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Postpartum contraception

Tamara Barghouthi, Cheryl Bushnell
Stroke risk is 3 times higher in pregnancy than in the general young adult population and carries high morbidity and mortality risks. The recognition of signs and symptoms of stroke and other serious cerebrovascular disorders in pregnant and postpartum patients is important for the obstetrician to be able to initiate urgent evaluation and management. The objective of this review is to provide an evidence-based summary of stroke incidence, risk factors, prevention, and treatment of stroke in pregnancy. The impact of postpartum contraceptive use can on stroke risk is summarized...
March 14, 2018: Clinical Obstetrics and Gynecology
Reni Soon, Katie McGuire, Jennifer Salcedo, Bliss Kaneshiro
This pilot study assessed the feasibility of conducting a larger randomized controlled trial comparing the proportion of adolescents using a levonorgestrel intrauterine device (LNG IUD) at six months postpartum when it is inserted immediately after vaginal delivery (within 10 minutes after placental expulsion) compared to insertion four to six weeks postpartum. Pregnant adolescents (14 to 19 years) who desired a LNG IUD for postpartum contraception were randomized to insertion of the LNG IUD either within 10 minutes of delivery of the placenta or at 4-6 weeks postpartum...
March 2018: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
Ekwutosi M Okoroh, Debra J Kane, Rebekah E Gee, Lyn Kieltyka, Brittni N Frederiksen, Katharyn M Baca, Kristin M Rankin, David A Goodman, Charlan D Kroelinger, Wanda D Barfield
Rates of short interval pregnancies resulting in unintended pregnancies remain high in the United States and contribute to adverse reproductive health outcomes. Long-acting reversible contraception (LARC) methods have annual failure rates of less than 1% compared with 9% for oral contraceptive pills, and are an effective strategy to reduce unintended pregnancies. To increase access to LARCs in the immediate postpartum period, several State Medicaid programs, including those in Iowa (IA) and Louisiana (LA), recently established reimbursement policies to remove the barriers to reimbursement of immediate postpartum LARC insertion...
March 9, 2018: American Journal of Obstetrics and Gynecology
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
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
Omar M Shaaban, Ahmed M Abbas, Hanaa R Mahmoud, Entsar M Yones, Ahmed Mahmoud, Mahmoud S Zakherah
OBJECTIVE: The current study aims to evaluate the effect of the use of single packet of levonorgestrel emergency contraceptive pills (LNG-ECPs) during breastfeeding on the health and development of the nursing infant. MATERIALS AND METHODS: The current study was an ancillary observational cohort study carried out in a university hospital. We counseled all women delivered and planning birth-space and breastfeed for at least 1 year for participation during postpartum hospital stay...
February 20, 2018: Journal of Maternal-fetal & Neonatal Medicine
Elizabeth E Krans, Joo Yeon Kim, Alton Everette James, David K Kelley, Marian Jarlenski
OBJECTIVE: The purpose of this study was to describe postpartum contraceptive utilization patterns among women with OUD and evaluate the relationship between postpartum contraceptive method choice and interpregnancy interval. METHODS: A retrospective cohort study was conducted with women in Pennsylvania Medicaid with a diagnosis of OUD between 2008 and 2013. Postpartum contraceptive use within 90 days after delivery was identified through claims data and categorized by effectiveness (highly-effective, effective, and no method observed)...
February 14, 2018: Drug and Alcohol Dependence
Isabel Morgan, Mary Elizabeth Hughes, Harolyn Belcher, Laurens Holmes
Objectives Postpartum visits are increasingly recognized as a window of opportunity for health care providers to counsel new mothers and promote healthy behaviors, including increasing contraceptive use and screening for postpartum depression. In Maryland, there is a lack of research on postpartum visit (PPV) attendance and the specific risk factors associated with not receiving postpartum care. In this study, we estimated the proportion of mothers in Maryland who attended a PPV and assessed maternal sociodemographic characteristics and health behaviors associated with PPV non-attendance...
February 19, 2018: Maternal and Child Health Journal
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
Blanca Bolea-Alamanac, Sarah J Bailey, Thelma A Lovick, Dirk Scheele, Rita Valentino
There is increasing recognition that women have a higher prevalence of certain psychiatric illnesses, and a differential treatment response and course of illness compared to men. Additionally, clinicians deal with a number of disorders like premenstrual syndrome, premenstrual dysphoric disorder, and postpartum depression, which affect women specifically and for which treatment and biological pathways are still unclear. In this article we highlight recent research which suggests that different biological mechanisms may underlie sex differences in responsiveness to stress...
January 1, 2018: Journal of Psychopharmacology
H Rees, D Pillay, S Mullick, M Chersich
Progress in reducing unintended pregnancies in South Africa is slow. The implant, introduced in 2014, expanded the range of available longacting reversible contraceptives (LARCs) and held much promise. Uptake, however, has declined precipitously, in spite of its ‘unmatched effectiveness’ and high levels of satisfaction for most users. We propose policy and provider interventions to raise implant use, underscored by a ‘LARC-first’ approach. Contraceptive counselling should focus on the particular benefits of LARCs and methods be presented in order of effectiveness...
