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。     

健康教育在产后访视中的应用体会

产后访视是妇幼保健工作的重要部分,通过访视可了解产妇及新生儿健康和哺乳情况,开展健康教育以指导产妇进行产后自我保健,传授科学育儿知识,促进母乳喂养成功,进行婴儿卫生保健护理,同时对影响母婴健康的异常情况及时指导处理,完成对母婴保健的整体服务。现就开展社区母婴保健服务中应用健康教育取得的良好效果介绍如下:1 访视内容1.1 产妇一般情况 体温、呼吸、脉搏、血压、自我感受。子宫收缩情况:如大小、硬度、活动度及有无压痛,恶露的颜色、量、性状、气味。腹部和会阴伤口愈合情况:如有无渗血、血     

城市妇女产后哺乳期闭经和避孕行为的随访研究

为探讨城市妇女在产后1年内的哺乳类型、闭经状况和避孕行为,本研究采用前瞻性随访研究方法,对1996年6月起在山东省淄博市5所区级医院分娩的496名产妇进行登记,并对其中有活产的494名妇女于产后42天、4个月和1年时进行访视。1年访视率为98.8％。被访视对象96.1％为初产妇。访视结果显示,完全母乳喂养妇女产后4个月时月经恢复率为14.7％,而混合喂养者为29.2％(P<0.05)。产后第1个月37.7％的妇女避孕,第2个月为62.3％,前3个月以使用避孕套为主。自产后3个月起宫内节育器使用率逐渐增加。寿命表法分析表明,依产后顺序月为序,完全哺乳概率与产后闭经概率的降低呈一致趋势。在产后4个月时产后闭经概率仍为68.2％,提示提高完全母乳喂养率,有助于哺乳期自然避孕的可行性。为保护母婴健康,防止产后非意愿妊娠的发生,应加强服务网络间联系和适时地为产后妇女提供优质服务。妇幼保健与计划生育服务相结合应成为我国基层初级生殖保健的方向。     

产后避孕

<正>产后妇女是育龄妇女中的一个特殊群体，她们面临着哺乳、哺乳时限的选择、可能发生的非意愿妊娠以及对避孕方法的认识和应用等一系列问题。因此，产后避孕必须得到夫妇双方、医生以及计划生育工作者等多方面的重视。为提高广大妇女的生殖健康水平，减少人工流产率，近年来国内外学者关于产后避孕进行了大量的综合性研究。     

429例产后42d妇女的避孕节育知识意愿及需求调查

４２９例产后４２ｄ妇女的避孕节育知识意愿及需求调查葛蕙苓上海市卫生局妇幼处２００００２庄留琪苏昭仪金勤上海市计划生育技术指导所在生殖健康已引起人们日益关注的今天，为推行避孕方法知情选择，减少妇女意外妊娠，加强生殖保健服务研究，以更好地适应上海地区育龄...     

社会环境因素对妇女产后避孕的影响

对上海市４０３７例产后妇女避孕行为及其影响因素的调查,结果表明妇女产后平均４．６１月开始避孕。年龄在２５～２９岁、职业为干部、文化程度和经济收入较高、接触亲友层次高及孕前接受过避孕宣教的妇女,产后开始避孕的时间较早。妇女产后一般首选的避孕方法为ＩＵＤ,其次为避孕套。经济、文化、人口学特征和社会环境等因素对妇女避孕方法的选择产生一定的影响。３７．５８％的产后妇女未用或未及时使用避孕措施,大部分妇女对产后不孕期有误解（认为不来月经就不会怀孕,认为一直哺乳不会怀孕等）,避孕知识和信息的缺乏是妇女未用避孕方法的重要原因。加强宣传力度,鼓励妇女（特别是年龄较青、职业层次、文化程度、经济收入及接触亲友层次较低的妇女）产后尽早使用避孕措施,是提高妇女生殖健康水平的一个重要方面     

社区产后访视健康教育对母乳喂养的影响

目的:通过社区产后访视健康教育知识宣传让产妇和家属了解和接受母乳喂养知识和技能,提高母乳喂养率.方法:社区产后访视人员在产妇及新生儿出院后3天、28天各进行上门访视一次,先了解产妇及新生儿健康状况、母乳喂养知识了解程度和喂养技能掌握情况,再根据当前存在的问题给予纠正.对可能发生的问题给予预防措施指导.利用健康教育宣传母乳喂养知识,使产妇及家属了解和接受母乳喂养知识.结果:社区产后访视健康教育宣传指导使产妇及家属接受和正确实施母乳喂养,从而提高了母乳喂养率.结论:社区产后访视利用健康教育宣传和指导母乳喂养知识和技能对提高母乳喂养率有很大的促进作用.     

