Postpartum contraceptive use among pregnant women who delivered at Cipto Mangunkusumo General Hospital: A descriptive study

HIGHLIGHT1. As maternal mortality rate (MMR) is still high, there should be ways to reduce the rate, one of which is the prevention of conception through contraceptive methods. 2. A descriptive study was conducted to all patients giving birth in a national hospital between 2016 to 2019 covering data on the patients, including age, parity, the origin of referral, and type of contraception.3. Most patients who gave birth in the hospital had postpartum contraception, especially permanent contraception and long-term contraception. ABSTRACTObjectives: The maternal mortality rate in Indonesia is one of the highest in the world at 305 out of 100.000 live birth. One of the best ways to reduce MMR is conception prevention through contraceptive methods. According to 2018 Demographic and Health Survey, Indonesia’s Contraceptive Prevalence Rate is as low as 57%, not even reaching the 2015 Millenium Development Goals target of 65%. We conducted a study on postpartum contraceptive use in Dr. Cipto Mangunkusumo National Central General Hospital (RSCM) to see the use of contraception in RSCM so that it can be an example of how contraception is used in RSCM for patients who give birth here.Materials and Methods: A descriptive study was conducted from all patients giving birth in RSCM from 2016 until 2019, data including patient data, consisting of patient age, parity, the origin of referral, and type of contraception, are input from the medical recordResults: There were 5,596 deliveries, consisting of 3,785 C-sections and 1,811 vaginal deliveries. As much as 5332 (95.3%) of subjects had postpartum contraception, 725 (13.67%) of which received tubectomy, and most of which received long-term contraceptive methods (IUD 4414 (82.78%) and implant 44 (0.82%)). As many as 1.065 subjects were more than 35 years of age, 6,2% of which did not use any postpartum contraception. As many as 984 subjects were RSCM bookcases, 6,9% of which did not use any postpartum contraception.Conclusion: Most patients giving birth in RSCM had postpartum contraception, especially permanent contraception and long-term contraception. The contraception profile in RSCM alone can neither describe nor represent the condition and distribution of contraceptive methods in Indonesia because RSCM is a national referral and medical education center whose cases are relatively more complex.

Social support in women with potential Essure-related complaints: an analysis of Facebook group content (Preprint)

BACKGROUND Social support groups are an important resource for people to cope with problems. Previous studies have reported the different types of support in these groups, but little is known about the type of reactions that sharing of personal experiences induce among members. It is important to know how and to what extent members of support groups influence each other regarding the consumption of medical care. We researched this in a online Facebook group of women sterilized with Essure®. Essure® was a device for permanent contraception. From 2015 onwards, women treated with Essure® for tubal occlusion raised safety concerns and experience numerous of complaints. OBJECTIVE To evaluate the use of social support in a Facebook community of Essure® Problems Netherlands. METHODS All post in a closed online Facebook group named: Essure Problems Netherlands between March 8 and May 8 of 2018 were included. In total 3,491 Facebook posts were analysed using a modified version on the social support behaviour code created by Cutrona and Suhr (1992). Posts were abstracted and aggregated into a database. Two investigators evaluated the posts, developed a modified version on the social support behaviour code book, and applied codes to data. RESULTS Results show that 92% messages contained a form of social support. In 68,8% of posting social support was given and in 31,2% social support was received. Informational and emotional support are the most frequently used form of given social support (53.4 and 43.6%, respectively). The same distribution is seen with receiving social support: informational support in 81,5% and emotional in 17,4% of the cases. CONCLUSIONS The main purpose of women in the Essure® problems group was to give and receive informational and/or emotional support.

Comparing options for females seeking permanent contraception in high resource countries: a systematic review

Background Multiple options for permanent or long-acting contraception are available, each with adverse effects and benefits. People seeking to end their fertility, and their healthcare providers, need a comprehensive comparison of methods to support their decision-making. Permanent contraceptive methods should be compared with long-acting methods that have similar effectiveness and lower anticipated adverse effects, such as the levonorgestrel-releasing intrauterine contraception (LNG-IUC). We aimed to understand the comparability of options for people seeking to end their fertility, using high-quality studies. We sought studies comparing laparoscopic tubal ligation, hysteroscopic tubal occlusion, bilateral salpingectomy, and insertion of the LNG-IUC, for effectiveness, adverse events, tolerability, patient recovery, non-contraceptive benefits, and healthcare system costs among females in high resource countries seeking to permanently avoid conception. Methods We followed PRISMA guidelines, searched EMBASE, Pubmed (Medline), Web of Science, and screened retrieved articles to identify additional studies. We extracted data on population, interventions, outcomes, follow-up, health system costs, and study funding source. We used the Newcastle–Ottawa Scale to assess risk of bias and excluded studies with medium–high risk of bias (NOS < 7). Due to considerable heterogeneity, we performed a narrative synthesis. Results Our search identified 6,612 articles. RG, BV, BC independently reviewed titles and abstracts for relevance. We reviewed the full text of 154 studies, yielding 34 studies which met inclusion criteria. We excluded 10 studies with medium–high risk of bias, retaining 24 in our synthesis. Most studies compared hysteroscopic tubal occlusion and/or laparoscopic tubal ligation. Most comparisons reported on effectiveness and adverse events; fewer reported tolerability, patient recovery, non-contraceptive benefits, and/or healthcare system costs. No comparisons reported accessibility, eligibility, or follow-up required. We found inconclusive evidence comparing the effectiveness of hysteroscopic tubal occlusion to laparoscopic tubal ligation. All studies reported adverse events. All forms of tubal interruption reported a protective effect against cancers. Tolerability appeared greater among tubal ligation patients compared to hysteroscopic tubal occlusion patients. No high-quality studies included the LNG-IUC. Conclusions Studies are needed to directly compare surgical forms of permanent contraception, such as tubal ligation or removal, with alternative options, such as intrauterine contraception to support decision-making. Systematic review registration PROSPERO [CRD42016038254].

Vasectomy interest and awareness among patients and their partners in prenatal clinics in the United States

ObjectiveAlthough vasectomy is safer, more effective and less expensive than tubal ligation, rates of permanent contraception are consistently higher in women than in men. We sought to explore vasectomy interest and awareness in patients and their partners during prenatal visits, a time when contraceptive counselling is typically performed.MethodsAnonymous surveys were distributed between January and July 2019 to a cross-sectional, convenience sample of pregnant women and their partners, if available, presenting for outpatient prenatal care at two hospitals (one public, one private) serving different patient populations in Chicago, Illinois, USA. Survey questions gauged participant awareness and interest in vasectomies.ResultsSurveys were completed by 436 individuals (78% female, 24% male). Seventy percent of respondents indicated interest in vasectomy after achieving optimal family size, but most respondents had never discussed it with their healthcare provider. Factors associated with vasectomy interest included being partnered, having a lower household income, and knowing someone who has had a vasectomy. Almost 50% of respondents would be interested in obtaining information about vasectomies from their obstetrician or prenatal care provider.ConclusionsMany patients and their male partners in the prenatal clinic setting were interested in vasectomy as a method for permanent contraception, but most respondents had never received counselling. Since comprehensive prenatal care includes contraceptive planning, obstetric providers are uniquely positioned to educate individuals on vasectomy.