Epidemiological profile and pain degree in women who inserted intrauterine device

The intrauterine device (IUD) is a long-acting reversible contraceptive (LARC) option and has a low cost to the health system. It is an excellent cost-effective strategy for contraception. This study aimed to characterize the epidemiological profile of women who had an IUD inserted, in addition to evaluating the degree of pain during insertion, correlating it with age and obstetric variables. This is a retrospective study with women who inserted an IUD in a reference service in Sergipe between November 2018 and February 2021. Information such as age, number of pregnancies, deliveries and abortions before IUD insertion, pathology or reason for IUD indication, pain scale, hysterometry and wire size after insertion was analyzed. The study included 346 women who inserted copper IUDs and 47 who inserted hormonal IUDs. The mean age of patients was 27.1 years and 33.7 years, mean pain was 4.6 and 5.5 and mean hysterometry was 8.29 and 8.55, respectively. It was noticed that more than 60% of women had at least one pregnancy prior to insertion of the device, in both cases. There was no correlation between pain level and age and parity. Most women who inserted IUDs were in the post-adolescent phase. In addition, most had already had at least one previous pregnancy and experienced moderate pain during IUD insertion.

Contraception in Adolescents

Adolescents are at risk for unwanted pregnancy when they become sexually active, and contraception is an important part of mitigating this risk. Use of contraceptive methods, and long-acting reversible contraceptive methods such as implants and intrauterine devices in particular, has increased among adolescents. Although sexual activity has declined and contraceptive use has increased among adolescents in the United States in recent years, the unintended pregnancy rate remains high. All of the currently available contraceptive methods are safe and effective for adolescents to use; however, adolescents may have specific concerns about side effect profiles and unscheduled bleeding that should be addressed during contraceptive counseling. Healthcare providers should prioritize adolescents' needs and preferences when approaching contraceptive counseling, and also consider the unique access and confidentiality issues that adolescents face when accessing contraception.

Long-acting reversible contraception utilization and associated factors among women in extended postpartum period in southern Ethiopia

Background Postpartum long-acting reversible contraceptive is important to prevent unintended and closed spaced pregnancy following the first 12 months of childbirth. Few data were available on postpartum long-acting reversible contraceptive use in Ethiopia. So, this study aimed to assess the long-acting reversible contraception use and associated factors among women who gave birth in the last 12 months. Methods A community-based cross-sectional study was conducted from October 1st to November 2019. Systematic random sampling was applied to recruit a total of 416 study participants. Data were collected using a structured questionnaire. Data were entered using Epidata 4.6 and exported to SPSS version 25 for analysis. P-value < 0.05 with 95% confidence interval (CI) used to declare statistical significance. Result In this study, long acting contraceptive utilization among women in the extended postpartum period was 22.6%. Maternal age ≤ 24 years (AOR = 3.7, 95% CI: 1.5, 8.9), being married (AOR =3.5 95% CI: (1.17–10.28)), menses resumption (AOR = 4.9 95% CI: (2.92, 8.20)), sexual intercourse resumption (AOR = 7.1 95% CI: (4.03, 12.56)) and received postpartum family planning counseling (AOR = 3.2 95% (1.95, 5.28)) were the factors associated with Long-acting reversible contraception use. Conclusion This finding showed postpartum women’s long-acting reversible contraceptive use during the extended postpartum period was low. The factors significantly associated with extended postpartum modern contraceptive use were women’s age, being married, menses resumption, sexual intercourse resumption, and got postnatal family planning counseling. Strengthening Antenatal and postnatal counseling of postpartum family planning would improve long-acting reversible contraception use.

Abortion care in a pandemic: an analysis of the number and social profile of people requesting and receiving abortion care during the first COVID-19 lockdown (March 16 to June 14, 2020) in Flanders, Belgium

Background The COVID-19 pandemic and the national COVID-19 measures might have increased potential barriers to abortion care and created new ones, especially for vulnerable groups. This study documents the impact of the pandemic and the lockdown measures on the profile of people going through the abortion process. Methods Using anonymized patient records from a Belgian abortion centre, we first compared the number of abortion requests and procedures during the first COVID-19 lockdown with the same months in the five preceding years. Next, we analysed the social profile of people requesting an abortion in those two time periods and looked at the number of long-acting reversible contraceptive devices (LARC) placed after curettage. Results The abortion centre saw a drop in the number of abortion requests during the lockdown. This difference was more pronounced for people in paid employment and people using (modern) contraception. People were also more likely to request an abortion earlier in their pregnancy. The drop in abortion procedures and LARC’s placed after curettage was proportionate to the drop in abortion requests and did not differ according to clients’ characteristics. Conclusion Questions arose concerning the potential selectivity with which COVID-19 influenced the need for abortion care and accessibility to services. Although there was a general drop in abortion requests and procedures during the first COVID-19 lockdown in the studied abortion centre, our results suggest that the profile of people requesting and receiving an abortion did only slightly change during the lockdown, and did not affect vulnerable groups visibly harder.

