scholarly journals Rejection of a contraceptive method during the immediate postpartum period in adolescent patients

2016 ◽  
Vol 4 (7) ◽  
Author(s):  
María Guadalupe Torres Paredes ◽  
Guillermo Barragán Ramírez
Keyword(s):  
Informed Consent ◽  
Birth Control ◽  
Postpartum Period ◽  
Contraceptive Method ◽  
Contraceptive Methods ◽  
Vacuum Aspiration ◽  
Lack Of Information ◽  
Manual Vacuum Aspiration ◽  
Adolescent Patients ◽  
Post Abortion

Adolescents generally have little information on the correct use of contraception and fertility, increasing the risk of pregnancy. The aim of this study was to determine why adolescents do not accept contraception during the immediate postpartum period. Adolescent patients included presented 12 to 19 years old, who signed the letter of informed consent, they were in immediate postpartum, post-abortion (implemented curettage, manual vacuum aspiration) or pot-cesarean section and who did not accept the use of a contraceptive method. A total of 148 patients with a mean ± SEM age of 17.3 ± 1.3 years were included. Only 107 (90.7%) of the patients had prenatal care, and only 77 (72%) of the patients were guided about the contraceptive methods that could be used in the immediate postpartum period. The 3 main reasons to reject contraception were: ignorance about contraception that she can use (n = 26; 22%), the couple will use birth control (n = 16; 13.6%) and she has no partner (n = 12; 10.2%). In conclusion, we observed that most teens do not use contraception, mainly due to lack of information or by leaving the responsibility to their partner.

scholarly journals Midwives’ Integration of Post-Abortion Manual Vacuum Aspiration in the Democratic Republic of Congo: A Mixed Methods Case Study & Positive Deviance Assessment

2020 ◽  
Author(s):  
Kirsty Marie Bourret ◽  
Sylvie Larocque ◽  
Amélie Hien ◽  
Carol Hogue ◽  
Kalum Muray ◽  
...  
Keyword(s):  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Positive Deviance ◽  
Republic Of Congo ◽  
Abortion Care ◽  
Vacuum Aspiration ◽  
Post Abortion Care ◽  
Manual Vacuum Aspiration ◽  
Post Abortion

Abstract Background: Despite a recognized need for midwives to provide post abortion care, there exist barriers preventing them from integrating lifesaving skills such as manual vacuum aspiration (MVA) into practice. This collaborative research with the Professional Association of Congolese Midwives (SCOSAF), sought to understand how certain midwives in the Democratic Republic of Congo (DRC) have overcome barriers to successfully integrate MVA for post abortion care. Specifically, in order to provide locally-driven solutions to the problem of inadequate post abortion care in the DRC, this study aimed to identify examples of positive deviance, or midwives who had successfully integrated MVA in complex working environments following an in-service training facilitated by their midwifery association, SCOSAF.Methods: Creswell’s mixed method comparative case study design was used to identify positive deviant midwives who had practiced MVA one or more times post training and to explore their strategies and enabling factors. Other midwives who had not practiced MVA post training permitted for a comparison group and further interpretations. Sources of data included a sequential survey and semi-structured interviews. Results: All 102 midwives invited to be surveyed were recruited and 34% reported practicing MVA post training (positive deviant midwives). No statistical significance was found between the two groups’ demographics and practice facility type. Overall, both groups had positive attitudes regarding midwifery-led MVA and legalization of abortion. Positive deviant midwives demonstrated and described more confidence and competence to practice and teach MVA. They were more likely to identify as teachers and overcome interprofessional barriers by teaching MVA to physicians, medical students and other midwives and position themselves as experts during post abortion emergencies.Conclusion: Results provided important insight to midwives’ integration of post abortion care in Kinshasa. Strategies used by positive deviant midwives in emergencies allowed them to navigate challenging contexts in order to practice MVA, while simultaneously increasing the credibility of their profession and the dissemination of evidenced-based MVA practice. Programs designed to work with and promote positive deviant midwives as knowledge brokers could be tested for their overall impact on the diffusion of midwifery-led MVA to improve access to safe, respectful reproductive care.

