Contraceptive Goals and Evaluation of Newlymarried Couples in Shanghai, China

Based on the data from the survey of 7,872 newly married couples, who got the marriage licenses in two districts of Shanghai, during the period from Aug. 1987 to Aug. 1988, we analyzed contraceptive goals evaluation and acceptability of newly-married couples within fifteen months after their marriage and before their having a baby. About half of couples had ever used contraception after marriage, mainly for reason of “expecting to be relaxed temporarily” and “expecting to be pregnant”. The contraceptive methods commonly used were rhythm and condom, in general for reason of “convenience in use” as well as “harmlessness to health” and “effectiveness”. The reason for switching contraceptive methods was “interference with intercourse” and “low effectiveness”. 64 percent of couples were unwilling to use pill, mainly for fear of “harm to health”. The factors affecting acceptability of pill and injection were wife‘s age at marriage, her educational level, occupation and character, couple‘s contraceptive knowledge and their health status and monthly income.     

Choice and Changes of Contraceptive Methods after Primiparous Delivery in Shanghai

Totally,3 701 primiparous women in Shanghai were followed up for 15 months after delivery to assess their initial and subsequent changes in choice of contraceptive methods.Results showed that 15 months after delivery,95.46% of women had already used a contraceptive method.The leading first choice of contraceptive methodsamong urban women was the condom(50.72%) or IUD(29.09%),while the leading first choice among rural women was IUD(56.65%)or the condom(30.60%).Within 15 months after delivery,women whose first choice had been the condom tended to switch usually to an IUD.But fewer women whose first method was an IUD switched to other methods.At the 15th month follow-up,94.54% of women were all using a method,with 60.76% of urban women and 71.07% of rural women using IUDs.Multinominal logistic regression analysis suggests that women‘s characteristics influence the choice of methods.Urban, well-educated women were more likely to choose condom and rhythm,and less likely to choose OC.Older women tended to use condom and rhythm more often than younger women.Breast feeding women were less likely to use OC.Women who received recommendations regarding postpartum contraception from family planning workers were more likely to use IUD.It was concluded that family planning workers should increase women‘‘s awareness of the advantages and disadvantages of different methods,dispel myths and rumors about some methods and improve women‘‘s knowledge of informed choice.     

Contraceptive use behavior among never married young women who are seeking pre gnancy termination in Beijing

Objective To identify contraceptive use behavior and its determinants among never married young women with an unwanted pregnancy and seeking pregnancy termination in Beijing.Methods A cross-sectional study, adopting the Lawrence’ PRECEDE-PROCEED model was conducted in 1999 in Beijing, China. A total of 306 unmarried young women, aged 18 to 24 years and requesting pregnancy termination, were face to face interviewed.Results Only 13% of the young women insisted on contraceptive use, and almost an equal proportion occasionally or never used contraceptives (26% and 27%, respectively). Among 224 women who had contraceptive use during the past 12 months, the methods used most often were condom (49%), withdrawal (28%) and the rhythm method (16%). One of the most important reasons cited by 73 percent of women who had never used contraceptives was that they did not realize the risk of getting pregnant. The results of logistic regression analysis revealed that knowledge on contraception, boyfriend’s approval of contraceptive use, perceived risk of getting pregnant, perceived availability of contraceptive services and discussion of contraception with boyfriend were important indicators of a young woman’s contraceptive use behavior.Conclusion These results indicate an urgent need to develop sex education on conception and contraception among young women and men. It is equally important to enhance young women’s perception about the risk of unwanted pregnancy and the complications of induced abortion. Promoting men’s cooperation and participation in contraceptive use as well as strengthening communication on contraception between young women and their partners is essential.     

北京市未婚青年避孕行为的调查研究(英文)

Ｕｎｗａｎｔｅｄｐｒｅｇｎａｎｃｙａｎｄｐｒｅｇｎａｎｃｙｔｅｒｍｉｎａｔｉｏｎａｍｏｎｇｎｅｖｅｒｍａｒｒｉｅｄｙｏｕｎｇｗｏｍｅｎａｒｅｗｏｒｌｄｗｉｄｅｐｒｏｂｌｅｍｓｔｈａｔａｆｆｅｃｔｗｏｍｅｎ ,ｔｈｅｉｒｆａｍｉｌｉｅｓａｎｄｔｈｅｗｈｏｌｅｓｏｃｉｅｔｙ Ｕｎｗａｎｔｅｄｐｒｅｇｎａｎｃｙａｍｏｎｇａｄｏｌｅｓｃｅｎｔｓｒｅｓｕｌｔｓｉｎａｔｌｅａｓｔｔｗｏｍｉｌｌｉｏｎｕｎｓａｆｅａｂｏｒｔｉｏｎｓａｎｎｕａｌｌｙｉｎｔｈｅｗｏｒｌｄ ,1　ａｎｄｕｎｓａｆｅａｂｏｒｔｉｏｎｓａｒｅ…     

