)，比较早期和延迟产后插入LNG-IUS。数据被提取并合并为荟萃分析。合并结果表示为相对危险度(RR)， 95%置信区间(CI)。主要观察指标为母乳喂养延续、LNG-IUS排出、子宫穿孔、LNG-IUS使用、满意度和妊娠次数。结果:纳入12项随机对照试验，共1006名女性。我们的分析显示，早期和延迟插入LNG-IUS在任何母乳喂养延续方面没有显著差异(RR 0.99;95% ci 0.84, 1.16;p = 0.88)。在消除异质性后，与延迟插入组相比，早期插入组在终点使用LNG-IUS的优势具有统计学意义(RR 1.27;95% ci 1.07, 1.51;p = 0.006)。与早期插入组相比，延迟插入组的LNG-IUS排出明显减少(RR 5.32;95% ci 2.68, 10.53;p = 0.00001)。两组在满意度、妊娠次数和子宫穿孔风险方面无显著差异。结论:产后早期插入LNG-IUS对母乳喂养延续无负面影响。产后早期插入可作为延迟产后插入的替代方法。
{"title":"The effect of early vs. delayed postpartum insertion of the LNG-IUS on breastfeeding continuation: a systematic review and meta-analysis of randomised controlled trials","authors":"A. Abdelhakim, Mohammad Sunoqrot, A. H. Amin, H. Nabil, Ayman N. Raslan, A. Samy","doi":"10.1080/13625187.2019.1665175","DOIUrl":"https://doi.org/10.1080/13625187.2019.1665175","url":null,"abstract":"Abstract Objective: The aim of the study was to compare early vs. delayed postpartum insertion of the 52 mg levonorgestrel intrauterine system (LNG-IUS). Methods: The databases of PubMed, Scopus, Web of Science and CENTRAL were searched to February 2019. The search comprised randomised controlled trials (RCTs) comparing early vs. delayed postpartum insertion of the LNG-IUS. Data were extracted and combined in a meta-analysis. Pooled results were expressed as the relative risk (RR) with 95% confidence interval (CI). The main outcome measures were breastfeeding continuation, LNG-IUS expulsion, uterine perforation, LNG-IUS use, satisfaction and number of pregnancies. Results: Twelve RCTs were included, comprising 1006 women in total. Our analysis indicated no significant difference between early and delayed insertion of the LNG-IUS in terms of any breastfeeding continuation (RR 0.99; 95% CI 0.84, 1.16; p = 0.88). After removal of heterogeneity, there was a statistically significant superiority in LNG-IUS use at the endpoint in the early insertion group compared with the delayed insertion group (RR 1.27; 95% CI 1.07, 1.51; p = 0.006). LNG-IUS expulsion was significantly less in the delayed insertion group in comparison with the early insertion group (RR 5.32; 95% CI 2.68, 10.53; p = 0.00001). No significant differences were found between the groups in satisfaction, number of pregnancies and risk of uterine perforation. Conclusion: Early postpartum insertion of the LNG-IUS has no negative effects on breastfeeding continuation. Early postpartum insertion may be used as an alternative to delayed postpartum insertion.","PeriodicalId":22423,"journal":{"name":"The European Journal of Contraception & Reproductive Health Care","volume":"74 1","pages":"327 - 336"},"PeriodicalIF":0.0,"publicationDate":"2019-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86335136","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 : 2019-09-03DOI: 10.1080/13625187.2019.1661377
M. Haag, S. Gudka, K. Hersberger, I. Arnet
Abstract Objectives: Since 2002, Swiss community pharmacists have dispensed emergency contraception (EC) as pharmacist-only medicine ideally using the official Swiss protocol. Our study aimed to determine pharmacists’ resolution of an imaginary EC case, compliance with the protocol, and provision of information on the risk of sexually transmitted infections (STIs). Methods: We conducted a simulated patient study with 69 students who each visited a community pharmacy. The scenario started with the student requesting the ‘morning after pill’. Current practice was assessed using an online evaluation form adapted from the Medication-Related Consultation Framework. Descriptive and statistical analyses were carried out. Results: All pharmacists correctly identified that the person needed EC. All pharmacists used an EC protocol and asked on average 10.9 (standard deviation 0.68) of 11 compulsory EC assessment questions. In total, 93% of pharmacists addressed EC counselling items and 56% addressed the risk of STIs, mainly by mentioning that condoms offered the best protection (76%). Conclusions: Community pharmacists correctly issued the EC, complied with the dispensing protocol and used their professional judgement to ensure optimal EC use. There is nevertheless room for improvement regarding pharmacists’ STI counselling. Finally, the protocol’s STI section could be enriched with specific information to guide counselling.
{"title":"Do Swiss community pharmacists address the risk of sexually transmitted infections during a consultation on emergency contraception? A simulated patient study","authors":"M. Haag, S. Gudka, K. Hersberger, I. Arnet","doi":"10.1080/13625187.2019.1661377","DOIUrl":"https://doi.org/10.1080/13625187.2019.1661377","url":null,"abstract":"Abstract Objectives: Since 2002, Swiss community pharmacists have dispensed emergency contraception (EC) as pharmacist-only medicine ideally using the official Swiss protocol. Our study aimed to determine pharmacists’ resolution of an imaginary EC case, compliance with the protocol, and provision of information on the risk of sexually transmitted infections (STIs). Methods: We conducted a simulated patient study with 69 students who each visited a community pharmacy. The scenario started with the student requesting the ‘morning after pill’. Current practice was assessed using an online evaluation form adapted from the Medication-Related Consultation Framework. Descriptive and statistical analyses were carried out. Results: All pharmacists correctly identified that the person needed EC. All pharmacists used an EC protocol and asked on average 10.9 (standard deviation 0.68) of 11 compulsory EC assessment questions. In total, 93% of pharmacists addressed EC counselling items and 56% addressed the risk of STIs, mainly by mentioning that condoms offered the best protection (76%). Conclusions: Community pharmacists correctly issued the EC, complied with the dispensing protocol and used their professional judgement to ensure optimal EC use. There is nevertheless room for improvement regarding pharmacists’ STI counselling. Finally, the protocol’s STI section could be enriched with specific information to guide counselling.","PeriodicalId":22423,"journal":{"name":"The European Journal of Contraception & Reproductive Health Care","volume":"64 1","pages":"407 - 412"},"PeriodicalIF":0.0,"publicationDate":"2019-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84740278","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}
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