人工流产妇女避孕知识、避孕方法使用现状及避孕失败原因初探

目的:了解人工流产妇女避孕知识及避孕方法使用现状。方法:对本院519例接受人工流产妇女进行横断面问卷调查。结果:64.9%的妇女本次妊娠是由于未采取避孕措施;35.1%的妇女本次妊娠是由于避孕失败。本次研究中,避孕套(92.7%)和避孕药(90.1%)的知晓率最高,知道避孕套如何正确使用的比率也最高(81.9%)。而避孕膜的知晓率(7.9%)和正确使用率(2.3%)均最低。在168例因避孕失败而导致本次妊娠的育龄女性中,最常用的避孕方法依次是避孕套(41.1%)、避孕药(19.1%)、紧急避孕药(14.3%)、安全期避孕(13.1%)。调查显示:婚姻状况、性伴学历、文化程度、职业、收入因素都对人工流产妇女的避孕知识和既往避孕行为产生不同程度的影响。结论:人工流产妇女对避孕知识的认知程度较低,对很多避孕方法的正确使用也知之甚少,应加强避孕知识的宣传教育,尤其是文化层次较低者和学生中,提高对意外妊娠风险的认识。     

上海市长宁区未婚流动人口的避孕措施使用状况及其影响因素

目的:了解未婚流动人口的避孕措施使用状况及其影响因素。方法:采用结构式匿名问卷对上海市长宁区新泾镇1092名15～24周岁未婚流动人口的性与生殖健康知识、态度、行为和避孕措施使用状况等进行调查。结果:有22.6%的对象自我报告有性经历,男女性经历比例分别为34.8%和12.7%。9.4%的对象曾经怀孕或使其性伴怀孕,男女分别为13.7%和6.0%。其中,1/3的对象或其性伴有过2次及2次以上的妊娠。怀孕的主要原因为未避孕(54.4%)。仅7.3%的对象坚持每次性生活都使用避孕措施,21.1%的对象从未使用过避孕措施。59.8%的对象首次性行为时未使用避孕措施。使用最多的避孕方法为避孕套(76.4%),其次是口服避孕药(34.4%)、安全期(33.3%)和体外排精(30.3%)。避孕药具主要来源于药店(60.5%)。不避孕或未坚持使用避孕的主要原因是因为“偶尔的性生活不会怀孕(36.7%)”、“通常性生活是在无思想准备情况下发生(24.0%)”“不懂得避孕(17.5%)”及“不好意思买/要避孕药具(16.2%)”等。多因素分析结果提示,月平均收入较高、在上海居住时间较短、避孕知识得分较高者避孕使用频率较高;文化程度较高、服务行业职工、避孕知识得分较高、与媒体接触较多者避孕套使用比例较高。结论:未婚流动人口的避孕措施使用率低,提高他们的避孕知识水?     

无痛人工流产者避孕知识与行为的调查

目的:了解无痛人工流产者对避孕知识的知晓程度与实际使用情况及影响因素。方法:采用横断面调查的方法,对因非意愿妊娠而自愿要求无痛人工流产者进行面对面的问卷调查,探究她们对于避孕方法的知与行的异同及其原因,并采用单因素和多因素非条件Logistic回归法分析每种避孕方法使用情况的影响因素。结果:在609名无痛人工流产者中,平均年龄为28.3±5.2岁,重复人工流产率为50.1%,首次性生活年龄为22.0±2.8岁。知道≥3种避孕方法者占95%以上。对某种避孕方法,使用者与知晓者的比例总体上从高到低顺序为避孕套(91.0%)、紧急避孕药(71.2%)、安全期(63.3%)、体外排精(58.8%)、杀精剂(21.1%)、口服避孕药(OC)(19.2%)、宫内节育器(IUD)(8.9%);目前使用者与曾经使用者的比例总体上从高到低顺序为安全期(83.4%)、避孕套(79.0%)、体外排精(71.2%)、杀精剂(50.0%)、紧急避孕药(36.1%)、IUD(11.4%)、OC(10.0%)。IUD和OC的停用和不愿使用的比例较高,主要原因是顾虑其副作用。未婚无分娩史者对安全期、体外排精、IUD和OC的知晓率较低,有分娩史者使用安全期、避孕套和IUD的比例最高,使用OC的比例最低;年龄、收入、流产次数对未婚无分娩史者选用避孕方法的影响比较大。结论:妇女对避孕方法的知晓度较高,但多未使用高效的避孕方法,避孕失误多,应加强流产后服务及避孕知情选择工作,指导妇女正确地选择和使用避孕方法,提高避孕效率。     

