| 1. |
- Elgán, Carina, 1962-, et al.
(författare)
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Influence of smoking and oral contraceptives on bone mineral density and bone remodeling in young women : a 2-year study
- 2003
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Ingår i: Contraception. - : Elsevier. - 0010-7824 .- 1879-0518. ; 67:6, s. 439-447
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Tidskriftsartikel (refereegranskat)abstract
- The objective of the study was to explore the influence of menstrual irregularities, oral contraceptives and smoking on bone mineral density (BMD) development and bone turnover with time. Healthy young women (n = 118) were divided into four categories: (a) women neither smoking nor using oral contraceptives; (b) women who were smokers; (c) women using oral contraceptives; (d) women who were smoking and using oral contraceptives. They responded to a validated questionnaire with 34 questions concerning lifestyle and the Sense of Coherence scale (SOC). BMD was measured by dual energy x-ray absorptiometry (DEXA). Deoxypyridinoline (DPD) was measured in urine. Data were analyzed by multiple linear regression analysis. Among smokers, BMD level decreased during a 2-year period and smoking was associated with a larger negative change in BMD. Use of oral contraceptives moderated the negative impact of smoking. Women using oral contraceptives at baseline and with regular bleeding induced by contraceptive pills had a significantly higher BMD at baseline and at follow-up. They also had lower SOC than women who had natural regular bleedings. Use of oral contraceptives in combination with smoking was linked to high alcohol consumption and higher frequency of self-reported body weight reduction, which reduced the negative BMD change in this category. DPD level and difference were strongly associated with estrogen influence. It is concluded that smokers without OCs had a negative BMD development and BMD in young women with irregular menstruations seems to be improved by OC.
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| 2. |
- Aneblom, Gunilla, et al.
(författare)
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Women's voices about emergency contraceptive pills "over-the-counter" : a Swedish perspective
- 2002
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Ingår i: Contraception. - 0010-7824 .- 1879-0518. ; 66:5, s. 339-343
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to describe women’s experiences with the emergency contraceptive pill (ECP) as a prescription-free over-the-counter (OTC) product. Women (median age 24) who had bought ECP as an OTC product were interviewed in focus groups. Data were analyzed by content analysis. All participants appreciated the OTC availability. Timesaving aspects were seen as important benefits and pharmacies were seen as the right place to sell ECP. The media was the main source of information about OTC, probably due to the debates of the introduction of ECP as an OTC product in Sweden. All women discussed the mechanism of action. The women’s experiences of interacting with the pharmacists were both positive and negative. Inconsistencies in routines with regard to providing ECP and different attitudes toward use of ECP among the pharmacists, were identified. The women expected up-to-date information about ECP and the OTC availability from gynecologists and other health professionals.
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| 3. |
- Falk, G, et al.
(författare)
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Young women requesting emergency contraception are, despite contraceptive counseling, a high risk group for new unintended pregnancies
- 2001
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Ingår i: Contraception. - 0010-7824 .- 1879-0518. ; 64:1, s. 23-27
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Tidskriftsartikel (refereegranskat)abstract
- Since its introduction in Sweden in 1994, emergency contraception has become a welcome addition to the campaign against unwanted pregnancy. In addition to an unplanned pregnancy, unprotected sexual intercourse may also involve the risk of contracting sexually transmitted diseases (STD). The aim of this study was to assess the short- and long-term risk of unintended pregnancy and to determine the frequency of chlamydia infections in women receiving emergency contraception. Between September 1998 and February 1999 young women aged 15-25 years had the opportunity to obtain emergency contraception (Yuzpe method) at a youth clinic in the city of Orebro where the opening hours were extended to include Saturdays and Sundays. A follow-up visit 3 weeks after treatment, which included contraceptive counseling, was offered to all participants. At both visits, a pregnancy test and a chlamydia test were performed, and the women completed a questionnaire. After the initial visit, the young women where monitored for new pregnancies during the following 12 months. One pregnancy occurred in the 134 young women who received emergency contraception during the study period. None of the women had a positive chlamydia test. Of those requesting emergency contraception, 54% did so because no contraception was used, 32% because of a ruptured condom, 11% because of missed oral contraceptives (OC), and 5% had mixed reasons. At long-term follow-up 1 year after the initial visit, 10 of the 134 young women had experienced an unplanned pregnancy that terminated in legal abortion in 9 women. All these women had either started and terminated OC or had never commenced the prescribed OC. Young women who request emergency contraception are, despite a planned follow-up with contraceptive counseling, a high risk group for new unintended pregnancies. In Sweden they do not seem to be a high risk group for STD.
