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Julie H Hernandez, Pierre Akilimali, Annie Glover, Rebecca Emel, Albert Mwembo, Jane Bertrand
OBJECTIVES: To document the experience of three groups of Family Planning service providers participating in task-shifting for the provision of subcutaneous depot-medroxyprogesterone acetate (DMPA-SC) at the community level in the DRC. STUDY DESIGN: This article compares results from interviews with DMPA-SC providers in two separate pilot studies: 1) 53 medical and nursing school students teaching women how to self-inject (2016-2017); and 2) 34 lay community health workers providing DMPA-SC in rural areas of Lualaba (2017)...
July 18, 2018: Contraception
Luciana E Hebert, Brandon J Hill, Michael Quinn, Jane L Holl, Amy K Whitaker, Melissa L Gilliam
OBJECTIVE: To evaluate the effect of miPlan, a waiting-room contraceptive counseling mobile application (app), on interest in discussing long-acting reversible contraception (LARC) during the clinical encounter and LARC uptake. STUDY DESIGN: This randomized controlled trial evaluated the miPlan contraceptive counseling app. African American and Latina young women ages 15 to 29years attending four family planning clinics in a large Midwestern city were randomized to either: 1) use miPlan (intervention) prior to the contraceptive clinic visit or 2) contraceptive clinic visit alone (control)...
July 10, 2018: Contraception
Stephanie A Kung, Biani Saavedra-Avendano, Evelyn Aldaz Vélez, María Consuelo Mejía Piñeros, Gillian M Fawcett Metcalfe, Blair G Darney
OBJECTIVE: No standard exists to measure religiosity in abortion studies. We test whether religiosity is associated with support for abortion among Mexican Catholics and whether different measures of degree of Catholicism alter the relationship. STUDY DESIGN: We conducted a nationally representative cross-sectional study using survey data from 2669 self-identified Mexican Catholics (response rate 85%). Our three outcomes were 1) overall support for legal abortion and support for abortion under exceptions, grouped as having 2) traditionally high agreement (rape, life) and 3) low agreement (on demand, socioeconomic)...
June 26, 2018: Contraception
Bethany G Everett, Jessica N Sanders, Kyl Myers, Claudia Geist, David K Turok
OBJECTIVES: To estimate the prevalence of sexual-minority women among clients in family planning centers and explore differences in LARC uptake by both sexual identity (i.e., exclusively heterosexual, mostly heterosexual, bisexual, lesbian) and sexual behavior in the past 12months (i.e., only male partners, both male and female partners, only female partners, no partners) among those enrolled in the survey arm of the HER Salt Lake Contraceptive Initiative. METHODS: This survey categorized participants into groups based on reports of sexual identity and sexual behavior...
June 26, 2018: Contraception
Alexis Light, Lin-Fan Wang, Alexander Zeymo, Veronica Gomez-Lobo
OBJECTIVES: Female-to-male (FTM) transgender men (affirmed males) can experience planned and unplanned pregnancy during and after testosterone therapy. We conducted an exploratory study to understand current contraceptive practices and fertility desires among transgender men during and after transitioning. STUDY DESIGN: Self-identified transgender and transmasculine individuals assigned female at birth, ages 18-45, completed an anonymous online survey derived from standardized family planning surveys...
June 23, 2018: Contraception
Emily M Godfrey, Imara I West, John Holmes, Gina A Keppel, Laura-Mae Baldwin
OBJECTIVE: To evaluate the ability of electronic health record (EHR) data extracted into a data-sharing system to accurately identify contraceptive use. STUDY DESIGN: We compared rates of contraceptive use from electronic extraction of EHR data via a data-sharing system and manual abstraction of the EHR among 142 female patients ages 15-49years from a family medicine clinic within a primary care practice-based research network (PBRN). Cohen's kappa coefficient measured agreement between electronic extraction and manual abstraction...
