The Effect of Time in the U.S. on the Duration of Breastfeeding in Women of Mexican Descent

Objectives: Although women of Mexican decent have high rates of breastfeeding, these rates may vary considerably by acculturation level. This study investigated whether increased years of residence in the U.S. is associated with poorer breastfeeding practices, including shorter duration of any and exclusive breastfeeding, in a population of low-income mothers of Mexican descent. Methods: Pregnant women (n = 490) were recruited from prenatal clinics serving a predominantly Mexican-origin population in an agricultural region of California. Women were interviewed during pregnancy, shortly postpartum, and when their child was 6 months, 1 year, 2 years, and 3.5 years of age. Results: Increased years of residence in the U.S. was associated with decreased likelihood of initiating breastfeeding and shorter duration of exclusive and any breastfeeding. Median duration of exclusive breastfeeding was 2 months for women living in the U.S. for 5 years or less, 1 month for women living in the U.S. for 6 to 10 years, and less than one week for women living in the U.S. for 11 years or more, or for their entire lives (lifetime residents). After controlling for maternal age, education, marital status and work status, lifetime residents of the U.S. were 2.4 times more likely to stop breastfeeding, and 1.5 times more likely to stop exclusive breastfeeding, than immigrants who had lived in the U.S. for 5 years or less. Conclusions: Efforts are needed to encourage and support Mexican-origin women to maintain their cultural tradition of breastfeeding as they become more acculturated in the U.S.     

Contraceptive Use and Unintended Pregnancies Among HIV-Infected Women in Mumbai

Background:

Access to reproductive health services in Human Immunodeficiency Virus (HIV) programs can greatly enhance program''s potential to limit the spread of disease, reduce unintended pregnancies and safeguard the health of infected people.

Objectives:

To assess (i) knowledge, attitude, and use regarding contraceptives; safe sex and dual protection; (ii) fertility desires and unintended pregnancies post HIV and (iii) symptoms of reproductive tract infection/sexually transmitted infection (RTI/STI) among women infected with HIV.

Materials and Methods:

A cross-sectional study among 300 currently married HIV-positive women who had not undergone permanent sterilization with no immediate desire for pregnancy. Study site was Integrated Counseling and Testing Centers (ICTC) in tertiary hospitals of Mumbai and women were interviewed using a semistructured questionnaire.

Results:

In spite of good awareness about modern methods, 42.7 felt that contraceptives other than condoms were harmful to use due to their HIV status. Knowledge on dual protection was limited to condom (75%). Condom use increased from 5.7% pre-HIV to 71.7% post-HIV, with 89.6% reporting regular use. Future fertility desire was expressed by 8.7% women. Induced abortions post-HIV was reported by16.6% women, as pregnancies were unintended. About 69% wished to use dual contraceptive methods for effective protection if it was not harmful to be used by people living with HIV (PLHIV).

Conclusion:

Data reveals a need to promote modern contraceptive methods along with regular condom use to prevent unintended pregnancies and improve health-seeking behavior for contraception. Health system models that converge or link HIV services with other reproductive health services need to be tested to provide comprehensive reproductive healthcare to infected women in India.     

Intimate Violence Among Women of Mexican Origin: Correlates of Abuse

Data from the Mexican American Prevalence and Services Survey (Vega, Kolody, Aguilar-Gaxiola, Alderete, Catalano, & Caraveo-Anduaga, 1998) was used to test the impact of acculturation and acculturation stress on intimate partner abuse of women of Mexican origin. Findings indicated that higher acculturation increases intimate abuse, and social support reduces it. Acculturation stress increases abuse only among immigrants. Abuse rates are higher among U.S.-born Mexican Americans than immigrants. There are no additive effects of education and income in explaining abuse within a multivariate model. These results suggest a complex causal process that could not be fully addressed in this study. Our results highlight the need for improved understanding about how the acculturation and acculturation stress processes are differentially related to intimate violence among immigrants and U.S.-born Mexican Americans.     