产后服务对象避孕节育现状与需求相关调查研究

目的:了解服务对象产后避孕知识、产后访视、避孕节育状况与服务需求,为完善社区产妇健康管理及产后避孕服务模式提供科学的理论依据。方法:2013年10月1日~11月10日,对在天津医科大学总医院以及天津永久医院住院分娩的575名产后服务对象进行问卷调查,分别于产后42±7d、90±7d、180±7d进行电话随访。结果:(1)服务对象产后避孕相关知识总正确率为26.8%,其中有关宫内节育器(IUD)、单纯孕激素避孕法(POC)、复方口服避孕药(COC)、哺乳闭经避孕法(LAM)的正确率,分别是31.1%、18.6%、23.7%、44.9%。(2)服务对象产后3~7天访视率为94.0%,产后42d检查率为89.0%,其差异有统计学意义(P0.05)。两次访视中进行产后避孕宣教与指导的分别有50.7%和78.3%。(3)服务对象喜欢的避孕宣教形式为发放宣传手册资料(64.6%)、向医生护士咨询(17.4%)、热线电话(13.4%)。认为产后避孕宣教的最佳时间为产后42d健康检查(51.3%)、产后3~7d访视时(29.9%)。(4)服务对象母乳喂养率为86.5%,纯母乳喂养坚持到产后6个月的有40.0%。(5)服务对象性生活的恢复和开始使用避孕措施的平均时间为产后81.7±35.0d、产后98.4±39.1d,其中产后未避孕及未即时避孕的有27.3%。(6)服务对象选择的避孕方法前4位是男用避用套、体外排精、IUD、安全期,分别占83.2%、1.8%、1.8%、1.6%。至产后6个月依赖LAM避孕有20.8%。结论:服务对象产后访视率较好,访视内容不完善。服务对象避孕措施的平均落实时间滞后于性生活的恢复时间。服务对象产后避孕知识匮乏,在产后访视中有关避孕的宣教和指导不足。服务提供者可以通过发放宣传手册资料、鼓励服务对象向医生护士咨询、相关科室建立产后避孕热线电话等途径开展产后避孕的宣教和指导。将产后避孕的宣教和指导的时间着重放在产后42d健康检查、产后3~7d访视时。     

产后妇女避孕节育知识及避孕应用调查

目的:了解产后妇女避孕节育知识及避孕应用情况,以便为提高产后妇女避孕率,降低意外妊娠提供依据。方法:选取桂林市的191名产后1年内妇女为研究对象,采用问卷调查法调查避孕节育知识及避孕应用情况。结果:①产后1年妇女避孕率为62.8%,使用工具避孕占88.9%,避孕方式夫妻共同选择的占66.5%。②避孕相关知识总体掌握平均(56.7±13.3)分,知识维度得分排名在最后2位的分别是生育能力恢复时间及对人流危害的认知。结论:应采取多种措施加强对产后避孕的宣教,提高产妇避孕相关知识及产后的避孕率,从而避免意外妊娠,保证母婴健康。     

联合干预对妇女产后避孕的效果评价

产后近期意外妊娠对育龄妇女和婴儿的健康影响较大，由于产后哺乳的特殊性，再加上受传统观念的影响和产后避孕知识缺乏等，产后1年内人工流产率高于育龄妇女的平均水平[1]。目前国际上多利用产前检查、住院分娩、产后访视、产后检查和婴幼儿免疫接种时医务人员或专业培训人员为产妇提供产后避孕咨询、宣传教育、避孕措施落实等避孕服务[2]，取得一定效果。     

The quality of family planning services in rural China.

This article provides a preliminary analysis of three aspects of service quality in four rural counties in China--the availability of contraceptive methods, information given to users, and provider knowledge about methods. Contraceptive choice and characteristics of contraceptive use by women in the study areas are also examined. The data are derived from a survey carried out by the authors during 1987, under the auspices of China's State Family Planning Commission. The survey was conducted in four rural counties located in Fujian and Heilongjiang provinces. A total of 318 married women of reproductive age were randomly selected and interviewed. All family planning service sites serving the women were visited and a sample of service providers was interviewed. No shortage of contraceptives existed in any of the counties, but variations in community wealth and local procurement practices have resulted in the acquisition of an IUD with high failure rates. Although providers believe they inform women about method choices and side effects, women were poorly informed about the methods they selected. Not all providers who insert IUDs and distribute pills were knowledgeable about contraindications and side effects of the methods. Ever-use of contraception was nearly 100 percent, but most women, especially in Heilongjiang, have only used one method: the IUD or sterilization. Improvements in quality, especially in method mix, providers' level of knowledge, and the quality and quantity of information provided to users will likely improve contraceptive continuation, client satisfaction, and women's health.     