Contraceptive Method Choice Among Newly Married Couples and Influential Factors in Shanghai Municipality

A foliow-up study with 7,826 representative newly married couples for fifteen months after their weddings in Shanghai Municipality showed that among the 3,412 couples who actually adopted contraceptive method, rhythm was the main choice; the proportion for couples taking the contraceptive pill was much higher among sexually active couples before their weddings. The proportions of adopting rhythm or condom or the both, however, increased afterwards. About 86% of couples who had ever planned adopting the rhythm at registration actually used it. In fact, 16% of those who had ever planned to take pills eventually made this choice, because of their worry about any adverse side effects on mother‘s and fetus‘ health. Their knowledge about contraception, especially the pills, was incomprehensive. Approximately 62% of condom users had not been given any instruction regarding its use when they got this contraceptive device one year later. Half of the pill and spermicide users learnt these respective methods from their friends or relatives. The proportion of delivering contraceptives after marriage by F.P.P. was rather low. By fitting the multinomial logistic regression model, it is indicated that couple‘ s evaluation on contraceptive methods and contraceptive goal were the main factors determining newlyweds‘ method of choice. Wife‘s knowledge on contraception and the accessibility of contraceptives and devices also influenced the method choice to some extent.     

Relationship between Contraceptive Knowledge, Cognition and Behaviors among Vocational High School Students

Rise in prevalence rate of sexual activity among middle/high school students have gone with decline in age of sex initiation in recent years. Due to special training purposes and characteristics of student resources, most vocational high school students s…     

The profile of women who seek emergency contraception from the family planning service

OBJECTIVES. To review the profile of emergency contraceptive users, their reasons for using emergency contraception, and whether they use it correctly. DESIGN. Retrospective analysis of medical records. SETTING. Six Birth Control Clinics and three Youth Health Care Centres of the Family Planning Association of Hong Kong. PARTICIPANTS. Women requesting emergency contraception between 2006 and 2008. MAIN OUTCOME MEASURES. Demographics of emergency contraception users, reasons for requesting emergency contraception, number of times the subject had unprotected intercourse before emergency contraception use, type of emergency contraception provided, coitus-treatment intervals, and outcomes. RESULTS. A total of 11 014 courses of emergency contraception were provided, which included 10 845 courses of levonorgestrel-only pills, 168 intrauterine contraceptive devices, and one course of pills plus an intrauterine contraceptive device. The mean age of the users was 30 years. Two thirds (65.6%) were nulliparous and 64.9% had not had a previous abortion. Their major reasons for requesting emergency contraception were: omission of contraceptive at the index intercourse (38.9%), condom accidents (38.0%), and non-use of any regular contraceptives (20.6%). Non-users of contraceptives were more likely to have had a previous abortion. In all, 97.9% of women took emergency contraception within 72 hours of their unprotected intercourse; 98% had had a single act of unprotected intercourse. None of the intrauterine contraceptive device users became pregnant. The failure rate for emergency contraceptive pills was 1.8%. CONCLUSIONS. Women requested emergency contraception because contraceptives were omitted or condom accidents. Health care providers should focus on motivating women with a history of abortion to use contraceptives, and ensure that condom users know how to use them correctly. Most women followed instructions on the use for emergency contraception and their outcomes were satisfactory.     

郑州市人工流产女青年避孕知识、态度、行为及其影响因素分析

目的:调查郑州市人工流产女青年人工流产的原因和对避孕的知识、态度、行为,并分析其影响因素.方法:采用整群抽样的方法,选取2005年8月至2005年10月在郑州市所辖医院要求人工流产的女青年共1 100人进行横断面调查.结果:被调查者首次性行为始于16.4～25.0岁,中位数22.5岁.65.1%的女青年是第1次做人工流产.未采取避孕措施(67.9%)和避孕失败(32.1%)是导致非意愿妊娠的主要原因.在622名曾经使用过避孕方法的女青年中,最常用的避孕方法依次是安全套、紧急避孕、安全期.单因素分析结果显示:年龄、出生地、文化程度是影响避孕知识得分的主要因素(P＜0.05或0.01).Logistic回归分析结果显示:流产女青年在过去3个月中的避孕行为与男方是否关心避孕问题、流产次数、避孕知识水平有关(P＜0.05或0.01).结论:亟需对未婚青年开展有关避孕知识的教育,提高对意外妊娠风险的认识,促进男性积极参与避孕.     

