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Este mes en... Contraception
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Este mes en... Contraception:
Acceptability of the distribution of DMPA-SC by community health workers among acceptors in the rural province of Lualaba in the Democratic Republic of the Congo: a pilot study The objective of this research is to assess the acceptability of the provision of subcutaneously-administered depo medroxyprogesterone acetate (DMPA-SC) by non-clinically trained community-health workers (CHW) among acceptors in the rural province of Lualaba in the Democratic Republic of the Congo (DRC).
Combined oral contraceptive interference with the ability of ulipristal acetate to delay ovulation: A prospective cohort study To determine if a combined oral contraceptive (COC) initiated shortly after ulipristal acetate (UPA) administration interferes with its mechanism of action.
Prenatal intent and postpartum receipt of long-acting reversible contraception among women receiving medication-assisted treatment for opioid use disorder Many women with opioid use disorder (OUD) do not use highly effective postpartum contraception such as long-acting reversible contraception (LARC). We evaluated factors associated with prenatal intent and postpartum receipt of LARC among women receiving medication-assisted treatment (MAT) for OUD.
Effects of different progestins on prostaglandin biosynthesis in human endometrial explants To compare the effects of chlormadinone acetate (CMA), dienogest (DNG) and drospirenone (DRSP) on prostaglandin biosynthesis in a human endometrial explants model.
Do women want to talk about birth control at the time of a first trimester abortion? To investigate if women desire talking to a counselor or physician about contraception when seeking first trimester medical or surgical abortion.
Is contraceptive self-injection cost-effective compared to contraceptive injections from facility-based health workers? Evidence from Uganda To assess the cost-effectiveness of self-injected subcutaneous depot medroxyprogesterone acetate (DMPA-SC) compared to health worker-administered intramuscular DMPA (DMPA-IM) in Uganda.
Controversies in family planning: persistently elevated serum human chorionic gonadotropin levels after aspiration abortion Low but rising serum human chorionic gonadotropin (hCG) levels occur infrequently after an induced abortion. Because this scenario rarely occurs after suction aspiration, clinicians may have higher suspicion for an uncommon diagnosis. The differential diagnosis includes both common and uncommon diagnoses, such as incomplete abortion, heterotopic or ectopic pregnancy, a new intrauterine pregnancy, and gestational trophoblastic neoplasia. The etiology of this presentation may be unclear, especially in the absence of abnormal bleeding or pain which would suggest incomplete abortion, or when significant time has passed since the procedure.
Contraceptive method use among HIV-positive women in a US urban outpatient clinic: an exploratory cross-sectional study Effective contraceptive method use is important for HIV-positive women to meet fertility goals, prevent unintended pregnancy and reduce risk of vertical HIV transmission. Our objective was to evaluate factors associated with HIV-positive women’s contraceptive method use at last coitus defined as more effective [Tier 1 and 2 methods (T1/2)] versus less effective [Tier 3 or no method (T3/none)] by the US Medical Eligibility Criteria for contraception use.
Integration of contraceptive services into anticoagulation management services improves access to long-acting reversible contraception Integration of services is a promising way to improve access to contraception in sub-Saharan Africa, but few studies have evaluated this strategy to increase access to contraception among women requiring anticoagulation. Our objective was to evaluate a model of care integrating contraceptive counseling and provision within an anticoagulation management clinic in Eldoret, Kenya to determine the impact on LARC use.
Availability of long-acting reversible contraceptives in Los Angeles County clinics through a Medicaid state plan amendment program To assess the availability of long acting reversible contraceptive (LARC) methods in Los Angeles County through providers participating in a California State Medicaid State Plan Amendment Program called Family Planning, Access, Care and Treatment (Family PACT).
Introducing the subcutaneous depot medroxyprogesterone acetate injectable contraceptive via social marketing: lessons learned from Nigeria's private sector The subcutaneous depot medroxyprogesterone acetate (DMPA-SC) injectable contraceptive was introduced in South West Nigeria in 2015 through private sector channels. The introduction included community-based distribution and was supported by a social marketing approach. From program monitoring and evaluation, aimed at understanding performance, market reach and other process measures, we identify lessons learned to inform future scale-up efforts.
Pregnancy scares and change in contraceptive use We examined whether the experience of a “pregnancy scare” is related to subsequent changes in contraceptive use that increase the risk of unintended pregnancy.
Relationship of job role and clinic type to perceived stigma and occupational stress among abortion workers To describe the role of worksite characteristics, job role, and abortion stigma in clinical abortion workers' occupational stress.