上海市城区产后妇女意外妊娠及影响因素分析

目的:了解上海市城区产后妇女意外妊娠的发生及其影响因素。方法:通过结构式问卷,对1767名产后1-2年妇女的产后意外妊娠情况进行调查。结果:产后第1年和第2年意外妊娠发生密度分别为4.64/100人年和6.57/100人年。产后性生活恢复、避孕开始、母乳喂养和产后闭经的中位时间分别为产后4个月、5个月、6个月和4个月。产后妇女最常用的3种避孕措施为避孕套、安全期和体外排精。产后1年内意外妊娠单因素分析显示:不同年龄组、文化程度、户籍、产后性生活开始早晚、母乳喂养及闭经时间长短间意外妊娠的发生密度差异有统计学意义(P<0.05)。多元Cox逐步回归分析显示,产妇年龄越大、母乳喂养时间越长、性生活开始时间越晚,产后1年内意外妊娠发生的风险越小;而外来人口意外妊娠发生的风险高于户籍人口。结论:产后妇女避孕开始滞后于性生活恢复,大多使用避孕效果相对不太稳定的避孕方法。外来人口、年轻产妇、产后开始性生活较早、母乳喂养时间较短的人群是产后1年内意外妊娠的高危人群。产后应尽早落实可靠的避孕措施及加强避孕套正确使用的宣教。     

孕妇产后的避孕意愿及其影响因素

本文对上海市黄浦区、普陀区、青浦县、奉贤县 40 37名孕妇对产后避孕意愿及影响因素进行了分析。结果显示 :79.96 %的妇女考虑产后避孕。2 5～ 2 9岁的妇女较其它年龄段的妇女考虑产后避孕的比例要高。产后避孕意愿与本人文化程度及职业无关 ,而亲戚朋友的文化程度对产后避孕意愿有影响。工作单位要求在 1年内落实避孕措施、接受过有关避孕知识教育或为此进行咨询或查阅书籍的妇女考虑产后使用避孕方法的比例较高。单位或计划生育部门建议使用的避孕方法以宫内节育器最高 ,占 97.1 4% ,避孕套仅为 1 .0 2 % ;妇女自我选择的避孕方法中宫内节育器为多 ,占 82 .34% ;其次为避孕套 ,占 1 1 .2 1 %。 L ogistic回归分析表明 :年龄、文化程度、职业、家庭收入等对产后避孕意愿影响不大。产后愿意哺乳者、接受过避孕教育、咨询或查阅书籍者、了解避孕知识年龄较小者、知晓宫内节育器者对产后避孕意愿有正面作用。建议在计划生育服务中 ,今后需加强产后避孕教育 ,开展各种避孕方法知情选择的教育和咨询 ,指导妇女在产后选择最适合于自己的避孕方法 ,从而减少产后意外妊娠的发生     

