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Elizabeth G Raymond, Tara Shochet, Hillary Bracken
OBJECTIVES: To summarize data on the accuracy and acceptability of a strategy for identifying ongoing pregnancy after medical abortion treatment using a low-sensitivity pregnancy test (LSPT). STUDY DESIGN: We searched PubMed to identify studies that evaluated the use of a single post-treatment LSPT for detection of ongoing pregnancy after treatment with mifepristone and misoprostol. We extracted, assessed, and summarized data from each study. RESULTS: We found 10 studies that evaluated 6 LSPTs with human chorionic gonadotropin detection thresholds of 1000, 1500, or 2000 mIU/ml...
March 10, 2018: Contraception
Craig J Heck, Stephanie A Grilo, Xiaoyu Song, Tom Lutalo, Neema Nakyanjo, John S Santelli
OBJECTIVE(S): Covert contraceptive use (CCU) is the use of family planning without a partner's knowledge. This study sought to examine CCU prevalence among women living in Rakai, Uganda, predictors of CCU, and why women resort to CCU. STUDY DESIGN: We used data from women (15-49years) currently using contraceptives (oral contraceptives, Depo Provera, implants, intrauterine devices, and periodic abstinence) during Round 15 (2011-2013) of the Rakai Community Cohort Survey (n=2206)...
March 4, 2018: Contraception
Katrina Kimport, Rebecca Kriz, Sarah C M Roberts
OBJECTIVES: Investigations into Crisis Pregnancy Centers (CPCs) have documented the provision of deceptive information about abortion, but it is unclear how many pregnant women actually visit CPCs and what impact visits have on their pregnancy decision-making. STUDY DESIGN: We conducted a mixed methods study. We surveyed patients at one of two local abortion clinics and three prenatal clinics in Southern Louisiana about whether they had visited a CPC for this pregnancy and conducted in-depth interviews with prenatal patients who reported a CPC visit about their experience...
March 2, 2018: Contraception
Katherine A Ahrens, Marie Thoma, Casey Copen, Brittni Frederiksen, Emily Decker, Susan Moskosky
BACKGROUND: The relationship between unintended pregnancy and interpregnancy interval (IPI) across maternal age is not clear. METHODS: Using data from the National Survey of Family Growth, we estimated the percentages of pregnancies that were unintended among IPI groups (<6, 6-11, 12-17, 18-23, 24+ months) by maternal age at last live birth (15-19, 20-24, 25-29, 30-44years). RESULTS: Approximately 40% of pregnancies were unintended and 36% followed an IPI<18months...
March 1, 2018: Contraception
Melissa J Chen, Jennifer K Hsia, Mitchell D Creinin
OBJECTIVE: We evaluated a novel concept of initiating the etonogestrel implant as a "back-up" method in women who desire using combined oral contraceptives (COC) but want to decrease their risk of unintended pregnancy with a more effective method. STUDY DESIGN: In this prospective cohort study, we planned to include 20 women as a proof-of-concept. We enrolled both new COC starters and continuing COC users and placed an etonogestrel implant. Participants completed daily bleeding diaries and attended follow-up visits at 1, 3, and 6 months...
February 26, 2018: Contraception
Kavita Shah Arora, Barbara Wilkinson, Emily Verbus, Mary Montague, Jane Morris, Mustafa Ascha, Brian M Mercer
OBJECTIVE: We sought to assess fulfillment of sterilization requests while accounting for the complex interplay between insurance, clinical, and social factors in a contemporary context that included both inpatient and outpatient postpartum sterilization procedures. STUDY DESIGN: This is a retrospective single-center cohort chart review study of 1331 women with a documented contraceptive plan at time of postpartum discharge of sterilization. We compared sterilization fulfillment within 90days of delivery, time to sterilization, and rate of subsequent pregnancy after non-fulfillment between women with Medicaid and women with private insurance...
