Abortions and Contraception Use among Czech and Romanian Women: Comparison of Representative National Studies

IntroductionThis article presents the results of representative national studies comparing the behavior and attitudes of Czech and Romanian women regarding abortion and contraception use.AimDescribe the attitudes to abortion and incidence of abortion in female population of these countries.MethodsIndependently and anonymously conducted questionnaire with 1,011 Czech and 1,001 Romanian women, with the participants' age from 15 to 50 years. The sample represented both Czech and Romanian female populations with respect to age, education, and the size of their place of residence.Main Outcome MeasuresQuestionnaire studies awareness, attitudes, and behavior related to the area of sexual life, contraception, and family planning.ResultsBased on the acquired information, it can be postulated that Romanian women, despite having a less liberal opinion on abortions than their Czech peers, undergo abortion more often than Czech women (Romanian 28%, Czech 16%), are less informed about potential side effects, and more often use less reliable methods of contraception (the so‐called “natural contraception”—vs. hormonal contraception, which is the method of choice of Czech women).ConclusionThese results indicate that despite more liberal attitudes toward abortion, Czech women have less frequent incidence of abortion than Romanian women and they have more relevant information about contraception and their sexual behavior is more conscious and responsible. Hollá K, Weiss P, Unzeitig V, and Cibula D. Abortions and contraception use among Czech and Romanian women: Comparison of representative national studies.     

Contraceptive behaviour of teenagers requesting abortion

OBJECTIVE: To examine the contraceptive use of teenage girls requesting abortion. STUDY DESIGN: A questionnaire survey was made concerning contraceptive use, awareness and the attitude toward contraceptives. The Mantel-Haenszel test was applied to compare contraceptive determinants between teenagers (<20 years old) and older women. RESULTS: The use of reliable contraceptive methods was significantly less frequent among the teenagers than among the older counterparts, but this difference was much more significant (P<0.001) between those who requested abortion (OR=0.44) than between the controls (OR=0.51). The knowledge about emergency contraceptive pills was similarly significantly poorer between the teenagers in the abortion group (P<0.001) relative to the older women (OR=0.07) and the teenagers in the control group (OR=0.10). Financial means was not a significant determinant in the choice of contraceptives. CONCLUSION: To prevent unwanted pregnancy among teenagers, the media, the family, the school and health-care providers should focus on sexual education and information.     

国产女用避孕套的临床有效性试验

目的 了解国产女用避孕套（阴道套）的临床避孕效果。方法 将６０３对育龄期志愿者夫妇随机分成两组,其中３０４例使用阴道套避孕（阴道套组）,２９９对使用阴茎套避孕（阴茎套组）。随访６个月,以生命表法统计、Ｌｏｇ ｒａｎｋ检验比较两组的妊娠率、因症停用率和其他原因停用率等。６０３对夫妇使用前后宫颈刮片和阴道脱落细胞检查均无异常。结果 ６个月的随访率,阴道套组和阴茎套组分别为９９．０１％和９９．６７％;两     

Contraceptive practices and intentions of Ukrainian women.

OBJECTIVES: This study was undertaken to investigate contraceptive practices and factors behind contraceptive preferences among Ukrainian women attending for abortion or gynecological health check-up. METHODS: Women attending for abortion (n = 919) and healthy non-pregnant women (n = 297) were studied by an anonymous 192-item self-questionnaire in a hospital-based unmatched case-control design. RESULTS: The average number of abortions per woman rose with age to 4.6 in the abortion group and 2.4 abortions in the non-pregnant group. In the abortion and non-pregnant groups, no contraceptive use during the past year was reported by 27% and 20% and at the time of conception or during the previous month, by 61% and 51%, respectively. Nevertheless, no intention to use contraception in the future was reported by 15% and 8% of women, respectively. A history of previous childbirth (odds ratio (OR) = 1.8), at least two induced abortions (OR = 1.7) and sexual education obtained from literature (OR = 1.8) were associated with preference to use modern contraceptives. Intention to use no contraception in the future was associated with giving no answer about acceptance of abortion as a birth control method (OR = 5.4), uncertainty whether to use abortion or an intrauterine device in a situation of choice (OR = 1.8), low income (OR = 1.9) and no answer about housing situation (OR = 3.9). Lack of experience with contraception reduced the intention to use any method in the future. CONCLUSIONS: Better reproductive education/information and economic incentives could contribute to a change from abortion to use of contraception.     

