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Este mes en... Contraception
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Este mes en... Contraception:
“It's her body”: low-income Men's perceptions of limited reproductive agency 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.
Feasibility study of family planning services screening as clinical decision support at an urban Federally Qualified Health Center network 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.
Response to “study of contraceptive Mobile app fails to provide convincing findings”
Daniel R. Mishell Jr., MD, Outstanding Article Award 2018 The Daniel R. Mishell Jr., MD Outstanding Article Award honors the principal investigators who have published the most outstanding articles in Contraception over the preceding academic year (July to June).
A PATH to action perhaps?
Estimating six-cycle efficacy of the dot app for pregnancy prevention 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.
Women's preferences for permanent contraception method and willingness to be randomized for a hypothetical trial 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.
Counseling and referrals for women with unplanned pregnancies at publicly funded family planning organizations in Texas 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.
Intended pregnancy after receiving vs. being denied a wanted abortion 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.
Pill, patch, or ring? A mixed methods analysis of provider counseling about combined hormonal contraception 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).
Estimating abortion incidence among adolescents and differences in postabortion care by age: a cross-sectional study of postabortion care patients in Uganda To provide the first estimate of adolescents' abortion incidence in Uganda and to assess differences in the abortion experiences and morbidities of adolescent and nonadolescent postabortion care (PAC) patients.
Society of Family Planning clinical recommendations: contraception after surgical abortion 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.
Medicaid and receipt of interval postpartum long-acting reversible contraception We sought to evaluate the impact of insurance type on receipt of an interval postpartum LARC, controlling for demographic and clinical factors.
Family planning provision in pharmacies and drug shops: an urgent prescription Drug shops and pharmacies have long been recognized as the first point of contact for health care in developing countries, including family planning (FP) services. Drug shop operators and pharmacists should not be viewed as mere merchants of short-acting contraceptive methods, as this ignores their capacity for increasing uptake of FP services and methods in a systematic and collaborative way with the public sector, social marketing groups and product distributors. We draw on lessons learned from the rich experience of earlier efforts to promote a variety of public health interventions in pharmacies and drug shops.
Feasibility of patent and proprietary medicine vendor provision of injectable contraceptives: preliminary results from implementation science research in Oyo and Nasarawa, Nigeria Nigerian policymakers are debating task-shifting injectable contraceptive services to Patent and Proprietary Medicine Vendors (PPMVs).
DMPA-SC: an emerging option to increase women's contraceptive choices As countries strive to achieve the Sustainable Development Goal of universal access to sexual and reproductive health care services — including modern contraceptive methods through Universal Health Coverage (UHC) strategies, and the Family Planning 2020 goal of expanding access for an additional 120 million women and girls in 69 of the world's poorest countries — policymakers and program managers have a heightened interest in providing contraceptive methods that better meet women's needs. A subcutaneous formulation of the injectable depot medroxyprogesterone acetate (DMPA-SC) is one such option for broadening the spectrum of contraceptive choices .
The Management of a patient with a fragmented intrauterine device embedded within the cervical canal A 28-year-old woman presented with a malpositioned intrauterine device (IUD) that was fragmented and significantly entrenched within the cervical canal and myometrium. IUD malposition with concomitant device fragmentation and embedded segments, albeit rare, should be a consideration given the device's prevalence.
Beyond intent: exploring the association of contraceptive choice with questions about Pregnancy Attitudes, Timing and How important is pregnancy prevention (PATH) questions To explore women's responses to PATH questions (Pregnancy Attitudes, Timing and How important is pregnancy prevention) about hypothetical pregnancies and associations with contraceptive method selection among individuals who present as new contraceptive clients and desire to prevent pregnancy for at least 1 year.
First-trimester aspiration abortion practices: a survey of United States abortion providers To assess whether first-trimester aspiration abortion practices of US providers agree with evidence-based policy guidelines.
Continuation of subcutaneous or intramuscular injectable contraception when administered by facility-based and community health workers: findings from a prospective cohort study in Burkina Faso and Uganda The aim of this study was to examine continuation of subcutaneous and intramuscular depot medroxyprogesterone acetate (DMPA-SC and DMPA-IM) when administered by facility-based health workers in Burkina Faso and Village Health Teams (VHTs) in Uganda.
Planned, unplanned and in-between: the meaning and context of pregnancy planning for young people To understand how young people conceptualize planned, unplanned and “in-between” pregnancies.
An observational study to test the acceptability and feasibility of using medical and nursing students to instruct clients in DMPA-SC self-injection at the community level in Kinshasa Given the promise of DMPA-SC to increase community-level access to modern contraception in developing countries, we conducted an observational study to assess the acceptability and feasibility of DMPA-SC self-injection among women in Kinshasa, Democratic Republic of the Congo, and of medical/nursing (M/N) students as instructors for self-injection.
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 nonclinically trained community health workers (CHWs) 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 long-acting reversible contraception (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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.