Dual Use of Condoms With Other Contraceptive Methods Among Adolescents and Young Women in the United States

PurposeTo estimate the prevalence of and factors associated with dual method use (i.e., condom with hormonal contraception or an intrauterine device) among adolescents and young women in the United States.MethodsWe used 2006–2010 National Survey of Family Growth data from 2,093 unmarried females aged 15–24 years and at risk for unintended pregnancy. Using multivariable logistic regression, we estimated adjusted odds ratios (aORs) and 95% confidence intervals (CIs) to assess the associations between dual method use at last sex and sociodemographic, behavioral, reproductive history, and sexual behavior factors.ResultsAt last sex, 20.7% of adolescents and young women used dual methods, 34.4% used condoms alone, 29.1% used hormonal contraception or an intrauterine device alone, and 15.8% used another method or no method. Factors associated with decreased odds of dual method use versus dual method nonuse included having a previous pregnancy (aOR = .44, 95% CI .27–.69), not having health insurance coverage over the past 12 months (aOR = .41, 95% CI .19–.91), and having sex prior to age 16 (aOR = .49, 95% CI .30–.78).ConclusionsThe prevalence of dual method use is low among adolescents and young women. Adolescents and young women who may have a higher risk of pregnancy and sexually transmitted infections (e.g., those with a previous pregnancy) were less likely to use dual methods at last sex. Interventions are needed to increase the correct and consistent use of dual methods among adolescents and young women who may be at greater risk for unintended pregnancy and sexually transmitted infections.     

Motivations for Pregnancy Planning Among Mexican Immigrant Women in North Carolina

Objectives: To enhance understanding of 1) Mexican immigrant women's attitudes toward planning their pregnancies and the factors that influence their fertility preferences, and 2) the effect of migration on their pregnancy planning decisions. Methods: Qualitative in-depth interviews were conducted with 11 Mexican immigrant women living in North Carolina. Participants were recruited by means of snowball sampling. Interviews were conducted in Spanish in the women's homes. Interviewing and analysis were conducted iteratively to allow emerging themes and interpretations to be developed and validated in subsequent interviews. Results: The women were strongly motivated to plan their pregnancies. Their primary considerations in pregnancy planning were their ability to give their children a good life and their ability to enjoy their families. Individual personal aspirations did not emerge as an important consideration. Migration intensified the women's felt need to plan their pregnancies. Conclusions: The Mexican immigrant women in this study had a strong familistic orientation. Far from diminishing their interest in planning their pregnancies, however, the high value they placed on family was their primary motivation for pregnancy planning. Migration to the U.S. intensified their felt need to plan their pregnancies. Understanding of the women's motivations for family planning may help health care providers better address the family planning needs of Mexican immigrant women.     

上海市人工流产妇女避孕节育状况调查

目的：了解上海市人工流产妇女的避孕节育现状,探讨人工流产对象避孕节育措施使用的影响因素。方法：2013年8月—10月在上海市4家医院对寻求人工流产服务的1 261例妇女进行匿名电子问卷调查。结果：近60%的流产对象为29岁及以下的妇女,未婚对象占32.6%;50%以上的对象属于重复流产。未婚者中未避孕的比例（48.0%）高于已婚者（33.9%）,而避孕失败的比例（38.6%）低于已婚者（47.8%）。Logistic回归分析显示,已婚人工流产对象中,年龄较小者、性生活频率低者更倾向于不采取避孕措施;年轻、未婚、收入较高、有人工流产史者更倾向于使用紧急避孕药。结论：上海市人工流产妇女年龄构成年轻化,重复流产比例较高;采取避孕措施比例低与避孕失败比例高是非意愿妊娠的主要原因;人工流产对象避孕意识淡薄和避孕节育知识匮乏;应加强流产后保健服务和避孕措施尤其是紧急避孕药的使用方法指导。     

Pregnancy Intention and Contraceptive Use Among Adult Women

Objectives: We examined pregnancy intention measures and contraceptive use behaviors among reproductive-age women using data from two CDC-based surveillance systems. Methods: We analyzed data for women aged 18–44 from 4 states that collected information on pregnancy and contraceptive use from both the Behavioral Risk Factor Surveillance System (BRFSS, n = 4201) and the Pregnancy Risk Assessment Monitoring System (PRAMS, n = 7761) in 2000. Standard definitions of intended and unintended pregnancy were used. Results: BRFSS data show that 4% (95% CI: 2.8–5.2) of the women were pregnant at the time of interview and that 57% (95% CI: 41.9–71.9) of these pregnancies were intended. Women who had been pregnant within the last 5 years but were not currently pregnant reported that 61% (95% CI: 55.9–65.3) of their most recent pregnancies had been intended. According to PRAMS, 58% (95% CI: 56.5–60.5) of women with live births had intended pregnancies. Contraceptive use varied across the surveys; 68% (95% CI: 65.7–70.7) of all non-pregnant women from BRFSS and 87% (95% CI: 85.1–87.9) of women with a recent live birth from PRAMS reported using contraceptives. Conclusions: Although contraceptive use differed between the BRFSS and PRAMS, the patterns of pregnancy intention were similar for women who had a pregnancy within the past 5 years, those who recently delivered a live-born infant, and those who were currently pregnant. It appears that reporting of pregnancy intention is not affected by timing of assessment across the two surveys.     