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| 4. |
- Wreje, U, et al.
(författare)
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Collagen metabolism markers as a reflection of bone and soft tissue turnover during the menstrual cycle and oral contraceptive use
- 2000
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Ingår i: Contraception. - 0010-7824 .- 1879-0518. ; 61:4, s. 265-270
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Tidskriftsartikel (refereegranskat)abstract
- Two different groups of women, 23 healthy young adults and 13 women with chronic posterior pelvic pain, were studied before and during use of oral contraceptives (OC). Collagen metabolism markers-here, the amino-terminal propeptide of type I procollagen, the carboxy-terminal telopeptide of type I collagen, and the amino-terminal of procollagen type III-as well as hormones and other endocrine factors indicating the balance between androgen expression/anabolism and catabolism of the subjects (testosterone, sex-hormone binding globulin, and insulin-like growth factor I were measured. Type I procollagen, the carboxy-terminal telopeptide of type I collagen, and the amino-terminal of procollagen type III were all significantly decreased during OC use. These findings implicate OC use-induced changes in collagen type I and III turnover. A shift in the anabolic/catabolic balance was also recorded indicating a less anabolic situation during OC use.
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| 5. |
- Wreje, U., et al.
(författare)
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Collagen metabolism markers as a reflection of bone and soft tissue turnover during the menstrual cycle and oral contraceptive use
- 2000
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Ingår i: Contraception. - : Elsevier. - 0010-7824 .- 1879-0518. ; 61:4, s. 265-270
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Tidskriftsartikel (refereegranskat)abstract
- Two different groups of women, 23 healthy young adults and 13 women with chronic posterior pelvic pain, were studied before and during use of oral contraceptives (OC). Collagen metabolism markers-here, the amino terminal propeptide of type I procollagen, the carboxy-terminal telopeptide of type I collagen, and the amino-terminal of procollagen type III-as well as hormones and other endocrine factors indicating the balance between androgen expression/anabolism and catabolism of the subjects (testosterone, sex-hormone binding globulin, and insulin-like growth factor I were measured. Type I procollagen, the carboxy-terminal telopeptide of type I collagen, and the amino-terminal of procollagen type III were all significantly decreased during OC use. These findings implicate OC use-induced changes in collagen type I and III turnover. A shift in the anabolic/catabolic balance was also recorded indicating a less anabolic situation during OC use.
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| 6. |
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| 7. |
- Abujrais, Sandy, et al.
(författare)
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A sensitive method detecting trace levels of levonorgestrel using LC-HRMS
- 2019
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Ingår i: Contraception. - : Elsevier BV. - 0010-7824 .- 1879-0518. ; 100:3, s. 247-249
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To develop a high resolution mass spectrometry (HRMS) method to quantify levonorgestrel (LNG) in serum. Study design: Levonorgestrel was extracted using solid phase extraction and measured using liquid chromatography (LC) HRMS. Results: Low limit of quantification (LLOQ) was 25 pg/mL and low limit of detection (LLOD) was 12.5 pg/mL. Precision and accuracy bias were <10%. LNG in serum samples from Mirena® users ranged between 37 to 219 pg/mL (n=12). In eight out of 22 patients with suspected intrauterine device (IUD) expulsion LNG was detected (26–1272 pg/mL). Conclusion: A sensitive, fast and simple LC-HRMS method was developed to detect trace levels of LNG. © 2019 Elsevier Inc.
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| 8. |
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| 9. |
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| 10. |
- Berger, Cecilia, et al.