scholarly journals Midwives’ Integration of Post-Abortion Manual Vacuum Aspiration in the Democratic Republic of Congo: A Mixed Methods Case Study & Positive Deviance Assessment

2020 ◽  
Author(s):  
Kirsty Marie Bourret ◽  
Sylvie Larocque ◽  
Amélie Hien ◽  
Carol Hogue ◽  
Kalum Muray ◽  
...  
Keyword(s):  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Statistical Significance ◽  
Republic Of Congo ◽  
Abortion Care ◽  
Vacuum Aspiration ◽  
Post Abortion Care ◽  
Manual Vacuum Aspiration ◽  
Post Abortion

Abstract Background: This collaborative research with the Professional Association of Congolese midwives (SCOSAF) in the province of Kinshasa, Democratic Republic of Congo sought to understand how midwives have integrated manual vacuum aspiration (MVA) for post abortion care. Methods: A positive deviant approach to Creswell’s mixed method comparative case study design was used to identify midwives who have integrated MVA post training and to explore enabling factors. Case group comparisons of positive and non-positive deviant midwives provided further interpretations. Results: All 102 midwives invited to be surveyed were recruited. They included 34% who reported practicing MVA post training. No statistical significance was found between the two groups’ demographics and facility type. Overall, groups had positive attitudes regarding midwifery, MVA, and legalization of abortion. Positive deviant midwives demonstrated and described more confidence and competence to practice and teach MVA. They were more likely to identify as teachers and overcome interprofessional barriers by teaching MVA to physicians, medical students and other midwives and position themselves as experts during post abortion emergencies.Conclusion: Results provided important insight to midwives’ integration of post abortion care in Kinshasa. Strategies used by positive deviant midwives in emergencies allowed them to navigate challenging contexts in order to practice MVA, while simultaneously increasing the credibility of their profession and the dissemination of evidenced-based MVA practice. Programs designed to work with and promote positive deviant midwives as knowledge brokers could be tested for its overall impact on the diffusion of midwifery led MVA to improve access to safe respectful reproductive care.

scholarly journals Midwives’ Integration of Post Abortion Manual Vacuum Aspiration in the Democratic Republic of Congo: A Mixed Methods Case Study & Positive Deviance Assessment

2020 ◽  
Author(s):  
Kirsty Marie Bourret ◽  
Sylvie Larocque ◽  
Amélie Hien ◽  
Carol Hogue ◽  
Kalum Muray ◽  
...  
Keyword(s):  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Positive Deviance ◽  
Republic Of Congo ◽  
Abortion Care ◽  
Vacuum Aspiration ◽  
Post Abortion Care ◽  
Manual Vacuum Aspiration ◽  
Post Abortion

Abstract Background: Despite a recognized need for midwives to provide post abortion care, there exist barriers preventing them from integrating lifesaving skills such as manual vacuum aspiration (MVA) into practice. This collaborative research with the Professional Association of Congolese Midwives (SCOSAF), sought to understand how certain midwives in the Democratic Republic of Congo (DRC) have overcome barriers to successfully integrate MVA for post abortion care. Specifically, in order to provide locally-driven solutions to the problem of inadequate post abortion care in the DRC, this study aimed to identify examples of positive deviance, or midwives who had successfully integrated MVA in complex working environments following an in-service training facilitated by their midwifery association, SCOSAF.Methods: Creswell’s mixed method comparative case study design was used to identify positive deviant midwives who had practiced MVA one or more times post training and to explore their strategies and enabling factors. Other midwives who had not practiced MVA post training permitted for a comparison group and further interpretations. Sources of data included a sequential survey and semi-structured interviews. Results: All 102 midwives invited to be surveyed were recruited and 34% reported practicing MVA post training (positive deviant midwives). No statistical significance was found between the two groups’ demographics and practice facility type. Overall, both groups had positive attitudes regarding midwifery-led MVA and legalization of abortion. Positive deviant midwives demonstrated and described more confidence and competence to practice and teach MVA. They were more likely to identify as teachers and overcome interprofessional barriers by teaching MVA to physicians, medical students and other midwives and position themselves as experts during post abortion emergencies.Conclusion: Results provided important insight to midwives’ integration of post abortion care in Kinshasa. Strategies used by positive deviant midwives in emergencies allowed them to navigate challenging contexts in order to practice MVA, while simultaneously increasing the credibility of their profession and the dissemination of evidenced-based MVA practice. Programs designed to work with and promote positive deviant midwives as knowledge brokers could be tested for their overall impact on the diffusion of midwifery-led MVA to improve access to safe, respectful reproductive care.