November 1, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Melinda Vanya, Iván Devosa, Katalin Barabás, György Bártfai, Zoltan Kozinszky
OBJECTIVES: The aims of the study were to describe the sociodemographic determinants, breastfeeding- and sexual life-related predictive factors of contraceptive use at 6-8 weeks postpartum. METHODS: A prospective, web-based questionnaire survey was carried out by distributing an access code to women immediately after delivery at the Department of Obstetrics and Gynaecology, the University of Szeged, Szeged, Hungary, between 1 September 2013 and 1 May 2015. RESULTS: In total, 1875 women were invited to participate in the study, 632 of whom refused or were excluded and 644 were not sexually active...
February 2, 2018: European Journal of Contraception & Reproductive Health Care
Saumya RamaRao, Francis Obare, Salisu Ishaku, Babacar Mané, Heather Clark, Wilson Liambila, Godwin Unumeri, Harriet Birungi, Nafissatou Diop, Deepa Rajamani, John Townsend
The progesterone vaginal ring (PVR) is a contraceptive designed for use by breastfeeding women in the first year postpartum. This Report presents results of an acceptability study of the PVR in Kenya, Nigeria, and Senegal. Women seeking postpartum family planning services were offered various contraceptive options including the PVR. Of the 174 participating women, 110 (63 percent) used one ring and 94 (54 percent) completed the study by using two rings over a six-month period. Women were interviewed up to three times: at the time they entered the study, at 3 months (the end of the first ring cycle), and at 6 months (the end of the second ring cycle or when they exited if they had discontinued earlier)...
February 2, 2018: Studies in Family Planning
A Mohammed-Durosinlorun, J Adze, S Bature, A Abubakar, C Mohammed, M Taingson, A Ojabo
OBJECTIVES: The objectives of the study were to determine factors affecting the interval between a woman's last childbirth and the initiation of contraception. MATERIALS AND METHODS: This was a retrospective study. Family planning clinic records of the Barau Dikko Teaching Hospital Kaduna from January 2000 to March 2014 were retrieved. Information was collected on demographics, reproductive, and contraceptive history. Data were analyzed using the SPSS version 15 software, and missing responses were excluded...
December 2017: Nigerian Journal of Clinical Practice
Ha Thi Thu Bui, Thi Minh Le, Tac Van Pham, Duong Thi Thuy Doan, Duy Anh Nguyen, Canh Chuong Nguyen, Duc Minh Duong
BACKGROUND: Gender inequalities influence the utilization of maternal health services in Vietnam, but little research has been published. This study, therefore, aimed to explore the association between gender inequalities and women's utilization of maternal health services in Vietnam. METHODS: The study was conducted in 8 provinces in the South Central Coast region of Vietnam during August 2013 to May 2014. A total of 907 women who delivered a year prior to the date of interview participated in the study...
March 2018: Journal of Public Health Management and Practice: JPHMP
Moira K Ray, Valerie King
No abstract text is available yet for this article.
January 1, 2018: American Family Physician
Vineet S Rolston, Laleh Boroujerdi, Millie D Long, Dermot P B McGovern, Wenli Chen, Christopher F Martin, Robert S Sandler, John D Carmichael, Marla Dubinsky, Gil Y Melmed
Background: Many women with inflammatory bowel disease (IBD) report changes in symptoms in association with hormonal changes during menses, pregnancy, and hormonal contraceptive use, suggesting a hormonal influence on disease activity. We aimed to identify and characterize IBD symptom fluctuations in women during times of hormonal variation. Methods: From June 2012 through September 2012, women enrolled in Crohn's and Colitis Foundation of America Partners , an online Internet cohort of patients with IBD, were invited to participate in this study...
January 18, 2018: Inflammatory Bowel Diseases
Annie Dude, Melissa Matulich, Samantha Estevez, Lilly Y Liu, Lynn M Yee
OBJECTIVE: Use of effective contraception could be one method to decrease recurrent preterm birth by increasing intervals between pregnancies. We assessed correlates of contraceptive counseling and uptake among women who delivered preterm. MATERIALS AND METHODS: This is a retrospective cohort study of women who delivered live-born singletons or twins before 32 weeks' gestation. We assessed documented contraceptive counseling and method uptake by postpartum discharge, using inpatient medical records, and correlates of highly effective contraception uptake by the postpartum visit using outpatient records...
January 23, 2018: Journal of Women's Health
Cheryl Robbins, Sheree L Boulet, Isabel Morgan, Denise V D'Angelo, Lauren B Zapata, Brian Morrow, Andrea Sharma, Charlan D Kroelinger
PROBLEM/CONDITION: Preconception health is a broad term that encompasses the overall health of nonpregnant women during their reproductive years (defined here as aged 18-44 years). Improvement of both birth outcomes and the woman's health occurs when preconception health is optimized. Improving preconception health before and between pregnancies is critical for reducing maternal and infant mortality and pregnancy-related complications. The National Preconception Health and Health Care Initiative's Surveillance and Research work group suggests ten prioritized indicators that states can use to monitor programs or activities for improving the preconception health status of women of reproductive age...
January 19, 2018: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
Elyse Fortier, Angel M Foster
OBJECTIVES: Postpartum contraception plays a significant role in reducing subsequent pregnancy. However, young mothers in Ottawa, the capital of Canada, face various barriers when trying to access contraception after delivery. Through this project we aimed to explore these barriers and understand the decision-making processes of young mothers surrounding postpartum contraception. STUDY DESIGN: We conducted 10 semi-structured in-depth interviews with young mothers living in Ottawa who had experienced a subsequent pregnancy within 24 months of their first childbirth...
January 8, 2018: Contraception
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