上海市户籍育龄妇女人工流产原因动态监测

目的 动态监测上海市户籍育龄妇女人工流产原因，方法 对2001年全市16个人工流产原因监测点人工流产对象的人工流产原因与1999年全市19个监测点进行了对比分析。结果 人工流产对象的平均年龄下降了0.5岁；平均人工流产次数从2.2次下降到1.8次，再次人工流产对象明显下降。职业中工人，学生和个体，待业的比例在下降，而商业服务，科研教育，职员和行政工作人员的比例在上升；70.9%的未婚和47.8%的已婚人工流产对象是没有避孕措施所致，其中主要是侥幸心理。已婚人工流产对象中“不懂避孕措施”的比例在下降，但在未婚对象中上升。安全期和体外排精失败的比例在下降，而避孕套失败的比例在上升。在今后打算中，拟采用安全期和避孕针药的比例在下降，而避孕套和未考虑的比例在上升。结论 建议今后适当提前进行避孕节育知识教育，同时加强婚前检查，人工流产和分娩时避孕节育知识的宣传教育，加强个别咨询和药具供应服务。     

964例重庆市区与区县人工流产妇女避孕状况对比分析

目的 比较分析重庆市市区与区县人工流产(以下简称人流)妇女避孕状况存在的差异,为优化计划生育服务策略提供理论依据.方法 采用国家人口计生委科学技术研究所的《流产后计划生育服务调查研究之妇女基线调查问卷》,对2015年该院门诊接收和该市区县接收的人流妇女进行避孕状况的调查.结果 (1)两组被调查者年龄与婚姻状况比较差异有统计学意义(P＞0.05);(2)未采取避孕措施及避孕失败是导致此次流产的主要原因,两组比较差异无统计学意义(P＞0.05);(3)人流术后拟将采取的避孕措施以宫内节育器、短效口服避孕药及避孕套为主,其中,选择宫内节育器及皮下埋植剂等长效避孕方式者,区县组高于市区组,而选择避孕套和短效口服避孕药等短效避孕方式者,则市区组高于区县组.两组比较差异有统计学意义(P＜0.05).结论 避孕措施使用率低或选择低效的避孕方式、存在侥幸心理或不了解避孕方法等因素是导致人流的主要原因,但总体来看,市区组选择高效避孕措施人群低于区县组.     

Contraceptive efficacy of the pill

Some women who use the pill are at a high risk of unplanned pregnancy. Health practitioners must evaluate drug medication data, gastrointestinal disturbances, and determine a patient's ability to use the pill effectively to identify those at high risk. Of the many types of contraceptives, the pill still comes the closest to being the most effective contraceptive. Nevertheless, the expected failure rate is lower than actual user rate due to a variety of reasons, such as forgetfulness in taking the tablets and temporary malabsorption problems. Since combined preparations of the pill such as the triphasic pill effect the hypothalamic-pituitary region, the endometrium, and the cervical mucosa, one would expect a high level of protection. Evidence indicates, however, that the triphasic pill is comparatively less effective than the fixed dose oral contraceptives. Additionally, studies reveal that certain women should not use oral contraceptives (e.g. women who smoke) because of increased risk to their health. Several benefits have been identified, however, in those women who are not considered high risk, such as a reduction in dysmenorrhea and irregular menstrual bleeding. Unfortunately, little is known on how to detect noncompliant users or how to motivate them to use the pill effectively. Yet research into alternative delivery routes, such as dermal patches and implants, has not reached the commercial level. In Australia, 25% of women of reproductive age choose oral contraceptives.     