川渝农村地区避孕措施的使用及服务状况调查

目的:了解川渝农村地区避孕节育的使用和服务状况,探讨影响计划生育服务质量的因素并提出改进意见。方法:采用定性与定量研究方法,调查育龄妇女避孕措施使用情况,并对计划生育服务站的设施和服务进行调查。结果:育龄妇女普遍缺乏避孕知识,70％以上的育龄妇女选用宫内节育器避孕。技术人员很少提供避孕节育的咨询、随访服务;服务过程中存在忽视生殖道感染等问题。一些技术人员对避孕节育知识掌握片面或不正确,村计生专干难以对避孕药具使用者提供有效的咨询及随访工作。结论:为提高农村避孕节育优质服务水平,应在宣教中增加避孕节育知识新内容;加强对技术服务人员知识、咨询、随访方面的教育和培训;结合计划生育开展生殖健康服务。     

四川省农村育龄妇女避孕方法知情选择干预项目研究报告

目的:评价开展避孕节育知情选择活动对四川省农村育龄妇女的避孕节育知识和知情选择的知识、能力、态度和避孕行为等影响。方法:在四川省兴文县的2个乡开展持续1·5年的、以社区为基础、20~49岁的已婚育龄妇女为对象的干预性研究,干预活动包括组织社区宣传活动、发放宣传资料、播放录像带、组织讲座、面对面的宣传和开展同伴教育,分析干预效果。结果:干预组育龄妇女对避孕方法的使用、原理、优点、缺点得分明显高于对照组,且在干预后避孕方法使用率及使用避孕套的比例均高于干预前;避孕方法使用的最终决定者由干预前计划生育服务人员转变为干预后为本人。结论:集知识、信息、咨询与服务为一体的社区避孕节育知情选择干预项目的实施,可显著提高农村育龄妇女的避孕节育知识水平和她们选择避孕方法的能力。     

Correlates of visit regularity among family planning clients in urban Yemen

Contraceptive discontinuation has been an important issue in low contraceptive prevalence countries like Yemen. Religious and cultural factors might play a large role in barriers against contraceptive acceptance. This study revealed the characteristics of women who accepted contraception and the factors related to the regularity of visits to a clinic in Yemen.Women perceived that accepting contraception was against neither Islam nor their husband's attitudes. They rather paid attention to mother and child health. Regularity of visits was not related to socioeconomic or demographic factors, but was related to satisfaction with family planning services. This implies that different approaches are needed to promote `continuation' and `regular visits'.A population policy which promotes birth spacing for maternal health in accordance with cultural contexts should be an effective and acceptable strategy in Yemen. Regular visits could be prompted by increasing the quality of services, including communication between clients and providers about side-effects and alternative choices of methods.     

Is Effective Contraceptive Use Conceived Prenatally in Florida? The Association Between Prenatal Contraceptive Counseling and Postpartum Contraceptive Use

The objective of this study is to describe the prevalence of postpartum contraceptive use among women experiencing a live birth in Florida in 2004–2005. To examine the association between family planning counseling during prenatal care visits and the use of effective contraceptive methods among postpartum women. Matched data from Florida PRAMS and Vital Statistics were used (n = 3,962). Weighted logistic regression was used to determine the association between prenatal family planning counseling and effective postpartum contraceptive use. Odds ratios were adjusted for use of contraception prior to pregnancy, well-baby checkup, race, ethnicity, nativity, education, marital status, poverty level, stress before or during pregnancy, and parity. Women who reported discussing family planning with their prenatal care provider were more likely to use effective contraception postpartum (AOR: 1.5, 1.1–2.0) compared to women who did not report a discussion. Women who used contraception prior to pregnancy (AOR: 2.3, 1.7–3.2) and women who experienced no stress before or during pregnancy (AOR: 2.0, 1.2–3.4) were also more likely to use contraception in the postpartum period. A significant interaction was identified between family planning counseling during prenatal visits and maternal education. Stratum specific odds ratios for women who received prenatal family planning counseling were significant for women with less than high school education (AOR: 2.5, 1.3–5.1) and for women with high school education (AOR: 2.0, 1.2–3.4). Women reporting family planning counseling during prenatal care were more likely to use effective contraception postpartum. While women with high school or less than high school education levels benefited from prenatal family planning counseling, the greatest benefit was observed for women with less than high school education. Integrating family planning counseling into prenatal care may increase the use of effective contraceptive methods among postpartum women.     