June 21, 2018: Contraception
Sarah Averbach, Mahesh Puri, Maya Blum, Corinne Rocca
OBJECTIVE: To evaluate whether conducting a bimanual examination prior to medication abortion (MAB) provision results in meaningful changes in gestational age (GA) assessment after patient-reported last menstrual period (LMP) in Nepal. STUDY DESIGN: Women ages 16-45 (n=660) seeking MAB at twelve participating pharmacies and government health facilities, between October 2014 and September 2015, self-reported LMP. Trained auxiliary nurse midwives assessed GA using a bimanual exam after recording LMP...
June 21, 2018: Contraception
Shifu Hu, Yingying Wang, Dandan Ke, Fang Zhou, Guiping Cheng, Heyu Liu, Wei Xia, Changhong Zhu
Objective(s) This study aimed to determine whether intrauterine placement of a novel composite material [copper (Cu) microparticles, low-density polyethylene, and methyl vinyl silicone rubber (Cu/LDPE/MVQ)] could prevent pregnancy in rabbits, and to evaluate the effects of Cu/LDPE/MVQ on the endometrial environment STUDY DESIGN: Eighty sexually mature female rabbits were randomly divided into four groups (n = 20 each group): control (sham-operated), LDPE/MVQ, Cu/LDPE/MVQ microcomposite, and bare Cu. Ten rabbits from each implant-bearing group were randomly selected for a mating experiment beginning 30 days after insertion...
June 20, 2018: Contraception
Kristiana Lehn, Linda Gu, Mitchell D Creinin, Melissa J Chen
OBJECTIVE: Evaluate completion of partial or total salpingectomy during Cesarean delivery based on intended procedure. STUDY DESIGN: We conducted a retrospective study of women who had a permanent contraception procedure during Cesarean delivery at an urban, academic hospital from November 2015 through April 2017. We reviewed all charts of women who had a Cesarean delivery to identify those who underwent concomitant tubal surgery, including both completed and attempted procedures...
June 20, 2018: Contraception
Nancy Z Fang, Jeanelle Sheeder, Stephanie B Teal
OBJECTIVE: The objective was to identify predictors of postabortion long-acting reversible contraception (LARC) initiation to increase providers' understanding of motivators of contraceptive choices. STUDY DESIGN: We prospectively enrolled a cohort of women having abortions at <13 weeks' gestational age who were eligible to receive no-cost contraceptive methods immediately postprocedure (N=1662) to evaluate the demographic and reproductive factors associated with choosing and receiving a long-acting contraceptive versus a short-acting method...
June 11, 2018: Contraception
C Berger, N Boggavarapu, E Norlin, S Queckbörner, K Hörnaeus, A Falk, M Engman, M Ramström, P G L Lalitkumar, K Gemzell-Danielsson
OBJECTIVE: The progesterone receptor modulator (PRM) Mifepristone hold the potential to be developed for regular contraception. However, long-term treatment can cause thickening of the endometrium and PRM associated endometrial changes (PAEC). The objective of this study was to explore the molecular expression of endometrium displaying PAEC after mifepristone treatment, in order to understand the future implications of PAEC and safety of long-term use. STUDY DESIGN: Endometrial biopsies were obtained from pre-menopausal women following three months of continuous mifepristone treatment...
June 8, 2018: Contraception
Holly M Burke, Mario Chen, Mercy Buluzi, Rachael Fuchs, Silver Wevill, Lalitha Venkatasubramanian, Leila Dal Santo, Bagrey Ngwira
OBJECTIVE: To describe women's experiences with subcutaneous depot medroxyprogesterone acetate (DMPA-SC) to inform scale-up of self-administered DMPA-SC. STUDY DESIGN: We conducted a 12-month randomized controlled trial in Malawi to measure DMPA-SC continuation rates. A total of 731 women presenting at six Ministry of Health clinics or to community health workers (CHWs) in rural communities were randomized to receive DMPA-SC administered by a provider or be trained to self-inject DMPA-SC...
June 8, 2018: Contraception
Lawrence B Finer, Laura D Lindberg, Sheila Desai
OBJECTIVE: To describe a new measure, the unintended pregnancy risk index (UPRI), which is based primarily on attitudinal and behavioral measures of women's prospective pregnancy desire, and compare it to the unintended pregnancy rate, typically calculated retrospectively. STUDY DESIGN: We used three rounds of the National Survey of Family Growth to calculate trends in the UPRI and compare it to the retrospective rate. The UPRI estimates the annual risk of becoming unintentionally pregnant, on a scale from 0 to 100...