Scientific abstracts featured research at the 2018 North American Forum on Family Planning
North American forum on family planning scientific abstracts New Orleans, Louisiana, October 20–22, 2018
Women's decision making for postpartum sterilization: does the Medicaid waiting period add value? Currently, patients with federally funded insurance are required to sign a sterilization consent form (SCF) at least 30 days prior to sterilization, while privately insured patients are not. Although this policy was designed to protect the reproductive rights of vulnerable populations, it has had the unintended effect of creating a disparity in access to an effective contraceptive method. Our qualitative study aims to clarify the decision-making process surrounding postpartum sterilization and assess if patients perceive that the SCF adds value.
Task-shifting the provision of DMPA-SC in the DR Congo: Perspectives from two different groups of providers 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.
Mobile contraceptive application use in a clinical setting in addition to standard contraceptive counseling: A randomized controlled trial 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.
Cognitive interviews to improve a patient-centered contraceptive effectiveness poster To refine the Centers for Disease Control and Prevention (CDC)’s contraceptive education poster using patient-centered design.
Access to emergency contraception in Kansas City clinics To assess the accessibility of ulipristal acetate (UPA) and copper intrauterine devices (IUDs) for emergency contraception (EC) in reproductive health centers in the Kansas City metropolitan area.
No one to turn to: low social support and the incidence of undesired pregnancy in the United States Young women may experience social barriers to achieving their reproductive goals. This analysis explored whether low social support may contribute to the high incidence of undesired pregnancy in young women in the United States.
Capturing compassion: A survey of Mexican Catholics assessing abortion support by reason for abortion and degree of Catholicism 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.
One in three: challenging heteronormative assumptions in family planning health centers 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 12 months (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.
Family planning and contraception use in transgender men 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.
Use of an electronic health record data sharing system for identifying current contraceptive use within the WWAMI region Practice and Research Network To evaluate the ability of electronic health record (EHR) data extracted into a data-sharing system to accurately identify contraceptive use.
Gestational dating using last menstrual period and bimanual exam for medication abortion in pharmacies and health centers in Nepal 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.
Successful completion of total and partial salpingectomy at the time of cesarean delivery Evaluate completion of partial or total salpingectomy during Cesarean delivery based on intended procedure.
Effect of a novel copper-containing intrauterine device material on the endometrial environment in rabbits 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.
Factors associated with initiating long-acting reversible contraception immediately after first-trimester abortion The objective was to identify predictors of postabortion long-acting reversible contraception (LARC) initiation to increase providers' understanding of motivators of contraceptive choices.
Molecular characterization of PRM-associated endometrial changes, PAEC, following mifepristone treatment The progesterone receptor modulator (PRM) mifepristone holds 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.
A prospective measure of unintended pregnancy in the United States 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.
Taking the provider “out of the loop:” patients' and physicians' perspectives about IUD self-removal This study describes the perspectives of patients and providers about intrauterine device (IUD) self-removal.
Abortion and student health services expanding the conversation with student perspectives 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.
Costs of administering injectable contraceptives through health workers and self-injection: evidence from Burkina Faso, Uganda, and Senegal 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.
Do women know whether their hospital is Catholic? Results from a national survey 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.
Historical record-setting trends in IUD use in the United States “No other contraceptive method has undergone so rapid and thorough a change of medical reputation as that experienced by intrauterine devices over the past few years” . These words from United States-based contraceptive researcher Christopher Tietze in 1966 also characterize the last 10 years in the United States.
Is pregnancy fatalism normal? An attitudinal assessment among women trying to get pregnant and those not using contraception To assess factors associated with pregnancy fatalism among U.S. adult women.
Patient choice of adjunctive nonpharmacologic pain management during first-trimester abortion: a randomized controlled trial 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.
Evaluating the capacity of California's publicly funded universities to provide medication abortion To explore capacity of University of California (UC) and California State University (CSU) student health centers (SHCs) to provide medication abortion (MA) and SHC staff perspectives on providing MA.
The politics of place: Presidential voting patterns and providers' prescription of emergency contraception The most effective forms of emergency contraception (EC) require a prescription or a medical procedure; therefore, provider willingness to offer EC remains critical to patient access. This study seeks to assess whether political alignment of a provider's county is associated with provider attitudes and behaviors regarding EC.
Surgical sterilization among US men and women with employer-based insurance: A claims data analysis To assess variability in the use of surgical sterilization among privately insured U.S. men and women.
Comparison of an additional early visit to routine postpartum care on initiation of long-acting reversible contraception: A randomized trial To investigate whether an early 3-week postpartum visit in addition to the standard 6-week visit increases long-acting reversible contraception (LARC) initiation by 8 weeks postpartum compared to the routine 6-week visit alone.
A multicenter randomized clinical trial of etonogestrel and levonorgestrel contraceptive implants with nonrandomized copper intrauterine device controls: effect on weight variations up to 3 years after placement To evaluate weight changes in women randomized to either the etonogestrel (ENG)- or the levonorgestrel (LNG)-releasing contraceptive implants and to compare with users of the TCu380A intrauterine device (IUD).