婚前避孕措施使用状况及其影响因素分析

本文对上海市7872对新婚夫妇婚前,包括结婚登记前和结婚登记至办婚礼期间(简称举办婚礼前,下同)避孕措施的使用状况作了分析。结果表明,结婚登记前和婚礼前,分别有12.3%和15.4%的夫妇有过性行为,其中分别有35.2%和23.7%的夫妇使用过避孕措施。最常使用的避孕措施为安全期、避孕套和体外排精。避孕失败率分别为33.7%和18.0%。避孕失败的最重要原因是安全期计算失误和体外排精失控。结婚登记前不使用避孕措施的主要原因是缺乏避孕知识和无法获得药具。影响夫妇在结婚登记前和婚礼前使用避孕措施的因素有:妻子的避孕知识分数、与他人谈论避孕的能力、夫妇的晚育意愿,发生性行为距结婚登记或距办婚礼的时间间隔。本文对婚前使用的避孕药具的来源及对避孕知识的了解途径也作了分析。调查表明,加强对未婚青年(包括已领取结婚证但尚未办婚礼的夫妇)避孕知识的宣教和避孕药具的发放是必要的。     

上海市已婚妇女初产后避孕方法的选择和转换

本文对上海市3701名已婚妇女初产后15个月内避孕方法的选择和转换进行了分析,分析结果表明：产后15个月内,95．46％的妇女采取过避孕方法。产后首次采取的避孕方法城市以避孕套（50．72％）和IUD（29．09％）为主,农村以IUD（56．65％）和避孕套（30．60％）为主,其它方法较少。首次避孕选择避孕套者,终止向IUD的转换率较高;而选用IUD者终止向其它方法的转换率较低。15个月随访时,94．54％的妇女正在使用某种避孕方法,其中60．76％的城市妇女71．07％的农村妇女正在使用IUD。多项分类Logistic回归分析结果表明不同特征的妇女对避孕方法的选择存在很大差异,城市、文化程度高的妇女倾向于选用避孕套和安全期,较少选用口服药;年龄大的妇女使用避孕套和安全期的人要多些;正在哺乳的妇女不愿用口服药;单位或计划生育部门对产后选用何种避孕方法有推荐意向的妇女使用IUD的比例较高。提示计划生育管理部门应根据妇女的不同特征耐心、细致、客观地向她们说明各种避孕方法的优点和缺点,需纠正社会上对一些避孕方法的偏见。应充分尊重妇女的避孕选择,使妇女自觉满意地实行计划生育。     

人工流产妇女非意愿妊娠的原因及可预测妊娠的比例分析

根据对上海市三所妇幼保健院 6 0 6名人工流产妇女的调查资料 ,分析了人工流产妇女非意愿妊娠的原因及可预测妊娠的比例。结果表明 ,人工流产对象中 98.1 8%为非意愿妊娠 ,其中 6 3.70 %为可预测的妊娠。已婚对象非意愿妊娠的主要原因是避孕失败 (73.1 % ) ,其中以安全期失败、体外排精失败和避孕套破裂或脱落为多 ;未婚对象非意愿妊娠的主要原因为未用或未坚持用避孕措施 (5 5 .4% ) ,而未用措施的主要原因是认为自己不会怀孕。意愿妊娠对象做人工流产的主要原因是优生 ,非意愿妊娠中已婚无子女对象的人工流产原因则主要是想晚点生育及工作学习的需要。本文提示 ,提高妇女的避孕措施使用率 ,鼓励对象使用效果可靠的避孕措施及推广紧急避孕法是降低人工流产的三个重要环节     

人工流产妇女紧急避孕知识及其影响因素

目的:了解非意愿妊娠妇女对紧急避孕知识的认知程度。方法:对本院519例接受人工流产妇女进行问卷调查。结果:有效问卷502份,81.9%的妇女有一定的紧急避孕知识,但只有65.5%的妇女曾使用过紧急避孕方法,19.1%的人工流产妇女曾有紧急避孕失败史。多数被调查对象知道的是激素类紧急避孕药(75.6%),但其中只有59.4%的被调查者知道同一周期不能2次及以上使用紧急避孕药;高达46.0%者获取紧急避孕药时未被告知如何使用。妇女的文化程度高、已婚者、曾使用过紧急避孕药及获得紧急避孕药时被告知如何使用者,紧急避孕知识较好。结论:应加强紧急避孕知识的宣教,尤其是未婚、文化程度低者,以减少意外妊娠的发生。     