(författare)
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Molecular characterization of PRM-associated endometrial changes, PAEC, following mifepristone treatment
- 2018
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Ingår i: Contraception. - : Elsevier. - 0010-7824 .- 1879-0518. ; 98:4, s. 317-322
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Tidskriftsartikel (refereegranskat)abstract
- Objective: 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. Study design: Endometrial biopsies were obtained from premenopausal women following 3 months of continuous mifepristone treatment. The biopsies were evaluated regarding occurrence of PAEC and followed up by a comparative analysis of gene expression in PAEC endometrium (n=7) with endometrium not displaying PAEC (n=4). Methods used included microarray analysis, Ingenuity Pathway Analysis (IPA) and real-time polymerase chain reaction. Results: Three genes relevant within endometrial function were up-regulated with PAEC: THY1 (p=.02), ADAM12 (p=.04) and TN-C (p=.04). The proliferation marker MKi67 was not altered (p=.31). None of the differentially regulated genes were involved in the endometrial cancer-signaling pathway (based on IPA knowledge database). Conclusion: The genes altered in endometrium displaying PAEC after 3 months of mifepristone exposure are mainly involved in the structural architecture of tissue. Implications: PAEC features may be explained by the altered genes and their networks affecting tissue architecture although not involved in endometrial cancer signaling pathways, and thus, treatment with mifepristone at this dosage does not show any adverse effect at endometrial level.
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| 11. |
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| 12. |
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| 13. |
- Ehn, Bodil, et al.
(författare)
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The process of opting for female permanent contraception : A qualitative study of women's experiences in Sweden
- 2021
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Ingår i: Contraception. - : Elsevier. - 0010-7824 .- 1879-0518. ; 103:1, s. 48-52
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: We aimed to explore Swedish women's decision-making experiences regarding permanent contraception. Study design: In this study, we included 17 women aged 30–48 who were scheduled to undergo female permanent contraceptive procedures. We conducted semistructured interviews using two broad open-ended questions. We analyzed these data using systematic text condensation based on the principles of psychological phenomenological analysis. Results: The interviewees experienced no counseling or support from health care workers regarding permanent contraception until they specifically asked for it. Participants reported that they themselves place the responsibility of permanent contraception solely on women. Consequently, our participants described feeling hesitancy and ambivalence in the process of deciding to have the procedure. Once the decision was made and the women were on the waiting lists for surgery, they experienced relief and empowerment. Conclusions: Our findings suggest that health care providers in Sweden miss opportunities to support patient-centered decision-making regarding permanent contraception. This study indicates that women make deliberate and considered decisions regarding permanent contraception and are best positioned to know when the procedure should take place in their reproductive lives. Implication statements: Health care professionals should discuss permanent contraception as an option with all women desiring contraception to allow them to decide if that method is right for them. © 2020 Elsevier Inc.
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| 14. |
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| 15. |
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| 16. |
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| 17. |
- Envall, Niklas, 1984-, et al.
(författare)
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Intrauterine mepivacaine instillation for pain relief during intrauterine device insertion in nulliparous women: a double-blind, randomized, controlled trial
- 2019
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Ingår i: Contraception. - : Elsevier BV. - 0010-7824 .- 1879-0518. ; 99:6, s. 335-39
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate whether intrauterine mepivacaine instillation before intrauterine device (IUD) insertion decreases pain compared to placebo.STUDY DESIGN: We performed a double-blind, randomized, controlled trial comparing mepivacaine 1% 10 mL versus 0.9% NaCl intrauterine instillation using a hydrosonography catheter 5 min before IUD insertion in women 18 years of age or older. Participants completed a series of 10-cm visual analogue scales (VAS) to report pain during the procedure. The primary outcome was the difference in VAS scores with IUD insertion between intervention group and placebo. Secondary outcomes included VAS before and after insertion and analgesia method acceptability.RESULTS: We randomized 86 women in a 1:1 ratio; both groups had similar baseline characteristics. In the intention-to-treat analysis, the primary outcome, median VAS with IUD insertion, was 4.8 cm in the intervention group [n=41, interquartile range (IQR) =3.1-5.8] and 5.9 cm in the placebo group (n=40, IQR=3.3-7.5, p=.062). In the per-protocol analysis, the median VAS with IUD insertion was 4.8 cm (IQR=3.1-5.5) and 6.0 cm (IQR=3.4-7.6) for the intervention and placebo groups, respectively (p=.033). More women in the intervention group reported the procedure as easier than expected (n=26, 63.4% vs. n=15, 37.5%), and fewer reported it as worse than expected (n=3, 7.3% vs. n=14, 35%, p=.006).CONCLUSION: Intrauterine mepivacaine instillation before IUD insertion modestly reduces pain, but the effect size may be clinically significant.IMPLICATIONS STATEMENT: While the reduction in VAS pain scores did not meet our a priori difference of 1.3 points for clinical significance, participants' favorable subjective reaction suggests that this approach merits further study.Copyright © 2019 Elsevier Inc. All rights reserved.KEYWORDS: Contraception; Intrauterine devices; Mepivacaine; Pain; VAS
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| 18. |
- Falk, Gabriella, 1955-, et al.