男性因素对人工流产妇女避孕措施使用的影响

目的:研究男性因素对人工流产妇女避孕措施使用意愿的影响。方法:本研究为现况调查。采用意向性抽样的方法,对北京市8家医院进行早期人工流产的妇女进行问卷调查,并随机抽取部分男伴进行了个人深入访谈。结果:人工流产妇女男伴的年龄为25.22±3.79岁,流动人口占55.2%。本次意外妊娠未使用避孕措施组中男性流动人口所占的比例为58.1%,高于避孕失败组中的50.8%(x2=5.243,P<0.05)。男女文化程度有差异的人群,其女伴避孕知识得分不及格的比例较高,占33.1%(x2=40.959,P<0.01)。结论:男性因素对人工流产妇女避孕措施的使用有一定影响,低文化程度、流动人口、以及男女双方在文化程度、户籍上存在差异的人群,女性避孕措施的使用率低,正确知识的知晓率低。     

北京市重复流产妇女流产后避孕方法坚持使用情况分析

目的 了解北京市重复人工流产妇女流产后避孕方法坚持使用情况及其影响因素. 方法 采用卡方检验和多元Logistic回归方法对问卷调查结果进行分析. 结果 被调查妇女中30.29％接受过2次及以上人工流产手术,90.47％选择人工流产的原因是非意愿妊娠.55.54％的妇女在人工流产4周后恢复月经,平均首次使用避孕方法的时间是在流产后5.11周.在本次流产前3个月,30.54％的妇女没有避孕.采取避孕措施的妇女中,仅有30.12％妇女自述能够坚持每次性生活都使用避孕方法.多元Logistic回归分析结果显示:妇女自身学历高、知道人工流产危害且丈夫对避孕态度积极的妇女坚持每次使用避孕方法的发生比是低学历妇女、不清楚人工流产危害以及丈夫避孕态度不积极妇女的1.702倍、3.377倍和4.076倍. 结论 妇女重复人工流产现象值得引起关注,通过提供流产后服务可以降低重复人工流产,其关键在于落实避孕方法的使用.在为育龄妇女提供生殖健康服务的同时,也应重视男性参与生殖健康服务,从而更好地提高服务效果.     

Ethnophysiology and Contraceptive Use Among Low-Income Women in Urban Brazil

Distrust and dissatisfaction with contraceptive methods among low-income Brazilian women contributes to incorrect contraceptive use, harmful health risks, and an extensive reliance on surgical sterilization. Data from ethnographic fieldwork in a low-income neighborhood in urban Brazil illustrate that women's concerns regarding contraception make sense in the context of their general health and illness beliefs and their understanding of reproductive physiology. Women interpret and experience biomedical concepts and contraceptive methods (such as “hormones” and oral contraceptives, respectively) according to an ethnophysiology of fecundity, menstruation, and conception. These popular representations of reproduction embody social relations and local experience and therefore persist despite the influence of biomedical models. Recognition of this ethnophysiology and greater emphasis on culturally appropriate counseling and education among health care professionals will improve women's experience and effective use of reversible contraception.     