产后妇女避孕节育干预与效果评价

目的:评价在上海市静安区产后妇女中进行避孕节育干预对提高产后避孕率并降低产后意外妊娠的效果。方法:对居住在静安区的产后1年内已婚妇女进行避孕服务干预,并于干预前和干预后进行问卷调查。结果:干预后0~3个月、4~6个月、7~9个月和9个月以上各时段避孕率均显著高于干预前,尤其是在有性生活的产后妇女中,产后的前6个月累积避孕率从干预前的58.9%提高到干预后的97.6%。产后1年内意外妊娠发生率为1.4%,意外妊娠主要原因为未避孕和避孕套、安全期避孕失败。结论:产后定期避孕干预能有效提高产后1年内妇女的避孕率,降低产后妇女意外妊娠率。     

上海闵行区人工流产女性避孕知识的调查与分析

目的:了解人工流产女性的避孕状况,为进一步实施干预、提高育龄妇女生殖健康水平提供依据。方法:面对面问卷访谈,收集和了解要求人工流产女性术前避孕知识、避孕情况等信息进行分析,提出应对措施。结果:726例人工流产访谈女性多数为已婚(75.48%);一次以上的重复流产达57.99%,未婚人工流产占24.52%。未采取避孕措施(51.38%)或避孕失败(48.62%)是导致意外妊娠的主要原因。访谈对象对避孕套、口服避孕药、宫内节育器有所知晓,但对其他避孕方法知之甚少。访谈对象中知道免费提供避孕药具专门机构者仅35.54%。结论:降低重复流产和未婚人工流产是当务之急。对此,需要广泛、持久、深入开展计划生育健康教育,提高育龄人群避孕意识、避孕知识水平。同时,需要加强人工流产后生殖保健服务。     

天津市18～49岁已婚者避孕情况的心理因素调查

本文调查了1211名18～49岁已婚成年人包括工人、干部和科技人员对避孕问题的心理活动。其中男性601人,女性610人。结果显示:80%已婚成年人至少知道五种避孕方法如避孕套、口服避孕药、宫内节育器、男性绝育和女性绝育。3.8%的人知道埋植和输卵管粘堵。只有0.7%的人对避孕方法一无所知,这些人多为新婚夫妇。研究还表明,最受欢迎的避孕方法是宫内节育器、避孕套和安全期。工人偏爱宫内节育器,科技人员偏爱避孕套。口服药是最不受欢迎的方法,多由于它的副作用影响。93.6%的被调查者对绝育持否定态度。仅6.4%的人主张这一方法,他们主要是科技人员和干部。     

Misperceptions about contraceptives keep abortion incidence high in Ghana

Only 13% of couples in Ghana practiced contraception in 1988. During the period of nursing following childbirth, it is traditional for the new mother to abstain from sexual intercourse. She is subject to considerable social scorn should she conceive too soon after a previous delivery. Conceiving in short order, nonetheless, women long resorted to clandestine, unsafe abortions during the postpartum interval. The government of Ghana legalized the practice of induced abortion in 1985 so that women could limit their fertility in safety with registered and certified medical practitioners. The author studied 900 women seeking an induced abortion or reporting complications resulting from induced abortion performed outside a hospital setting to see why, in spite of high knowledge of contraception, Ghanaian women resort to abortion instead of using contraception. Subjects were recruited from the KorleBu Teaching Hospital in Accra, the Tema General Hospital of Tema, the Nsawam Hospital of Nsawam, and two abortion clinics in Accra. 55% were married, 25% were teenagers, and 56% were residents of Accra, while the rest were from rural areas. Among those who were married, 45% were the third wives. Most of the women had some formal education and some degree of economic independence. 99% knew of at least one method of contraception, only 21% had ever used a modern method, 6% had used a condom, 4% had used withdrawal sometimes, and 3% had used the rhythm method. The women reported not using modern contraceptives mainly because of the belief that they cause harmful side-effects. For example, it was commonly thought that the oral contraceptive pill causes infertility and withdrawal causes stroke in men. Women also viewed contraceptives as messy, complicated, and/or difficult to use. 54% said they decided to abort their fetus because the pregnancy was out of wedlock; single parenthood is stigmatized in Ghana. 25% decided to abort to better space their children.     