(författare)
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Teenage mothers : a high-risk group for new unintended pregnancies
- 2006
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Ingår i: Contraception. - : Elsevier BV. - 0010-7824 .- 1879-0518. ; 74:6, s. 471-475
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: One of the targets of national health programs is to prevent unintended pregnancies, especially among teenagers. It is well established that these often lead to abortion. Preventive programs aimed at decreasing abortion rates should identify target groups at risk for unintended pregnancies.PURPOSE: This study was conducted to determine whether young mothers under 20 years of age constitute a group at risk for new unintended pregnancies.METHODS: A retrospective cohort study comprising teenagers giving birth to their first child from 1996 to 2000 was performed at Orebro University Hospital, Sweden. Data were collected from antenatal and medical records with particular regard to compliance with the postpartum visit and to whether a contraceptive method was prescribed. Information concerning repeat pregnancies during the 12 months after delivery was obtained.RESULTS: A total of 250 deliveries were recorded; 70% of the mothers attended the postpartum visit, and 71% received contraceptive prescriptions. At the 12-month follow-up, 56 (25%) had a new pregnancy, and of those, 20 (36%) had a legal abortion, making the abortion rate fivefold higher than expected in this age group.
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| 19. |
- Gainer, Erin, et al.
(författare)
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Bringing emergency contraception over the counter : experiences of nonprescription users in France, Norway, Sweden and Portugal.
- 2003
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Ingår i: Contraception. - 0010-7824 .- 1879-0518. ; 68:2, s. 117-24
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Tidskriftsartikel (refereegranskat)abstract
- Emergency contraceptive pills are now available on a nonprescription basis in over 25 countries worldwide. In an effort to learn about women's experiences with this new means of emergency contraception (EC) service delivery, we conducted focus-group discussions with nonprescription EC users from France, Norway, Portugal and Sweden. Participants from these countries overwhelming supported pharmacy access to EC, explaining that pharmacy delivery facilitated rapid access to the method. Despite expressing mixed reviews of the counseling given by the providing pharmacists, participants reported that they knew how use the method safely and properly. Most indicated that the package insert was easy to understand and adequately answered the majority of their questions. Participants described the EC experience as a motivating factor that, in many cases, has led to more consistent use of regular contraceptive methods. These data are valuable to policy-makers and institutions interested in learning more about the safety and acceptability of nonprescription access to emergency contraceptive pills.
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| 20. |
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| 21. |
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| 22. |
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| 23. |
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| 24. |
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| 25. |
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| 26. |
- Gemzell-Danielsson, K, et al.
(författare)
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UPA > LNG, but Not Good Enough
- 2013
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Ingår i: Contraception. - : Elsevier BV. - 1879-0518 .- 0010-7824. ; 88:5, s. 585-586
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 27. |
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| 28. |
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| 29. |
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| 30. |
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| 31. |
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| 32. |
- Ildgruben, Anna, et al.
(författare)
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Steroid receptor expression in vaginal epithelium of healthy fertile women and influences of hormonal contraceptive usage.