我国5城市育龄夫妇避孕知识掌握现状分析

目的了解我国城市居民中已婚育龄夫妇避孕知识的掌握情况及其影响因素。方法对广州等5个城市居民进行的“已婚育龄夫妇计划生育工作问卷调查”对此调查结果作进行统计学分析。结果我国城市已婚育龄夫妇的总体避孕知识合格率达70．10％,对现有避孕措施以避孕套最为了解。机关、院校人员的避孕知识水平总体上高于一般企事业单位。机关及企业育龄夫妇掌握避孕知识的影响因素有所不同,包括性别、地区、文化程度、生育意愿等。结论我国城市已婚育龄夫妇对避孕知识掌握较好。不同人群掌握避孕知识的影响因素有所不同。     

A field study of Depo-Provera: its use as a contraceptive method by women in a rural town in West Malaysia from February 1968 to December 1969

To determine the acceptability, practicability, and popularity of Depo-Provera as an additional contraceptive method to be offered by the National Family Planning Board NFPB of Malaysia, 550 patients of Sungai Besar, Malaysia, who accepted the Depo-Provera injection method from the start of the injection program, February 23, 1968, until the cutoff date of December 31, 1969, were studied. At the cutoff date, 318 (58%) were still receiving regular injections at 3-month intervals. The remaining 232 women discontinued use of the injection. Of those who discontinued use, 176 (32%) were interviewed, while the other 56 women were lost to follow-up, due mainly to migration. Assuming that 1 injection would protect a woman from getting pregnant for a 3-month period, the retention rates at the end of 12 and 24 months were 63% and 41%. These continuation rates were fairly high and were as good as those for the oral pill, which is the main contraceptive method provided since the beginning of the operational service program of the NFPB in May 1967. Except for a small number of Indian women with a high rate of discontinuation there was not much difference in continuing the method between the Malays (60%) and the Chinese (56%). The younger age group of women seemed to have a higher proportion of discontinuation. The findings showed that amenorrhea (35%)most bothered the women who discontinued the injection method. Irregular bleeding (20%) and other medical side effects (11%) were the other main complaints that caused women to discontinue using the injection as a contraceptive method. It was concluded that Depo-Provera (150 mg) injected once every 3 months appears to be simple, acceptable, popular, and effective as a contraceptive method among women in a rural town in Malaysia.     

Political constraints on contraceptive development in the United States

In the US there is a great need for new contraceptives because the current available choices are too limited. Many groups of women, teenagers, women over 40 and lactating mothers have even greater need because of their special requirement. There are 6 million annual pregnancies in the US, 50% of them are unintended. This is the highest percentage of unintended pregnancies in the developed world with Canada having only 39%, the UK 32%, and the Netherlands 17%. 46% of women can expect to have at least 1 unintended pregnancy in their lifetime. Almost half of these unintended pregnancies end in abortion. Of those seeking abortion, 26% are under 20 and 81% are under 30. 69% are white and 82% are single. 49% of these women reported not using contraception when they conceived. Even when a woman uses contraceptives she is still exposed to the risk of contraceptive failure. These failure rates vary from 5-30% for the pill to spermicides. Over a 10-year period the rate climbs to 25-50% for the pill or the IUD. In the US, contraceptives are the most expensive with the pill selling for 60 times what is costs for similar formulations in other countries. Norplant and IUDs, the most reliable reversible methods cost hundreds of dollars and thus make them unavailable for teenagers and poor women who need them most. The primary benefit of increased contraceptive prevalence (CP) is a reduction in the number of unwanted pregnancies and thus abortions. The CP rate for married women of reproductive age in the us is 66%, compared to 73% in Canada, 83% in the UK, 78% in Sweden, and 72% in the Netherlands. The reason new methods are not being developed are multiple: fear of product liability litigation; fear of poor product sales due to public fear; regulation and market pressures that simply do not make them profitable. It can take 12 years and $200 million to develop a new drug and US patents only last 17 years. Thus in order to make a profit the company must have a high rate of sales. Changes in the approval process and financial incentives similar to those for orphan drugs could bring new methods to market.     

Serum copper in rural women taking combined oral contraceptive

This prospective case-control study included 78 women between 15 to 45 years of age from rural area to see changes in serum copper level as a consequence of oral contraceptive use. Among the subjects, 34 women were included as controls because of not taking any form of hormonal contraceptives neither during the time of selection nor during one-year period prior to the study. Women in the control group were motivated to consume oral pill (Sukhi) for 3 consecutive cycles. At the 3(rd) month, 25 such women became available and henceforth included as cases on longitudinal basis. Another 44 women were randomly selected as cases on the basis of using combined oral contraceptives (Sukhi) for a duration of 4 months onwards. Considering different duration of oral contraceptive (OC) use, subjects were grouped as follows: Group I (n=34)--> controls, Group II (n=25)--> 3 months, Group III (n=17)--> 4 months - 2 years and Group IV (n=27)--> >2 years. Finally, 103 samples of blood (34 from controls and 69 from oral contraceptives users) were collected for estimation of Serum Copper (mgm/dl) by Atomic Absorption Spectrometry using UNICAM-AA Spectrometer. Mean+/-SD of Serum Copper significantly increased in all 3 contraceptive groups in comparison to controls (p<0.001). Further study including larger population from rural area was recommended to see correlation among serum copper and other trace elements with side effects of hormonal contraceptives. This preliminary study tried to explore the possibility of establishing biochemical monitoring of serum trace elements in OC users.     