Analysis Factors of the Intention of Postpartum Women using Long-Acting Reversible Contraceptive Based on the Theory of Planned Behavior

Introduction:The use of Long-Acting Reversible Contraceptive (LARC) in postpartum women is still low even though the government recommends an effective method to decrease population growth. Attitude, subjective norm, and perceived behavioral control are background factors that shape people's intentions in displaying behavior. This study aimed to analyze the correlation between attitude, subjective norm, and perceived behavioral control with postpartum women's intentions using LARC.Methods: This study used a descriptive correlational design with a cross-sectional approach. The populations were postpartum women ≤ 42 days in Tambaksari Sub-District Surabaya. The inclusion criteria were postpartum women who had not become KB acceptors and the exclusion criteria for postpartum women with widow status. The samples were 84 people that met using a purposive sampling technique. Data were collected with a questionnaire consisting of demographic data, attitude, subjective norm, perceived behavioral control, and intentionand analyzed using spearmen's rho test with a significance level of 0.05.Results: The result showed that attitude (p=0.000 r=0.604) , subjective norm (p=0.000 r=0.610), and perceived behavioral control (p=0.000 r=0.608) had significant correlation with intentions.Conclusion: The positive attitude, good subjective norm support, and robust perceived behavioral control give high intentions using LARC in postpartum women. The recommendations for future researchers are expected to conduct a comparative study of the behavior of choosing LARC and Non-LARC in postpartum women.

Women's Use of Long-Acting Reversible Contraception for Birth Timing and Birth Stopping

The use of long-acting reversible contraceptive (LARC) methods—intrauterine devices (IUDs) and implants—has recently expanded rapidly in the United States, and these methods together approach the contraceptive pill in current prevalence. Research on LARCs has analyzed their use to reduce unintended pregnancies but not their use to enable intended pregnancies. Knowledge of both is necessary to understand LARCs’ potential impacts on the reproductive life courses of U.S. women. We combine data from two nationally representative surveys to estimate women's likelihood and timing of subsequent reproductive events, including births resulting from an intended pregnancy up to nine years after discontinuing LARC use. We estimate that 62% of women will give birth, and 45% will give birth from an intended pregnancy. Additionally, 18% will have a new LARC inserted, and 13% will transition to sterilization. Most of these reproductive events occur within two years after discontinuing LARC use. Births from an intended pregnancy are especially common when no intervening switch to another contraceptive method occurs. We infer that women's motives for using LARC are varied but include the desire to postpone a birth, to postpone a decision about whether to have a(nother) birth, and to transition definitively to the completion of childbearing.

Conhecimento e uso de métodos contraceptivos de longa duração entre adolescentes: revisão integrativa da literatura

Contexto: métodos contraceptivos de longa duração (long-acting reversible contraceptive - LARC), embora efetivos e com duração igual ou superior a três anos, têm pouca familiaridade e uso entre adolescentes. Objetivo: descrever a produção científica sobre conhecimento e uso de contraceptivos de longa duração entre adolescentes. Método: revisão integrativa da literatura nas bases de dados: Science Direct e National Library of Medicine and National Institutes of Health (MEDLINE/PubMed), realizada em outubro e novembro de 2019. Utilizaram-se os descritores Long-acting reversible contraceptive e adolescente para buscar a produção científica do período 2011 a 2019. Resultados: foram encontrados 86 artigos e, após aplicação do fluxograma PRISMA, dez artigos foram inseridos no estudo, sendo oito quantitativos e dois qualitativos. Conclusão: conclui-se que o uso de LARC em adolescente está associado ao conhecimento e que o aconselhamento pode ser uma estratégia de apoio e vínculo, gerando confiança entre usuária e profissional, podendo este último influenciar na decisão quanto ao uso de LARC, assim como de outros métodos anticoncepcionais.