scholarly journals Midwives’ integration of post abortion manual vacuum aspiration in the Democratic Republic of Congo: a mixed methods case study & positive deviance assessment

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Kirsty M. Bourret ◽  
Sylvie Larocque ◽  
Amélie Hien ◽  
Carol Hogue ◽  
Kalum Muray ◽  
...  
Keyword(s):  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Positive Deviance ◽  
Republic Of Congo ◽  
Abortion Care ◽  
Vacuum Aspiration ◽  
Post Abortion Care ◽  
Manual Vacuum Aspiration ◽  
Post Abortion

Abstract Background Despite a recognized need for midwives to provide post abortion care, there exist barriers preventing them from integrating lifesaving skills such as manual vacuum aspiration (MVA) into practice. This collaborative research with the Professional Association of Congolese Midwives (SCOSAF), sought to understand how certain midwives in the Democratic Republic of Congo (DRC) have overcome barriers to successfully integrate MVA for post abortion care. Specifically, in order to provide locally-driven solutions to the problem of inadequate post abortion care in the DRC, this study aimed to identify examples of positive deviance, or midwives who had successfully integrated MVA in complex working environments following an in-service training facilitated by their midwifery association, SCOSAF. Methods Creswell’s mixed method comparative case study design was used to identify positive deviant midwives who had practiced MVA one or more times post training and to explore their strategies and enabling factors. Other midwives who had not practiced MVA post training permitted for a comparison gro cup and further interpretations. Sources of data included a sequential survey and semi-structured interviews. Results All 102 midwives invited to be surveyed were recruited and 34% reported practicing MVA post training (positive deviant midwives). No statistical significance was found between the two groups’ demographics and practice facility type. Overall, both groups had positive attitudes regarding midwifery-led MVA and legalization of abortion. Positive deviant midwives demonstrated and described more confidence and competence to practice and teach MVA. They were more likely to identify as teachers and overcome interprofessional barriers by teaching MVA to physicians, medical students and other midwives and position themselves as experts during post abortion emergencies. Conclusion Results provided important insight to midwives’ integration of post abortion care in Kinshasa. Strategies used by positive deviant midwives in emergencies allowed them to navigate challenging contexts in order to practice MVA, while simultaneously increasing the credibility of their profession and the dissemination of evidenced-based MVA practice. Programs designed to work with and promote positive deviant midwives as knowledge brokers could be tested for their overall impact on the diffusion of midwifery-led MVA to improve access to safe, respectful reproductive care.

scholarly journals Manual Vacuum Aspiration in IUFD 18 Weeks

2021 ◽  
Vol 21 (2) ◽  
pp. 114-148
Author(s):  
Ivanna Beru Brahmana
Keyword(s):  
Fetal Death ◽  
Ultrasound Examination ◽  
Uterine Cavity ◽  
Intrauterine Fetal Death ◽  
Minimal Risk ◽  
The Third ◽  
Vacuum Aspiration ◽  
Manual Vacuum Aspiration ◽  
Post Abortion

Manual Vacuum Aspiration (MVA) is an action to evacuate the uterine cavity up to 14 weeks gestation. In a more extensive pregnancy, it is worried that the action of the MVA is less clean so that it will still repeat the action of sharp curettage.  This article reports a multigravida aged 42 years old, G5P2A2, intrauterine fetal death (IUFD) at 18 weeks, undergoing MVA. Diagnosis of IUFD was performed using ultrasound examination. Before MVA was done, the patient was previously given 100 μg of misoprostol orally for dilation. This pregnancy was the third pregnancy with a second husband, all of whom had abortions. Manual Vacuum Aspiration had a minimal risk of uterine injury. After MVA was conducted, ultrasound examination was repeated to confirm a clean uterine cavity. It had been carried out on an indication of IUFD of 18 weeks gestation with the result of a clean uterine cavity and minimal bleeding. Furthermore, Post-Abortion Intra-Uterine Device (PAIUD) was installed adequately, not causing complaints. Based on the result, it can be concluded that MVA is effective for evacuation of uterine cavities on 18 weeks gestation.