June 4, 2018: Contraception
Jennifer R Amico, Ariana H Bennett, Alison Karasz, Marji Gold
OBJECTIVE: This study describes the perspectives of patients and providers about intrauterine device (IUD) self-removal. STUDY DESIGN: This qualitative study is a subanalysis of two datasets from a single project, which included semistructured individual interviews with 15 patients and 12 physicians. We derived the data for this analysis from portions of the interviews pertaining to IUD self-removal and provider removal. We analyzed data using deductive and inductive techniques to perform content and thematic analyses...
June 2, 2018: Contraception
Maria Catrina Jaime, Abeer Yakzan, Carrie Lewis, Eleanor Bimla Schwarz
OBJECTIVE: College students are known to experience unintended pregnancy and seek abortions. However, few student health centers currently offer abortion services. In this exploratory study, we aimed to expand understanding of student perspectives regarding on-campus abortion services. STUDY DESIGN: We invited UC Davis students to complete an anonymous web-based survey using 16 campus listservs and in-person recruitment. We elicited student knowledge of and opinions about on-campus Student Health and Counseling Services (SHCS) with 29 questions...
May 31, 2018: Contraception
Laura Di Giorgio, Mercy Mvundura, Justine Tumusiime, Allen Namagembe, Amadou Ba, Danielle Belemsaga-Yugbare, Chloe Morozoff, Elizabeth Brouwer, Marguerite Ndour, Jennifer Kidwell Drake
OBJECTIVE: To evaluate the 12-month total direct costs (medical and nonmedical) of delivering subcutaneous depot medroxyprogesterone acetate (DMPA-SC) under three strategies - facility-based administration, community-based administration and self-injection - compared to the costs of delivering intramuscular DMPA (DMPA-IM) via facility- and community-based administration. STUDY DESIGN: We conducted four cross-sectional microcosting studies in three countries from December 2015 to January 2017...
May 30, 2018: Contraception
Jocelyn M Wascher, Luciana E Hebert, Lori R Freedman, Debra B Stulberg
OBJECTIVES: Catholic healthcare limits access to common reproductive care. We assessed what percentage of US women seeking care at Catholic hospitals are aware of their hospital's religious affiliation and identified variables associated with correct identification. STUDY DESIGN: We conducted a national survey of women ages 18-45 (response rate 50%). The survey asked participants what hospital they would go to for reproductive care and what the religious affiliation of that hospital was...
May 29, 2018: Contraception
David Hubacher, Megan Kavanaugh
No abstract text is available yet for this article.
May 26, 2018: Contraception
Rachel K Jones
OBJECTIVES: To assess factors associated with pregnancy fatalism among U.S. adult women. STUDY DESIGN: I used data from the Change and Consistency in Contraceptive Use study, which collected information from a national sample of 4634 U.S. women aged 18-39 at baseline (59% response rate). I assessed pregnancy fatalism based on agreement with the statement: "It doesn't matter whether I use birth control, when it is my time to get pregnant, it will happen." I compared fatalism among all respondents to fatalism among respondents who were trying to get pregnant and those who did not want to get pregnant but were not using contraception...
May 21, 2018: Contraception
Mary Tschann, Jennifer Salcedo, Reni Soon, Bliss Kaneshiro
OBJECTIVE: To determine if offering patients a choice of adjunctive nonpharmacologic pain management during first-trimester aspiration abortion results in lower pain scores when compared with standard care. STUDY DESIGN: We enrolled women receiving first-trimester aspiration abortion at the University of Hawaii. We randomized patients to standard care (control) or standard care plus a choice of nonpharmacologic pain management options (intervention). Standard care was ibuprofen 800 mg orally at least 30 min preprocedure, lidocaine paracervical block and anticipatory guidance from the provider...
May 21, 2018: Contraception
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