Morbid obesity: potential effects of hormonal contraception Obesity has wide-ranging health consequences. It is strongly associated with cardiovascular risk factors such as diabetes, hypertension and dyslipidemia. In addition, obese patients have an increased risk of coronary artery disease, stroke and venous thromboembolism (VTE). These diseases result in obesity being an issue with important global implications for cardiovascular dysfunction. Furthermore, obesity may have an adverse effect on virtually all systems in the body, and it is the fifth leading cause of mortality worldwide .
Women's satisfaction, use, storage and disposal of subcutaneous depot medroxyprogesterone acetate (DMPA-SC) during a randomized trial To describe women's experiences with subcutaneous depot medroxyprogesterone acetate (DMPA-SC) to inform scale-up of self-administered DMPA-SC.
A noninferiority randomized controlled trial to compare transabdominal and transvaginal sonography for eligibility assessment prior to medical abortion To compare transabdominal sonography (TAS) to transvaginal sonography (TVS) in medical abortion eligibility assessment, specifically to measure how often clinicians chose to order additional testing for eligibility assessment following TAS and TVS, and to look for differences by patient and clinician characteristics. Also, to compare patient acceptability between the two modalities.
Video compared to conversational contraceptive counseling during labor and maternity hospitalization in Colombia: A randomized trial Assess if video-based contraceptive education could be an efficient adjunct to contraceptive counseling and attain the same contraceptive knowledge acquisition as conversation-based counseling.
Emergency contraception supply in Australian pharmacies after the introduction of ulipristal acetate: a mystery shopping mixed-methods study To explore the supply of emergency contraception (EC) from Australian community pharmacies after the introduction of ulipristal acetate (UPA) and to explore pharmacists' knowledge, decision-making, attitudes and beliefs surrounding supplying EC.
Two-year contraceptive continuation rates among immediate postpartum implant users at a district hospital in Malawi: a prospective cohort study To compare 2-year continuation rates in Malawian women undergoing immediate postpartum insertion of the levonorgestrel implant or etonorgestrel implant.
Comparative safety and efficacy of a dedicated postpartum IUD inserter versus forceps for immediate postpartum IUD insertion: a randomized trial To compare postpartum intrauterine device (PPIUD) insertion using a newly developed dedicated PPIUD inserter (inserter) to insertion with modified Kelly placental forceps (forceps).
Predictors for follow-up among postpartum patients enrolled in a clinical trial To identify risk factors for failure to attend postpartum follow-up within 3 months of delivery, including social support, intrinsic motivation, insurance type and prenatal care attendance.
A case series on the use of levonorgestrel 52 mg intrauterine system after organ transplant To assess the clinical performance (pregnancy and occurrence of pelvic infection) of the levonorgestrel 52-mg intrauterine system (LNG IUS) in solid organ transplant recipients.
Effect of the depot medroxyprogesterone acetate injectable and levonorgestrel implant on HIV genital shedding: a randomized trial To assess the effect of the depot medroxyprogesterone acetate injectable (DMPA) and of the levonorgestrel (LNG) implant on genital HIV shedding among women receiving antiretroviral therapy (ART).
Predictors of DMPA-SC continuation among urban Nigerian women: the influence of counseling quality and side effects In 2015, private healthcare providers in Nigeria introduced DMPA-SC (depot medroxyprogesterone acetate administered subcutaneously) into the method mix. We aimed to  examine the sociodemographic predictors of continued DMPA-SC use after 3 months, and  characterize the additional influences of contraceptive counseling quality and experiences of side effects on continuation.
Client and provider experiences with self-administration of subcutaneous depot medroxyprogesterone acetate (DMPA-SC) in Malawi As low- and middle-income countries (LMICs) consider adding self-administration of subcutaneous depot medroxyprogesterone acetate (DMPA-SC) to their contraceptive method mix, learning about family planning clients' and providers' experiences with self-injectable DMPA-SC during trials will inform introduction and scale-up efforts.
Multiple contraceptive method use and prevalence of fertility awareness based method use in the United States, 2013–2015 Contraceptive prevalence in the United States is typically calculated according to the most effective method of contraception reported. This could theoretically underestimate the number of women using fertility-awareness based methods (FABMs), including those who use other methods (e.g., condoms) during the fertile window, but the extent of any such underestimation has not been assessed.
Continuation of long-acting reversible contraceptives among Medicaid patients Our objective was to compare continuation and complication rates of subdermal etonogestrel implants and intrauterine devices (IUDs) using Medicaid insurance claims.
Contraceptive information on pregnancy resource center websites: a statewide content analysis Most pregnancy resource centers (PRCs) in the US are affiliated with national organizations that have policies against promoting or providing contraceptives, yet many provide information about contraception on their websites. In 2016, the state of Georgia passed a new law to publicly fund PRCs. This study sought to describe the contraceptive information on Georgia PRC websites.