February 25, 2018: Contraception
Ellen Laan, Yvette Zimmerman, Rik H W van Lunsen, Hanneke M M Termeer, Nicole Appels, Bart C J M Fauser, Herjan J T Coelingh Bennink
OBJECTIVES: To evaluate the effect of combined oral contraceptives (OCs) on sexual function, either alone or together with DHEA. STUDY DESIGN: An exploratory randomized, double-blind, placebo-controlled, comparative, crossover study was conducted in 81 OC users. Subjects discontinued their OC for one cycle before being randomized for 10cycles to a 30μg ethinyl estradiol (EE)/levonorgestrel (LNG) OC or a 30μg EE/drospirenone (DRSP) OC, along with daily use of 50mg dehydroepiandrosterone (DHEA) or placebo during 5 OC cycles before crossing over from DHEA to placebo or the reverse for another 5cycles...
February 25, 2018: Contraception
Katherine Whitehouse, Tiana Fontanilla, Leslie Kim, Mary Tschann, Reni Soon, Jennifer Salcedo, Bliss Kaneshiro
OBJECTIVE: Our objective was to document current practices of abortion providers on the use of medications to decrease bleeding during surgical abortion. STUDY DESIGN: We emailed surveys to 336 abortion providers through a professional listserv to elicit information on their use of medications to prevent and treat bleeding during first- and second-trimester surgical abortion. RESULTS: One hundred sixty-eight (50%) providers responded to our survey...
February 25, 2018: Contraception
Sari Bentsianov, Lonna Gordon, Ariella Goldman, Adam Jacobs, John Steever
Transgender men need contraception if engaging in intercourse with a cis-gender male partner. The copper IUD is an effective, non-hormonal contraceptive well suited for trans-males even while utilizing gender affirming hormone therapy. A gender-neutral medical facility with well-trained and sensitive staff is the ideal setting to provide such contraceptive care.
February 25, 2018: Contraception
J G Thorne, P D James, R L Reid
No abstract text is available yet for this article.
February 22, 2018: Contraception
Jennifer L Kerns, Biftu Mengesha, Blair C McNamara, Arianna Cassidy, Geffan Pearlson, Miriam Kuppermann
OBJECTIVE: We sought to explore the relationship between counseling quality, measured by shared decision making and decision satisfaction, and psychological outcomes (anxiety, grief, and posttraumatic stress) after second-trimester abortion for pregnancy complications. STUDY DESIGN: We conducted a cross-sectional study of women who underwent second-trimester abortion for complications. We recruited participants from Facebook and online support groups and surveyed them about counseling experiences and psychosocial issues...
February 22, 2018: Contraception
Jenna Jerman, Tsuyoshi Onda, Rachel K Jones
OBJECTIVE: To examine the motivations and circumstances of individuals seeking information about self-abortion on the Internet. STUDY DESIGN: We identified 26 terms that we anticipated someone might use to find information about self-abortion on the internet. Users who entered these terms into the Google search engine were provided with a link to our survey via Google AdWords. We fielded the survey over a 32-day period; users were eligible if accessing the survey from a U...
February 22, 2018: Contraception
Blair McNamara, Jennefer Russo, Sarina Chaiken, Janet Jacobson, Jennifer Kerns
OBJECTIVE: We sought to qualitatively understand patients' experiences with digoxin as a step before dilation and evacuation (D&E). STUDY DESIGN: We recruited English-speaking women from one abortion health center where digoxin is routinely used before D&E. We interviewed participants one to three weeks after the D&E about physical and emotional experiences with digoxin and understanding of its purpose. Using grounded theory, we analyzed transcripts iteratively, identifying themes from interviews; we stopped recruitment when we reached thematic saturation...