The elevated risk for violence against cohabiting women: a comparison of three nationally representative surveys of Canada

This study examined cohabiting women's elevated risk for male partner violence. It was predicted that an increased rate of cohabitation would be accompanied by a reduction in the bias toward selection into cohabitation and that this would result in greater similarity between characteristics of cohabiting and marital relationships as well as in their respective rates of violence. The results were generally consistent with this prediction. Cohabitation increased in Canada between 1993 and 2004, which appeared to have been reflected in some reduction in differences in selection and relationship variables as well as in lower rates of violence for cohabiting relative to married women. Nevertheless, persons who cohabited remained a select group and several relationship differences persisted. These selection and relationship differences accounted for the persistence of cohabiting women's elevated odds of violence in each survey. Results suggested that rates of violence in cohabiting and marital unions should eventually converge.     

Contraceptive counseling of diabetic women of reproductive age

OBJECTIVE: To evaluate the impact of diabetes on provision of contraceptive counseling. METHODS: We compared counseling provided to diabetic and nondiabetic women on 40,304 visits made to U.S. ambulatory practices by nonpregnant women, 14-44 years of age, included in the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, 1997-2000. Logistic regression, adjusting for age, race, ethnicity, insurance status, and provider characteristics was used to estimate the relationship between provision of contraceptive counseling and diabetes. RESULTS: Visits made by diabetic women of reproductive age were significantly less likely to include contraceptive counseling than visits made by nondiabetic women of reproductive age (odds ratio [OR] 0.42, 95% confidence interval [CI] 0.21-0.81). Visits made by diabetic women under 25 years of age were less likely to include contraceptive counseling than visits made by older diabetic women (OR 0.17, 95% CI 0.06-0.54). Overall, only 4% of visits made by diabetic women documented contraceptive counseling. When family planning was the primary reason for a visit (OR 34.4, 95% CI 20.8-56.9) or women visited a gynecologist (OR 24.3, 95% CI 16.7-35.2), women were significantly more likely to receive contraceptive counseling. However, diabetic women made only 0.3% of all visits to gynecologists. CONCLUSION: Ambulatory physicians in the United States rarely provide contraceptive counseling to diabetic women. This may contribute to adverse birth outcomes for some diabetic mothers who conceive before optimal glucose control is obtained.     

Contraceptive practices of women after abortion in Turkey

Objectives The aim of this study was to determine the postabortion contraception choices of women and the subsequent reduction in pregnancy rate. The changes in method of contraception during the 1-year follow-up period were also assessed. Methods Ninety women decided to practice family planning methods following an abortion procedure. The family planning choices of the postabortion family planning group were determined by active immediate family planning counselling. The control group, which consisted of 23 women who had had an abortion and wanted to become pregnant again, were followed-up for 1 year to determine their pregnancy rate. The pregnancy rates and methods used were determined during a 12-month follow-up period. Results Following counselling, 79.64% of the patients signed for immediate family planning practice. In the postabortion family planning group, one out of 90 patients (1.1%, Pearl index 1.29) practising contraception with a condom became pregnant. However, ten out of 23 (43.5%, Pearl index 54.2) patients in the control group became pregnant during the 1-year follow-up period (p < 0.05). In the postabortion family planning group, intrauterine devices (IUDs) (n = 43), injectable monthly contraceptives (n = 24) and tubal ligation (n = 9) were the most commonly preferred methods, with 47%, 27% and 10% of the women using these methods, respectively. At the end of the 12-month period, the drop-out rate among women using the injectable monthly contraceptives was significantly higher (13 patients, 54%) compared to other methods (p < 0.05). In one case out of 43 using an IUD (2.38%), the IUD was expelled during follow-up. Conclusion The use of postabortion family planning significantly decreased the postabortion pregnancy rate. The use of an IUD was the preferred immediate method of choice. Use of injectable monthly contraceptives was the method with the highest drop-out rate. The expulsion rate of postabortion IUDs was acceptable in our practice. The pregnancy rate in the control group was lower than the physiological fecundity would predict. This may suggest that, although couples plan to get pregnant, they do not concentrate on the ideal conditions for conception or they do, in fact, practice some form of family planning.     