Current status of contraceptive use among rural married women in Anhui Province of China

Objectives  This study aims to explore the current status of married women in regard of their use of contraceptive methods (permanent methods versus non-permanent methods) and to find out factors that affect the use of contraceptive methods in rural areas of Anhui Province of China.
Design  Survey.
Setting  Anhui, China.
Population  A total of 53,652 married women aged 18–49 years.
Methods  A multistage probability sampling method was used to identify a representative sample of 53,652 married women aged 18–49 years. All women were asked to provide detailed information by completing detailed questionnaires.
Main outcome measures  Contraceptive prevalence and influence factors.
Results  The total birth control rate of the sample was 95.2%. Samples choosing the permanent and nonpermanent contraceptive methods have taken up 46.7 and 48.5% respectively. Female sterilisation was the first choice with a usage rate of 43.6%, followed by intrauterine device (IUD), which was used by 41.1% of samples. Single-variable analysis showed that the choice of contraceptive methods was associated with age, education level, parity, frequency of sex intercourses in a month, contraceptive knowledge, RTI symptom and the gender of the last child of rural married women.
Conclusions  A significant increase in contraceptive use of rural married women in Anhui Province of China. Female sterilisation and IUD still play the dominant role. Effective family planning methods should be advocated through adequate counselling on the correct use and proper management, with consideration of the background of custom and belief.     

Effect of breast-feeding on postpartum menstruation, ovulation, and pregnancy in Alaskan Eskimos

A study compared postpartum conception, menstruation and ovulation o f 299 Alaskan Eskimo female noncontraceptive users of which 242 nursed t heir infants and 57 did not with a control group of 115 women who were newly married or who had discontinued contraceptive use. 2 factors were found to differentiate nursing from nonnursing women in relation to postpartum conception as follows: the annovulatory period of postpartum amenorrhea is longer for nursing than for nonnursing women and the number of annovulatory cycles after menstruation recurs is greater for the former than for the latter. A comparison of pregnancy probability r ates for controls with those nursing and nonnursing women showed that the control had a significantly higher probability rate of pregnancy than did those in the adjusted groups for the first 6 months with the nursers and for months 2 through 6 for the nonnursers. Conception rates were under 10% in women breast-feeding for at least 9 months whereas about 75% of the nonnursing women were pregnant within a similar period of time. Life-table analyses of pregnancy probability rates indicated that on the average the anovulatory period post amenorrhea was 3 months for nonnursing and 4 months for nursing women. The consistency of these findings with those reported for Indian women suggest that the physiologic effect of nursing on conception rates is independent of climate.     

Contraceptive prevalence among young women in Nigeria.

In almost all societies in the world there is an increase in sexual activity among young persons (10-24 years). There is a need for contraceptive use among them to prevent high risk unintended pregnancies. This study was carried out to determine the contraceptive prevalence among young women in Nigeria. The study population was 832 young women between the ages of 15 and 24 years. Only 11.1% of the respondents had ever used contraceptives although 63.2% of them had had sexual intercourse. Contraceptive usage was significantly higher (p<0.05) among the single sexually active women (38.5%) than among the married women (7.7%). Only 7.3% of respondents are currently using a contraceptive method. The main methods in use were condoms and pills. There is an unmet need for contraceptives among young women in Nigeria. It is necessary to improve these young women's abilities to protect themselves against unwanted pregnancies.