聚氨酯避孕套临床前使用可行性和可接受性分析

目的 对使用新型聚氨酯(Pu)男用避孕套的可行性和可接受性进行初步观察。方法 对30对健康已婚夫妇为期6周360次使用国产PU避孕套的效果进行问卷调查。结果 避孕套总破裂率(临床破裂 非临床破裂)为2．22％，临床滑脱率为16．5％，使用观察期间无意外妊娠发生。结论 新型PU避孕套的破裂率和滑脱率分别相近于和高于报道的乳胶避孕套使用情况，感官指标反映PU避孕套具有良好的可接受性。     

Study on Perception of Potential Condom Use among Unmarried Migrants

Objective To understand the perception of potential condom use and its influencing factors so as to promote condom use among unmarried migrants Method A survey, using self-administered structured anonx‘mous questionnaire, was conducted among 1 092 unmarried migrants aged 15～24 years old in urban area of Shanghai. Results The unmarried migrants had some knowledge of condom. However, their knowledge level and their attitude towards condom use were not so optimistic. Subjects‘ knowledge of contraceptives and STD/AIDS had a positive influence on their attitude toward condom use. Subjects with positive attitude to condom use were more likely to use condom in sexual activity (OR=1.61). Conclusion Unmarried migrants have lower rate of condom use if they have insufficient knowledge of condom. Therefore, it is essential to strengthen the sexual health education among unmarried sex-active migrants in order to encourage contraceptive use, especially condom use.     

子宫内膜HOXA10表达水平与吉妮宫内节育器相关性的研究

目的：研究子宫内膜HOXA10表达水平与吉妮宫内节育器的相关性。 方法：从使用吉妮宫内节育器的26名育龄女性（实验组）及10名未使用任何宫内节育器及激素避孕药的育龄女性（对照组）获得的子宫内膜活检标本,通过免疫组化方法进行HOXA10表达分析。结果：实验组的子宫内膜HOXA10的表达为4.39±1.4,弱于对照组的8.88±1.79 (P<0.01)。结论：实验组HOXA10表达显著下降,HOXA10表达的水平是子宫内膜容受性的重要指标,铜质吉妮宫内节育器作用机制可能涉及基因抑制子宫内膜容受性,HOXA10表达下降可能是导致铜质宫内节育器避孕作用的主要原因。     

TCu380A和带铜宫型节育器与TCu220C的临床效果比较

采用顺序随机分配法观察了３００例农村经产妇放置ＴＣｕ３８０Ａ和带铜宫型节育器（ＵＣＤＣｕ３００ＩＵＤ）的避孕效果、副反应和可接受性，并与目前较为理想的ＴＣｕ２２０Ｃ作对照．使用２４个月，随访率为１００％．结果表明：ＴＣｕ３８０Ａ和ＵＣＤＣｕ３００ＩＵＤ累积妊娠率分别为１．０％和２．０％，对照组（ＴＣｕ２２０Ｃ）为１．０％；脱落率顺序为２．０％、０．０％和１．０％；因症取出率依次为２．０％、３．０％及１．０％；继续存放率分别为９５．０％、９５．０％和９７．０％，上述各组间结果均无显著性差异（Ｐ＞０．０５）．证实三种ＩＵＤ均符合ＷＨＯ标准，易于农村推广使用．     

The copper-7 intrauterine contraceptive device: 5-year evaluation.

Over a 5-year period a family practitioner inserted copper-7 (Cu-7 intrauterine contraceptive devices (IUDs) in 134 women. The rates of continued use after 2 years, 53.0% for the women's first IUD and 63.9% for all their IUDs, and of accidental pregnancy, 2.4%, are comparable to those in the literature. However, in this series the rate of expulsion was 0.8%, much lower than that in the literature. Fertility did not appear to be reduced in women who planned to have pregnancies after the device was removed. A carefully scrutinized technique of insertion and conscientious follow-up make the Cu-7 IUD an acceptable form of contraception for many patients in a family practice.