Contraceptive risk-taking in women and men facing legal abortion

Objective: The aim of the study was to gain knowledge about contraceptive use, reproductive risk-taking and sexuality in Swedish women seeking abortion and their partners. Methods: Two hundred and eleven women and 75 men answered a questionnaire before the abortion. The data have been divided into six subgroups: women with and without previous experience of abortion, single women and women with a partner relationship, and women whose partner participated in the study and the male partners. Results: The main findings showed that there are more similarities than differences between the subgroups. Overall, there were no differences regarding use of contraceptives, sexual life and psychosocial characteristics. However, women with previous abortion experience were found to be older, had longer partner relationships and more often had children. Some gender differences were also found, i.e. women favored coitus-dependent contraceptives to a larger extent and took more responsibility for preventing unwanted pregnancies. At the time of conception, half the participants had not used any contraceptive methods and one-fifth had relied on 'natural family planning'. The most common reasons for not using contraceptives were related to risk-taking and/or to strong sexual desire. Twelve per cent of the women had felt pressure/threat from their partner in connection with the conception. Conclusion: In efforts to prevent undesired pregnancies, this study highlights the need to incorporate a gender perspective both in communication about risk-taking and in counselling about contraceptives.     

By women for women: Australia's national women's health policy

Australia is now in the sixth year of its National Women's Health Policy and Programme. It started when the women's movement broke the silence on women's experience and fuelled women's determination to do things for themselves as society was not providing what was needed. The knowledge base on women's health and the demands for change developed by women's health activists, taken up by a government with a strong social justice policy, led to a national consultation with Australian women in 1988 which lasted nearly two years. Groups and individuals representing more than a million women defined what they considered to be priority women's health issues: violence against women, reproductive health, mental health, occupational health, the health effects of sex role stereotyping, the health of carers, and the health of older women. A wide variety of services for women are now funded, including centres against sexual assault, health information, education and training programmes, and research and clinical services.     

Contraceptive practices of women after abortion in Turkey.

OBJECTIVES: The aim ofthis study was to determine the postabortion contraception choices of women and the subsequent reduction in pregnancy rate. The changes in method of contraception during the 1-year follow-up period were also assessed. METHODS: Ninety women decided to practice family planning methods following an abortion procedure. The family planning choices of the postabortion family planning group were determined by active immediate family planning counselling. The control group, which consisted of 23 women who had had an abortion and wanted to become pregnant again, were followed-up for 1 year to determine their pregnancy rate. The pregnancy rates and methods used were determined during a 12-month follow-up period. RESULTS: Following counselling, 79.64% of the patients signed for immediate family planning practice. In the postabortion family planning group, one out of 90 patients (1.1%, Pearl index 1.29) practising contraception with a condom became pregnant. However, ten out of 23 (43.5%, Pearl index 54.2) patients in the control group became pregnant during the 1-year follow-up period (p < 0.05). In the postabortion family planning group, intrauterine devices (IUDs) (n = 43), injectable monthly contraceptives (n = 24) and tubal ligation (n = 9) were the most commonly preferred methods, with 47%, 27% and 10% of the women using these methods, respectively. At the end of the 12-month period, the drop-out rate among women using the injectable monthly contraceptives was significantly higher (13 patients, 54%) compared to other methods (p < 0.05). In one case out of 43 using an IUD (2.38%), the IUD was expelled during follow-up. CONCLUSION: The use of postabortion family planning significantly decreased the postabortion pregnancy rate. The use of an IUD was the preferred immediate method of choice. Use of injectable monthly contraceptives was the method with the highest drop-out rate. The expulsion rate of postabortion IUDs was acceptable in our practice. The pregnancy rate in the control group was lower than the physiological fecundity would predict. This may suggest that, although couples plan to get pregnant, they do not concentrate on the ideal conditions for conception or they do, in fact, practice some form of family planning.     

Contraceptive risk-taking in women and men facing legal abortion.