医院服务提供者流产后服务现状

目的:了解郑州市医院服务提供者对流产后服务的知识、态度、行为及服务存在问题,为今后开展流产后服务提供科学依据。方法:采取整群抽样方式,对郑州市10家医院从事流产后服务的234名医护人员进行了调查,调查采用自填与询问相结合方式。结果:避孕方法知识水平较好者为72.2%,最需要的信息是如何生动进行计划生育宣教(70.94%)。仅有1.28%的服务提供者经常向流产妇女提供免费避孕药具。认为有必要向流产妇女提供避孕咨询服务和免费避孕药具的比例分别为89.75%和73.93%。对于今后推广实施流产后服务,认为亟需解决的问题依次是免费避孕药具的获得、妇女在流产手术后疼痛、能否抽出时间及计划生育宣教资料的获得等。结论:郑州市应加强对医院服务提供者的培训,提高医院服务提供者做好流产后服务的意识,计划生育和卫生部门应加强合作、共同推进流产后服务工作使其走向规范化。     

西安高校教工产后非意愿妊娠及相关因素调查

目的：调查西安高校教职工初产妇产后非意愿妊娠率和结局,以及避孕知识、需求及方法选择情况,为制定干预措施提供依据。方法采用自行设计的问卷,选择西安市4所非医学类本科高校教职工中2014年11月至2015年10月分娩的初产妇,于产后42天进行问卷调查其避孕知识与态度,于产后1年电话随访其避孕方法和非意愿妊娠情况,并进行分析。结果该时间段内分娩的初产妇共计277例,有效随访率为95．7％;调查对象对宫内节育器和安全套避孕法知晓率接近100％,但安全套正确用法知晓率仅为39．6％,其它避孕方法知晓率不足80％;对口服避孕药避孕法和口服药物紧急避孕混淆率高达77．7％;对自然分娩和剖宫产后放置宫内节育器的时间及哺乳期避孕法了解不足10％;绝大多数被调查者表示需要医务人员指导产后避孕知识;被调查者产后1年内意外妊娠率为9．4％。结论西安高校教职工初产妇产后避孕知识及方法认知水平较低且不全面,产后1年内意外妊娠发生率高达9．4％。多数初产妇对医务人员指导产后避孕知识需求迫切。医院、社区妇保及计划生育部门应加大健康教育指导水平和力度。     

Women on top: the relative influence of wives and husbands on contraceptive use in KwaZulu-Natal

OBJECTIVES: The purpose of this paper is to examine the relative influence of husband and wife on contraceptive practice. METHODS: A cross-sectional survey was conducted among adult men and women in KwaZulu-Natal, South Africa. A matched file for 238 married or cohabiting couples was created. RESULTS: Knowledge of methods of contraception was virtually universal and attitudes to contraception were favorable both in men and women. A substantial proportion of men and women reported using a method of contraception. The wife's desire to stop childbearing was the most powerful predictor of contraceptive use among couples, after adjustment for possible confounders. The husband's approval (or not) of family planning and his preference for future childbearing were not significantly related to contraceptive use. CONCLUSION: Contraceptive use within marital and cohabiting unions is high and the wife's fertility preference was found to be a key determinant of use. This conclusion challenges conventional wisdom that men are the dominant decision-makers in fertility and family planning decisions.     

Knowledge and use of contraceptive methods in rural Sereer,Senegal

This paper presents results from a retrospective survey carried out in a rural setting in Senegal (on 804 20-to-69-year-old men and 1,039 15-to-54-year-old women), and aims at improving the understanding of contraceptive knowledge and practice. Contraceptive knowledge was measured through spontaneous and recognized contraceptive methods; contraceptive practice was measured through the past and present use of contraception. The gap between spontaneously-cited methods and recognized methods is important. While about 80% of men and 70% of women had ever heard about any contraceptive method, only 46% of men and 23% of women could spontaneously mention a specific contraceptive method (respectively 33% and 17% mentioned a modern method). Analyses have shown that individual characteristics such as age, education, migration are all determinants of contraceptive knowledge. Married men and women are more likely to know about methods such as the pill, intra-uterine device (IUD) and injections, as a result of family planning campaigns, which have focused on these methods and targeted married women. Nevertheless, contraceptive practice is still low. Only 16% of men and 4% of women have ever used any method. Contraceptive prevalence (current use) of women is only 1.9% for all methods and 1.5% for modern methods. The more widespread use of condoms by young men (about 30% of single men have ever used a condom, against only 7% of ever married men) reflects its recent diffusion associated with a decrease in male age at first intercourse. The low contraceptive use by women reveals their lack of accessibility to contraception. Young generations are not able to find an adequate answer to their needs in the villages, where family planning still targets marital contraception. Recommendations are formulated in order to integrate adolescents more fully in policy programs.     

上海市流动人口节育模式的分析

１９９８年２月１６日至４月３日对上海市闵行区虹桥、梅陇两镇流动人口中育龄妇女的避孕节育现状、意愿进行了全面调查。研究结果表明,两地８４３例已婚育龄妇妇使用的避孕节育方法中宫内节育器居首位,占６８．１０％,绝育占２３．６０％,口服药占４．２％,其他避孕方法占４．００％,避孕率８８．６９％。已婚育龄妇女对现用避孕方法满意的占９４．３％,不同避孕方法的满意程度差别有显著性意义（Ｐ＝０．００１）,绝育、宫