影响育龄妇女避孕措施选择及效果的因素分析

目的:了解影响育龄妇女避孕方法选择和避孕效果的因素,为提高妇女避孕有效率提供建议。方法:采用整群抽样的方法,对2006年5月～2007年5月在我校附院妇产科门诊,要求人工流产的妇女826例进行横断面调查。结果:年龄、文化程度、婚育情况不同,避孕方法差异有统计学意义(P<0.01)。结论:年龄、文化程度、婚育情况是影响育龄妇女避孕措施选择的主要因素;避孕知识缺乏、侥幸心理、避孕方法不当是影响育龄妇女避孕效果的主要因素。重视避孕,正确使用避孕方法是提高育龄妇女避孕有效率的重要方面。     

Pregnant Women of Mexican Descent: Constructions of Motherhood

Past research related to pregnancy outcomes has tended to have a bio-medical focus. More recent research has begun to explore possible social and cultural influences on birth outcomes. Qualitative interviews were conducted with 28 pregnant women of Mexican descent in the Texas/Mexico border region to begin to describe the social and cultural contexts of pregnancy of women of Mexican ancestry. Participants' constructions surrounding pregnancy focused on the mother role. Goodness of fit between constructions of the mother role and women's lives and self-concepts resulted in positive or negative feelings about motherhood.     

上海市城区产后妇女避孕节育状况及服务需求的调查

目的:调查上海市城区产后妇女避孕节育现状和服务需求,为完善社区计划生育服务模式提供依据。方法:采用横断面调查的方法,对上海市徐汇区10个街道的1819名产后1～2年妇女进行匿名封闭式问卷调查。结果:调查对象以户籍人口为主(78.4%)。对象产后月经和性生活的平均恢复时间为4.94个月和5.04个月,产后采用避孕措施的平均时间为5.68个月。91.5%妇女产后已经采用避孕措施,前3位方法为:避孕套(78.4%)、安全期(13.1%)、体外排精(10.9%)和宫内节育器(10.9%)。既往有人工流产史者占23.89%,产后意外妊娠总发生率为7.86%,其中本市户籍与外来产妇产后意外妊娠发生率分别为7.41%和12.79%,外来产妇产后意外妊娠发生率显著高于本市产妇,差异具有统计学意义(P<0.05)。82.9%的对象认为产后避孕宣教有必要,认为合适的产后避孕宣教应在产后访视和产后体检时,有33.3%的对象认为婴儿体检或免疫接种时可安排产后避孕宣教;希望获得的产后避孕宣教方式仍以宣传资料为主(87.2%)。结论:产后是及早落实避孕措施的关键时期,城区产后计划生育工作要针对产后妇女的特点和需求开展避孕方法的知情选择和宣教,以提高广大生育后期妇女生殖健康水平。     

Gender Differences in Substance Use Among Mexican American School-Age Children

ABSTRACT: This study identified differences in gender between and among fourth, fifth, and sixth grade Mexican American students for use of four specific "minor" substances: cigarettes, beer, wine/liquor, and marijuana. Minor substances are believed to serve as a "gateway" to more intense and frequent use of minor and major substances. Students (N = 2,216; males 52% and females 48%) were surveyed to ascertain information pertaining to their substance use. The chi-square statistic found significant gender differences at the fourth and fifth grade for use of minor substances. Patterns of initiation of minor substance use by gender and grade are discussed in the context of substance use stage theory. Overall, results support the need for further research emphasizing within group variations in the substance use of singular ethnic groups. (J Sch Health. 1993;63(9):397–401)     

The Association Between Nonbarrier Contraceptive Use and Condom Use Among Sexually Active Latina Adolescents

PurposeThis study aimed to determine the association between use of highly effective methods of nonbarrier contraception and condom use in a sample of Latina adolescents and whether the change to a more effective method of nonbarrier contraception is associated with a change in condom use.MethodsAs part of a larger study, 442 sexually active Latina adolescents aged 14–18 years were surveyed immediately before an appointment with a medical care provider at a school-based health center and 3 months later. Ordinal logistic and linear regression were used in the analysis of cross-sectional and longitudinal data to assess the relationship between patterns of nonbarrier contraception and condom use.ResultsThe use of all types of nonbarrier methods of contraception was significantly associated with decreased condom use. Change over time from a less effective to a more effective nonbarrier method of contraception was also associated with a decrease in condom use. Greater number of sexual encounters was associated with lower the frequency of condom use.ConclusionsThe use of highly effective methods of nonbarrier contraception was associated with reduced frequency of condom use. This highlights the need to promote condom use concurrently with nonbarrier methods of contraception to improve protection against both pregnancy and STIs.     