OBJECTIVE: The aim of the study was to gain knowledge about contraceptive use, reproductive risk-taking and sexuality in Swedish women seeking abortion and their partners. METHODS: Two hundred and eleven women and 75 men answered a questionnaire before the abortion. The data have been divided into six subgroups: women with and without previous experience of abortion, single women and women with a partner relationship, and women whose partner participated in the study and the male partners. RESULTS: The main findings showed that there are more similarities than differences between the subgroups. Overall, there were no differences regarding use of contraceptives, sexual life and psychosocial characteristics. However, women with previous abortion experience were found to be older, had longer partner relationships and more often had children. Some gender differences were also found, i.e. women favored coitus-dependent contraceptives to a larger extent and took more responsibility for preventing unwanted pregnancies. At the time of conception, half the participants had not used any contraceptive methods and one-fifth had relied on 'natural family planning'. The most common reasons for not using contraceptives were related to risk-taking and/or to strong sexual desire. Twelve per cent of the women had felt pressure/threat from their partner in connection with the conception. CONCLUSION: In efforts to prevent undesired pregnancies, this study highlights the need to incorporate a gender perspective both in communication about risk-taking and in counselling about contraceptives.     

Contraceptive use among young women in Estonia: Association with contraceptive services

Objectives Our study aimed to explore the association between the use of effective contraceptive methods and access to different contraceptive services, as well as to describe accessibility-related obstacles when using contraceptive services and satisfaction with those services.

Methods From a population-based cross-sectional study carried out in 2004 (response rate 53.8%), the data of 16- to 24-year-old women requiring contraception (N = 868) were analysed. Factors associated with the use of effective contraceptive methods and, specifically, hormonal methods, were explored using multiple logistic regression analysis.

Results Effective contraception was used by 75.1% of the respondents. The use of effective contraceptive methods was associated with school-based sexuality education (adjusted prevalence odds ratio 2.69; 95% confidence interval 1.32 ? 5.50), visiting a youth-friendly clinic (YFC) (1.82; 1.03–3.23) or a private gynaecologist (2.08; 1.11–3.92). The use of hormonal methods was additionally associated with being a native Estonian speaker and visiting a family doctor. More than half of the respondents reported some obstacle in accessing contraceptive services. The highest satisfaction ratings were given to YFCs.

Conclusions Steps to promote the use of services that are youth-friendly and associated with better uptake of effective contraceptive methods are needed among all 16- to 24-year-old women.     

生物黏附缓释避孕凝胶杀精剂的临床有效性试验

目的　观察外用生物黏附缓释避孕凝胶杀精剂 (凝胶剂 )的临床避孕效果。方法　将2 4 0例育龄妇女志愿者随机分为两组 ,其中 12 0例使用凝胶剂 (凝胶剂组 ) ,12 0例使用避孕栓剂 (栓剂组 )。随访 6个月 ,以生命表法统计、Logrank检验比较两组的妊娠率、因症停用率和非医学原因停用率等。结果　两组使用药剂前后 ,宫颈刮片细胞学检查均无异常。 6个月的随访率 ,凝胶剂组和栓剂组分别为 10 0 0 %和 97 5 % ;粗累积妊娠率分别为 6 39/ 10 0妇女和 2 95 / 10 0妇女 ;因症停用率为3 4 5 / 10 0妇女和 4 5 7/ 10 0妇女 ;非医学原因停用率为 6 89/ 10 0妇女和 14 17/ 10 0妇女。两组比较 ,差异均无显著性 (P >0 0 5 )。结论　凝胶剂的临床效果与避孕栓剂一样 ,是安全、有效的。     

社区妇女避孕知识与行为状况调查与分析

目的:了解社区妇女对避孕知识的知晓和行为状况,以便更好地为她们提供计划生育服务和教育,提高避孕节育知情选择的正确率。方法:采用自行设计的调查表,以问卷调查的形式,对385例社区妇女进行问卷调查。结果:各种避孕知识及避孕方法知晓率为86%,行为正确率64%,其中紧急避孕行为正确率偏低。影响避孕知识水平的因素是文化程度的高低和职业。结论:要加大计划生育的宣传、咨询和指导力度,为社区妇女提供多种形式的、有针对性的机会生育优质服务,提高育龄妇女对避孕节育方法,尤其是紧急避孕方法的知晓度,扩大她们对避孕节育方法的选择范围,减少非意愿妊娠的发生。     

