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Madeline Cole, Stephanie Thomas, Brian M Mercer, Kavita Shah Arora
OBJECTIVE: To determine the association between provider training level and postplacental intrauterine device (IUD) outcomes following insertion instruction by email only. STUDY DESIGN: We conducted a single-center chart review of demographics, insertion, and clinical outcomes within six months of delivery for 116 patients who underwent postplacental levonorgestrel 52mg IUD placement from October 1, 2016 to March 31, 2017. RESULTS: We confirmed IUD retention, removal, or expulsion in 87 of 116 (75...
November 16, 2018: Contraception
Nathalie Kapp, Elisabeth Eckersberger, Antonella Lavelanet, Maria Isabel Rodriguez
OBJECTIVE: To describe the efficacy, safety, and acceptability of medical abortion in the late first trimester. STUDY DESIGN: We searched PubMed and Cochrane databases for articles in any language that examined the success of medical abortion at gestational ages (>63 to≤84days gestation). We sought articles that compared: medical abortion with surgical abortion at this gestational age, combination mifepristone and misoprostol and/or misoprostol alone); different dosages of misoprostol; different routes of misoprostol administration; frequency of dosing; and location of medical abortion (in health care facility vs...
November 13, 2018: Contraception
Michelle C Fox, Christine Klipping, Allison Martin Nguyen, Tara L Frenkl, Sandra M Cruz, Yinna Wang, Tjeerd Korver
OBJECTIVE: To evaluate the effect of investigational vaginal rings containing nomegestrol acetate (NOMAC) plus 17β-estradiol (E2) or etonogestrel (ENG) plus E2 in women with moderate to severe primary dysmenorrhea. STUDY DESIGN: This was a Phase 2b randomized, placebo-controlled, multicenter, double-blind study. We randomized participants to one of five treatment groups: four hormonal rings and one placebo ring. The investigational vaginal rings released 300μg of E2 daily along with 700μg or 900μg of NOMAC or 100μg or 125μg of ENG...
November 12, 2018: Contraception
Jane Cover, Maymouna Ba, Jennifer Kidwell Drake, Marėme Dia Ndiaye
OBJECTIVES: The primary objective of this study was to compare the 12-month continuation rate for women who self-injected DMPA-SC (subcutaneous depot-medroxyprogesterone acetate) with that for women receiving DMPA-IM (intramuscular depot-medroxyprogesterone acetate) from a provider. This research contributes to the broader goal of identifying solutions to support women to use contraception for their full desired duration. STUDY DESIGN: Participants were clients from 13 clinics in the Dakar and Thiés regions of Senegal who had decided to use injectable contraception prior to enrollment...
November 12, 2018: Contraception
Amy G Bryant, Anne Drapkin Lyerly, Stephanie DeVane-Johnson, Christine E Kistler, Alison M Stuebe
Postpartum contraceptive decision-making is complex, and recommendations may be influenced by breastfeeding intentions. While biologically plausible, concerns about the adverse impact of hormonal contraception on breast milk production have not been supported by the clinical evidence to date. However, the data have limitations. Which can lead providers with different priorities around contraception and breastfeeding to interpret the data in a way that advances their personal priorities. Discrepancies in interpretations can lead to divergent recommendations for individual women, and may cause conflict...
November 10, 2018: Contraception
M Antonia Biggs, Lauren Ralph, Sarah Raifman, Diana G Foster, Daniel Grossman
OBJECTIVE: The objective was to assess women's personal interest in and support for three alternative models of medication abortion (MA) provision. STUDY DESIGN: Using an online survey of a U.S. national, probability-based representative sample of women ages 18-49, we gauged personal interest in and general support for three alternative models for accessing abortion pills: (1) in advance from a doctor for future use, (2) over-the-counter (OTC) from a drugstore and (3) online without a prescription...
November 9, 2018: Contraception
Sarah Averbach, Othman Kakaire, Rachel McDiehl, Christine Dehlendorf, Felicia Lester, Jody Steinauer
OBJECTIVE: This study assessed whether immediate postpartum insertion of levonorgestrel contraceptive implants is associated with a difference in infant growth from birth to six months, onset of lactogenesis, or breastfeeding continuation at three and six months postpartum, compared to delayed insertion at six to eight weeks postpartum. STUDY DESIGN: We conducted a randomized trial of women in Uganda who desired contraceptive implants postpartum. We randomly assigned participants to receive either immediate (within five days of delivery) or delayed (six to eight weeks postpartum) insertion of a two-rod levonorgestrel contraceptive implant system...
November 5, 2018: Contraception
Yoonjoung Choi, Anoop Khanna, Linnea Zimmerman, Scott Radloff, Blake Zachary, Danish Ahmad
OBJECTIVE: Measuring current use of contraception relies on self-reported responses from survey respondents. Reporting validity may be affected by women's interpretation of the question and may vary by background characteristics of women. The study aims to understand levels and patterns of under-reporting of female sterilization in a population with high sterilization rates. STUDY DESIGN: Data came from the Performance Monitoring and Accountability 2020 survey conducted in Rajasthan, India, in early 2017...
October 31, 2018: Contraception
Claudia Geist, Patty Cason, Rebecca G Simmons, Jessica N Sanders, Bethany G Everett, Abigail Ra Aiken, Kyl Myers, David K Turok
No abstract text is available yet for this article.