Do health promotion messages integrate unintended pregnancy and STI prevention? A content analysis of online information for adolescents and young adults Recently there have been calls to strengthen integration of unintended pregnancy and sexually transmitted infection (STI) prevention messages, spurred by increasing use of long-acting reversible contraception. To assess the extent to which public health/clinical messages about unintended pregnancy prevention also address STI prevention, we conducted a content analysis of web-based health promotion information for young people.
Twelve-month discontinuation rates of levonorgestrel intrauterine system 13.5 mg and subdermal etonogestrel implant in women aged 18–44: A retrospective claims database analysis To investigate the 12-month discontinuation rates of levonorgestrel intrauterine system 13.5 mg (LNG-IUS 13.5) and subdermal etonogestrel (ENG) implant in the US.
Outcomes of dilation and evacuation with and without feticide by intra-cardiac potassium chloride injection: a service evaluation To compare procedure duration, complications, and acceptability of dilation and evacuation (D&E) with and without feticide by intra-cardiac potassium chloride (KCL) injection.
The intrauterine device as emergency contraception: how much do young women know? Unprotected intercourse is common, especially among teens and young women. Access to intrauterine device (IUD) as emergency contraception (EC) can help interested patients more effectively prevent unintended pregnancy and can also offer ongoing contraception. This study evaluated young women's awareness of IUD as EC and interest in case of need.
Phase I/II pharmacokinetic and pharmacodynamic evaluation of two levonorgestrel-only contraceptive patches in a multicenter randomized trial To evaluate the pharmacokinetic and pharmacodynamic effects of two novel levonorgestrel (LNG)-only contraceptive patches.
Advance provision of emergency contraception to young men: An exploratory study in a clinic setting To explore the acceptability of advance provision of emergency contraceptive pills (ECPs) to young men seeking health care.
Comparison of expulsions following intracesarean placement of an innovative frameless copper-releasing IUD (Gyn-CS®) versus the TCu380A: A randomized trial The intent of this study (primary outcome measure) is to assess the expulsion rate of a newly developed copper releasing frameless intrauterine IUD GyneFix® Cesarean Section (Gyn-CS®) at 3 months' follow-up, compared to the TCu-380A IUD, inserted immediately postplacental expulsion following cesarean section delivery.
Recent intrauterine device use and the risk of precancerous cervical lesions and cervical cancer Understanding the effect of contraceptives on the development of precancerous lesions of the cervix and cervical cancer may provide information that is valuable to women in contraceptive decision-making. The purpose of this study was to evaluate the association between recent intrauterine device (IUD) use (by type) and cervical intraepithelial neoplasia 2, 3, adenocarcinoma in situ or cancer (CIN2+ or CIN3+).
Second-trimester surgical abortion practices in the United States To assess whether second-trimester surgical abortion practices of U.S. providers agree with evidence-based policy guidelines.
Hyperinsulinemic-euglycemic clamp over the first year of use of depot-medroxyprogesterone acetate as a contraceptive The literature lacks data on the use of the gold-standard hyperinsulinemic-euglycemic clamp (HEC) technique for the evaluation of insulin resistance (IR) in depot-medroxyprogesterone acetate (DMPA) users. This study assessed carbohydrate metabolism in non-obese users of DMPA using the HEC technique.
Structured integration of family planning curriculum: comparative assessment of knowledge and skills among new medical graduates in Ethiopia The objective was to assess if structured integration of a comprehensive family planning (FP) training into a medical school curriculum improves FP knowledge and skill scores of medical interns.
Emergency contraception in Albania: a multimethods qualitative study of awareness, knowledge, attitudes and practices Contraceptive prevalence is relatively low in Albania, and abortion is the mainstay of family planning. Although levonorgestrel-only emergency contraceptive pills are available, uptake of this method is minimal. Emergency contraception (EC) could play a significant role in addressing women's need for an effective and discreet pregnancy prevention method. However, information about the dynamics surrounding EC is limited.
Continuation of injectable contraception when self-injected vs. administered by a facility-based health worker: a nonrandomized, prospective cohort study in Uganda The purpose of this study was to compare 12-month continuation rates for subcutaneous depot medroxyprogesterone acetate (DMPA-SC) administered via self-injection and DMPA-IM administered by a health worker in Uganda.
Can inhibition of retinoic acid biosynthesis function as a non-hormonal female contraceptive? Vitamin A deficient females have reduced fertility due to decreased retinoic acid production. WIN 18,446 inhibits retinoic acid biosynthesis and functions as a contraceptive in males. We tested whether WIN 18,446 treatment would suppress fertility in female mice.
The status of provision of post abortion care services for women and girls in Eastern and Southern Africa: a systematic review To conduct a systematic review of the status of post-abortion care (PAC) provision in Eastern and Southern Africa with particular reference to reach, quality and costs of these services.