Analysis of national representative opinion surveys concerning gestational surrogacy in Japan

OBJECTIVE: Although gestational surrogacy offers several advantages, this procedure has given rise to some ethical and legal issues. We aimed to clarify the factors affecting the attitude of the Japanese toward gestational surrogacy. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: Nationwide opinion surveys concerning assisted reproductive technologies (ART) were carried out in 1999 and 2003. Participants included 2568 and 3647 people from the general public surveyed in 1999 and 2003, respectively (1564 people received only the questionnaire, and 2083 people received a questionnaire and brochure about ART). MAIN OUTCOME MEASURE: Multivariate-adjusted odds ratio and 95% confidence interval from logistic regression models for factors affecting the attitude toward gestational surrogacy. RESULTS: In both surveys, approximately half of respondents approved of gestational surrogacy; 20-30% disapproved of the procedure. People with high socioeconomic status clearly expressed their opinion on this issue. A liberal attitude toward gender role promoted approval of gestational surrogacy; a liberal attitude toward family had the opposite effect. CONCLUSION: Our findings suggest that socioeconomic status affects people's expression of their opinion regarding this issue, while attitudes toward this procedure were influenced by individual belief. Considering socioeconomic status and diversity of individual belief is required for further discussion on this topic.     

Contraceptive practices in women with repeat termination of pregnancies.

The incidence of repeat termination of pregnancies (TOP) has been increasing in the past decade in-spite-of widespread availability of free and effective contraceptive methods. A retrospective analysis of case notes of women referred for TOP in the Family Planning clinic at Luton, between January and October 2005 was carried out. A total of 159 women were referred for TOP. Of these, 42 (26.4%) were repeat procedures. In this subgroup, 78.5% had used one or more contraceptive methods after the first termination. However, only 61.9% of them continued to use contraception at the time of presentation for a repeat TOP, the most common method being the male condom. Half of the total women seen for a repeat TOP were under 6-weeks' gestation and 14.2% had been treated for sexually transmitted infections in the past. The incidence of repeat TOPs is increasing in the UK. Many studies have shown that the periabortion contraceptive practices are generally poor. In our study, women undergoing repeat termination of pregnancies were either not using contraception or using a method with a high failure rate. We also found the highest number of repeat TOPs occurring in the 20 - 25 age group. Effective contraceptive counselling is vital to combat this worrying trend. Routine 2-week follow-up appointments after TOP and regular auditing of the periabortion contraceptive practices are needed.     

Contraceptive use among women with medical conditions: Factors that influence method choice

ObjectiveTo identify factors that influence contraceptive initiation among women with medical conditions.Study designWe conducted an exploratory cross-sectional survey of women 18–45 years old with medical conditions who received contraception consultation from complex family planning specialists at five University of California Medical Centers from June 2014-June 2015. We asked survey participants about factors that influence their decision of choosing and initiating a contraceptive method, how they accessed family planning specialists and the impact of this consultation on their contraceptive method choice.ResultsAmong 97 participants, 61 (63%) had one medical condition, 28 (29%) had two medical conditions, and 8 (8%) had three or four medical conditions. A majority of participants initiated long-acting reversible contraceptive methods including an intrauterine device (n = 54, 56%) and the contraceptive implant (n = 17, 18%). The most common reason for initiating contraception was to avoid pregnancy in the immediate future for personal reasons (n = 43, 44%). The most common reason for initiating a particular contraceptive method was safety given their medical condition (n = 19, 20%). After the consultation with the complex family planning specialist, participants commonly reported that the person with the most influence on their contraceptive method choice was the complex family planning specialist (n = 35, 36%) and less commonly the primary care provider (n = 9, 9%) and not at all by a family member or friend (n = 0, 0%).ConclusionWomen with medical conditions are highly influenced by a complex family planning specialist in regard to their contraceptive options and when receiving such counseling, will often choose highly effective methods.ImplicationsThis study provides insight into contraceptive decision-making among women with medical conditions referred to a complex family planning specialist for contraceptive care.