October 16, 2018: Contraception
Seema D Shah, Linda Prine, Eve Waltermaurer, Susan E Rubin
OBJECTIVE: To assess the feasibility of an intervention introducing family planning services screening clinical decision support to improve provision of contraception and/or preconception services for women of reproductive age in our primary care Federally Qualified Health Center (FQHC) network. STUDY DESIGN: We implemented a family planning services screening prompt for support staff to ask women 13-44years at non-obstetric visits at specified time intervals. The response displayed in the electronic medical record for the provider to review, linked to a documentation tool...
October 15, 2018: Contraception
E Berglund Scherwitzl, O Lundberg, K Gemzell Danielsson, J Trussell, R Scherwitzl
No abstract text is available yet for this article.
October 15, 2018: Contraception
Megan Hamm, Mark Evans, Elizabeth Miller, Mario Browne, David Bell, Sonya Borrero
OBJECTIVES: While some attention has been paid to men's contraceptive use and attitudes in international contexts, relatively little is known about the attitudes towards contraception and pregnancy of low-income, urban men in the U.S. STUDY DESIGN: We conducted semi-structured interviews with 58 low-income men in Pittsburgh, PA, to explore their perspectives on contraception, pregnancy, fatherhood, and relationships. We analyzed the interviews using a combination of content analysis, the constant comparison method, and thematic analysis...
October 15, 2018: Contraception
Anita L Nelson
No abstract text is available yet for this article.
October 13, 2018: Contraception
Victoria H Jennings, Liya T Haile, Rebecca G Simmons, Hanley M Fultz, Dominick Shattuck
OBJECTIVE: To assess six-cycle perfect and typical use efficacy of Dynamic Optimal Timing (Dot), an algorithm-based fertility app that identifies the fertile window of the menstrual cycle using a woman's period start date and provides guidance on when to avoid unprotected sex to prevent pregnancy. STUDY DESIGN: We are conducting a prospective efficacy study following a cohort of women using Dot for up to 13 cycles. Study enrollment and data collection are being conducted digitally within the app and include a daily coital diary, prospective pregnancy intentions and sociodemographic information...
October 11, 2018: Contraception
Kari White, Katelin Adams, Kristine Hopkins
OBJECTIVES: To compare pregnancy options counseling and referral practices at state- and Title X-funded family planning organizations in Texas after enforcement of a policy restricting abortion referrals for providers participating in state-funded programs, which differed from Title X guidelines to provide referrals for services upon request. STUDY DESIGN: Between November 2014 and February 2015, we conducted in-depth interviews with administrators at publicly funded family planning organizations in Texas about how they integrated primary care and family planning services, including pregnancy options counseling and referrals for unplanned pregnancies...
October 1, 2018: Contraception
Adriana Piazza, Kelly Schwirian, Fiona Scott, Machelle D Wilson, Nikki B Zite, Mitchell D Creinin
OBJECTIVE: To understand women's preferences for permanent contraception by salpingectomy or tubal occlusion following standardized counseling and evaluate the practicality of a future randomized trial. STUDY DESIGN: We invited pregnant and non-pregnant women planning permanent contraception at the University of California, Davis (UCD) and University of Tennessee (UT) Obstetrics and Gynecology clinics to participate. We enrolled women when they received routine counseling and signed procedure consent...
September 26, 2018: Contraception
Ushma D Upadhyay, E Angel Aztlan-James, Corinne H Rocca, Diana Greene Foster
OBJECTIVES: To understand how having or being denied an abortion affects the likelihood of trying to become pregnant, overall pregnancy rates, and the rate and timing of an intended pregnancy in the future. STUDY DESIGN: The Turnaway Study is a prospective cohort study of women who received or were denied a wanted abortion. Women were recruited from one of 30U.S. abortion facilities. We examined subsequent intended pregnancy among those who presented just under the facility's gestational limit and received an abortion (Near-Limit Abortion Group, n=413) and those who presented for abortion just beyond the facility's gestational limit, were denied an abortion and went on to parent the child (Parenting Turnaways, n=146)...
September 20, 2018: Contraception
Amaranta D Craig, Jody Steinauer, Miriam Kuppermann, Julie A Schmittdiel, Christine Dehlendorf
OBJECTIVE: In this study we aimed to investigate the content and process of contraceptive counseling surrounding combined hormonal contraceptive (CHC) methods (combined oral contraceptives, the ring, and the patch). STUDY DESIGN: We performed a mixed methods analysis of data collected as part of the Patient-Provider Communication about Contraception study, in which reproductive age women and their providers were recruited at several San Francisco Bay Area clinics from 2009-2012...
September 15, 2018: Contraception
Andrea Hsu Roe, Deborah Bartz
These recommendations present an evidence-based assessment of provision of contraceptives at the time of surgical abortion. Most methods of contraception, including the intrauterine devices (IUD), implant, depot medroxyprogesterone injection, oral contraceptive pill, contraceptive patch, monthly vaginal ring, barrier methods and some permanent methods, can be safely initiated immediately after first- or second-trimester surgical abortion. Provision of postabortion contraceptives, particularly IUDs and implants, substantially reduces subsequent unintended pregnancy...
September 6, 2018: Contraception
Barbara Wilkinson, Mustafa Ascha, Emily Verbus, Mary Montague, Jane Morris, Brian Mercer, Kavita Shah Arora
OBJECTIVE: We sought to evaluate the impact of insurance type on receipt of an interval postpartum LARC, controlling for demographic and clinical factors. STUDY DESIGN: This is a retrospective cohort study of 1072 women with a documented plan of LARC for contraception at time of postpartum discharge. This is a secondary analysis of 8654 women who delivered at 20 weeks or beyond from January 1, 2012, through December 31, 2014, at an urban teaching hospital in Ohio...
September 5, 2018: Contraception
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