Reproductive Health of the Rapidly Growing Hispanic Population: Data from the Pregnancy Risk Assessment Monitoring System, 2002

Objectives One in five US babies are Hispanic, and many Hispanics are recent immigrants. This study’s goal is to compare reproductive health characteristics between Hispanic and non-Hispanic White (NHW) mothers and to determine whether those characteristics differ by Hispanic birth increases. Methods State-based Pregnancy Risk Assessment Monitoring System 2002 data were used to compare Hispanic and NHW mothers of live-born infants overall and in tertiles of states with the highest and lowest Hispanic birth increases during 1998–2002. We calculated crude and adjusted risk ratios (RR) for each characteristic for Hispanics (N = 5,104) relative to NHWs (N = 22,608) and conducted t-tests to compare the RRs in high and low tertile groups. Results Hispanic mothers are younger, of lower socioeconomic status, and less likely to receive early prenatal care. They smoke and drink less, breastfeed their infants more often, and report less preterm labor and hypertension during pregnancy, but may be at greater risk of gestational diabetes. When compared to states with smallest birth increases, Hispanics in states with the largest increases are more likely than NHWs to report healthy behavior, e.g., continued breastfeeding and normal BMI. However, they are more likely to report late prenatal care, hospitalization during pregnancy, and low socioeconomic status. A lower risk of hypertension is reported only by Hispanics in states with small birth increases. Conclusions Reproductive health characteristics among Hispanic and NHW women differ, but Hispanic women more closely resemble NHW women in states with small increases in Hispanic births. Percent increase in Hispanic births may be a useful measure for states planning future program needs among Hispanic women and infants. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.     

妇女产后月经恢复、避孕与再妊娠概率生命表法分析

本文讨论产后哺乳期闭经作为一种避孕方法纳入计划生育规划中的可行性。基于哺乳期自然避孕的机理,鼓励产后妇女尽可能地延长完全母乳喂养期限,充分发挥哺乳期闭经的避孕作用,既避免了可能的再妊娠,又有益于产妇和婴儿的健康。本研究采用现况调查方法,对山东省淄博市张店区南定镇和沣水乡的2 315例自1993年1月～1995年12月期间凡生育过至少一个活产婴儿的已婚育龄妇女进行了抽样调查。用生命表法分析了产后月经恢复、避孕和再妊娠等事件的发生概率。结果显示,产后三个月时,城乡妇女月经恢复累积概率分别为0.3042和0.3329;避孕累积概率分别为0.5909和0.8700;再妊娠累积概率分别为0.0009和0.0038。数据表明,妇女月经恢复之前,有相当数量的妇女较早使用了避孕方法,意味着哺乳期的避孕作用尚未引起人们的足够重视。因此,建议加强哺乳期闭经可作为一种避孕方法宣传、咨询和培训。     

Promotoras Across the Border: A Pilot Study Addressing Depression in Mexican Women Impacted by Migration

The migration of working-aged men from Mexico to the United States fractures the family-centered support structures typical of Latin America and contributes to high levels of depression in women left behind in migratory sending communities in Mexico. Mujeres en Solidaridad Apoyandose (MESA) was developed to improve depression in women through social support in a resource poor setting. MESA is a promotora intervention that trains women in the community to lead social support groups over a five-week period. The MESA curriculum uses a combination of cognitive behavioral theory techniques, psychoeducation, and social support activities aimed at alleviating or preventing depression in women. Results from this pilot efficacy study (n = 39) show that depressed participants at baseline experienced declines in depression as measured by the Center for Epidemiologic Studies Depression Scale at follow-up. Other findings demonstrate the complexity behind addressing social support and depression for women impacted by migration in different ways.     

Risk of smoking initiation among Mexican immigrants before and after immigration to the United States

Research has suggested that Latinos are less likely to initiate smoking than non-Latino whites. This advantage may be due in part to social and structural factors that deter smoking initiation among Latino immigrants, such as entry into the restrictive regulatory environment surrounding smoking in the U.S. and decreased exposure to family smoking influences, given that immigrants often leave parents and siblings behind in countries of origin. Although available data do not support a direct test of this hypothesis this study conducts an indirect test by comparing risk of initiation among Mexican immigrants before and after immigration to the U.S. If such factors influence initiation among Mexican immigrants, their risk should decline after immigration, relative to risk before immigration, since they are subject to these forces only after moving to the U.S.     

Variation in Postpartum Use of Most and Moderately Effective Contraceptive Methods Among Louisiana Women

Maternal and Child Health Journal - Women experiencing unintended and short-interval pregnancies are at increased risk for adverse outcomes. Nationally, researchers report disparities in...