scholarly journals Efficacy of Misoprostol as a Post Abortion Care

2014 ◽  
Vol 8 (2) ◽  
pp. 71-74
Author(s):  
M Jha ◽  
NS Chitrakar ◽  
B Shakya ◽  
R Jha
Keyword(s):  
Single Dose ◽  
Early Pregnancy ◽  
Abortion Care ◽  
Vacuum Aspiration ◽  
Obstetrics And Gynaecology ◽  
Incomplete Abortion ◽  
Post Abortion Care ◽  
Oral Misoprostol ◽  
Manual Vacuum Aspiration ◽  
Post Abortion

Aims: This study was done to find the efficacy of Misoprostol as a post-abortion care in our setting. Methods: Women with incomplete abortion of gestational age ≤ 12 weeks or uterine size ≤ 12 weeks with open cervical os, haemoglobin ≥ 9 gm% and stable physical condition; were given 600 microgram Misoprostol orally and were observed for 24 hours for complete expulsion. If the patient failed to expel within 24 hours of Misoprostol administration manual vacuum aspiration or suction evacuation was done. Results: One hundred and twenty-two women were enrolled in the study. Among them, 41% had complete expulsion within 24 hours of administration of misoprostol and 49% had incomplete expulsions. The success rate was high in the group of < 8 weeks of pregnancy. Among 50 (41%) successful cases, 38 (76%) belonged to 8 weeks of gestation by bimanual examination (p = 0.02). Conclusions: Single dose of oral Misoprostol was effective, safe and alternative method to the management of incomplete abortion compared to the manual vacuum aspiration or suction evacuation in case of early pregnancy abortion.Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 2 / Issue 16 / July-Dec, 2013 / 71-74 DOI: http://dx.doi.org/10.3126/njog.v8i2.9778

scholarly journals Midwives’ Integration of Post-Abortion Manual Vacuum Aspiration in the Democratic Republic of Congo: A Mixed Methods Case Study & Positive Deviance Assessment

2020 ◽  
Author(s):  
Kirsty Marie Bourret ◽  
Sylvie Larocque ◽  
Amélie Hien ◽  
Carol Hogue ◽  
Kalum Muray ◽  
...  
Keyword(s):  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Statistical Significance ◽  
Republic Of Congo ◽  
Abortion Care ◽  
Vacuum Aspiration ◽  
Post Abortion Care ◽  
Manual Vacuum Aspiration ◽  
Post Abortion

Abstract Scientific AbstractBackground: This collaborative research with the Professional Association of Congolese midwives (SCOSAF) in the province of Kinshasa, Democratic Republic of Congo sought to understand how midwives have integrated manual vacuum aspiration (MVA) for post abortion care.Methods: A positive deviant approach to Creswell’s mixed method comparative case study design was used to identify midwives who have integrated MVA post training and to explore enabling factors. Case group comparisons of positive and non-positive deviant midwives provided further interpretations.Results: All 102 midwives invited to be surveyed were recruited. They included 34% who reported practicing MVA post training. No statistical significance was found between the two groups’ demographics and facility type. Overall, groups had positive attitudes regarding midwifery, MVA, and legalization of abortion. Positive deviant midwives demonstrated and described more confidence and competence to practice and teach MVA. They were more likely to identify as teachers and overcome interprofessional barriers by teaching MVA to physicians, medical students and other midwives and position themselves as experts during post abortion emergencies.Conclusion: Results provided important insight to midwives’ integration of post abortion care in Kinshasa. Strategies used by positive deviant midwives in emergencies allowed them to navigate challenging contexts in order to practice MVA, while simultaneously increasing the credibility of their profession and the dissemination of evidenced-based MVA practice. Programs designed to work with and promote positive deviant midwives as knowledge brokers could be tested for its overall impact on the diffusion of midwifery led MVA to improve access to safe respectful reproductive care.

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