February 22, 2018: Contraception
Melissa F Natavio, Victoria K Cortessis, Nikki B Zite, Katharine Ciesielski, Hilary Eggers, Niquelle Brown, Penina Segall-Gutierrez
OBJECTIVE: To learn whether a version of the Medicaid Sterilization Consent Form (SCF) adapted for populations of low-literacy can help Spanish-speaking women better understand the process and consequences of tubal sterilization. STUDY DESIGN: We randomly assigned Spanish-speaking women, ages 21-45 years, to review either a "standard" or "low-literacy" version of the Medicaid SCF. We assessed sterilization-related knowledge using items from the Postpartum Tubal Sterilization Knowledge questionnaire, using as the primary outcome correct identification of least 4 or more knowledge items and as secondary outcome participants' preferred version of the SCF...
February 22, 2018: Contraception
Brett L Worly, Tamar L Gur, Jonathan Schaffir
OBJECTIVE: We performed a systematic review to look for an association between progestin-only contraception and depression. METHODS: We searched PubMed, Ovid and Web of Science for English-language articles including progestin-only contraception and depression from database inception to September 2016. We evaluated study quality with the procedures guiding reviews for the United States Preventive Services Task Force and the Cochrane Risk of Bias Tools. We included studies that evaluated progestin-only contraception and depression, focusing on externally validated depression measures...
February 20, 2018: Contraception
David Hubacher, Hannah Spector, Charles Monteith, Pai-Lien Chen
OBJECTIVES: To measure the 24-month impact on continuation, unintended pregnancy, and satisfaction of trying long-acting reversible contraception (LARC) in a population seeking short-acting reversible contraception (SARC). STUDY DESIGN: We enrolled 916 women aged 18-29 who were seeking pills or injectables in a partially randomized patient preference trial. Women with strong preferences for pills or injectables, started on those products, while others opted for randomization to LARC or SARC and received their methods gratis...
February 19, 2018: Contraception
Athena Tapales, Ayana Douglas-Hall, Hannah Whitehead
OBJECTIVE: To explore the sexual and reproductive health (SRH) behaviors, health insurance coverage, and use of SRH services of women in the United States (U.S.) by nativity, disaggregated by race and ethnicity. STUDY DESIGN: We analyzed publicly-available and restricted data from the National Survey of Family Growth to assess differences and similarities between foreign-born and U.S.-born women, both overall and within Hispanic, non-Hispanic (NH) white, NH black, and NH Asian groups...
February 14, 2018: Contraception
Catherine S Todd, Tracy C Anderman, Sarah Long, Landon Myer, Linda-Gail Bekker, Greg E Petro, Heidi E Jones
BACKGROUND: Women living with HIV (WLHIV) experience high rates of unmet contraceptive need and unintended pregnancy. Contraceptive method-specific continuation rates and associated factors are critical for guiding providers tasked with both reproductive health (RH) and HIV care. We conducted this systematic review to determine whether contraceptive continuation rates differ between WLHIV and uninfected women and, for WLHIV, whether differences are impacted by method type, antiretroviral therapy (ART) use, or other factors...
February 9, 2018: Contraception
Jessica Y Shim, Ashlesha Patel
We report two patients with bilateral pulmonary embolism who presented to our county hospital reproductive health services clinic. Both patients underwent an uncomplicated first trimester aspiration abortion while on therapeutic unfractionated heparin therapy. Anticoagulation therapy may be modified to safely perform first trimester surgical termination without significant blood loss.
February 8, 2018: Contraception
Nerys Benfield, Felicia Hawkins, Laurie Ray, Andrea McGowan, Ketty Floyd, Dawn Africa, Myrta Barreto, Erika Levi
OBJECTIVES: Nurses play an integral role in intrapartum and postpartum patient education. This exploratory study aims to assess the attitudes, knowledge, and practices of labor and delivery and postpartum nurses regarding contraception, and evaluate for changes in these measures one year after an institutional initiative allowing routine availability of immediate postpartum long-acting reversible contraception (LARC). STUDY DESIGN: In 2014 Montefiore Medical Center began to routinely offer comprehensive immediate postpartum contraception...
February 8, 2018: Contraception
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