- 2005
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Ingår i: Contraception. - : Elsevier BV. - 0010-7824 .- 1879-0518. ; 72:5, s. 383-392
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The objective of this study was to evaluate whether long-term usage of hormonal contraceptives modifies the steroid receptor expression in the human vaginal epithelium of healthy young women. METHODS: In a cross-sectional study, three groups of hormonal contraceptive users [combined oral contraceptives (COCs), levonorgestrel implants (LNG) and depot medroxyprogesterone acetate injections (DMPAs)] were compared to controls. Fifteen subjects (20-34 years) were enrolled to each group. Vaginal biopsies were collected at two occasions from each subject, and serum concentrations of E(2) and progesterone were measured. Monoclonal antibodies directed against progesterone receptors (PRs) and estrogen receptors (ERs) were used in immunohistochemistry on formalin-fixed tissue sections of vaginal mucosa. A program for immunohistomorphometric quantification was devised to estimate frequency of epithelial steroid receptor-expressing cells. RESULTS: Progesterone receptor expression was markedly down-regulated and significantly reduced in DMPA users compared to controls, COC and LNG users. In DMPA users, the ER expression was significantly elevated in the first compared to the second sample, and significantly elevated compared to LNG users. Estradiol concentration in serum was significantly reduced in hormonal contraceptive users compared to controls. CONCLUSIONS: Steroid receptor expression in human vaginal epithelium is altered by long-term use of DMPA compared to controls.
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| 33. |
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| 34. |
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| 35. |
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| 36. |
- Larsson, Margareta, et al.
(författare)
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Emergency contraceptive pills over-the-counter : a population-based survey of young Swedish women
- 2004
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Ingår i: Contraception. - : Elsevier BV. - 0010-7824 .- 1879-0518. ; 69:4, s. 309-315
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Tidskriftsartikel (refereegranskat)abstract
- One year after emergency contraceptive pills (ECP) had become prescription-free, we sent a questionnaire to 800 randomly selected women in mid-Sweden. The aim was to investigate women's knowledge, attitudes and practices regarding the method. The response rate was 71% (n = 564). The majority of the women, 65%, would prefer to purchase ECP over-the-counter (OTC) in a pharmacy. Attitudes toward the method were predominantly positive, but one fourth (24%) had worries about side effects and one third (33%) considered ECP to be a kind of abortion. Logistic regression showed that correct knowledge of and positive attitudes toward ECP contributed to estimated future use of ECP. Although women favored the OTC option, persistent misunderstanding about ECP implies that routine information from gynecologists and health professionals as well as media campaigns is needed along with the deregulation in order to make ECP an accepted and properly used contraceptive method.
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| 37. |
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| 38. |
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| 39. |
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| 40. |
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| 41. |
- Nyberg, Sigrid
(författare)
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Mood and physical symptoms improve in women with severe cyclical changes by taking an oral contraceptive containing 250-mcg norgestimate and 35-mcg ethinyl estradiol
- 2013
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Ingår i: Contraception. - : Elsevier. - 0010-7824 .- 1879-0518. ; 87:6, s. 773-781
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Tidskriftsartikel (refereegranskat)abstract
- Background: The purpose of this study was to investigate how women without and with different severity of premenstrual symptoms react to treatment with a combined oral contraceptive containing 250-mcg norgestimate/35-mcg ethinyl estradiol (EE). Focus was placed on mood and physical symptoms. Study Design: This open, prospective study evaluated 24 women using norgestimate/EE for three cycles in a 21/7 regimen. Symptoms and bleeding pattern were captured by daily ratings on the Cyclicity Diagnoser scale. Results: Women with severe premenstrual mood symptoms improved in summarized negative mood (p<.001) and summarized positive mood (p<.05), as well as in swelling (p<.05) and effect on daily life (p<.05). Women with no or mild or moderate symptoms did not show any significant improvement or deterioration in any symptom after 3 months of treatment. Conclusions: Norgestimate 250 mcg/EE 35 mcg significantly improved premenstrual summarized negative mood symptoms during 3 treatment months compared to pretreatment in women with severe premenstrual symptoms, together with improvement in positive symptoms, swelling and effect on daily life. (C) 2013 Elsevier Inc. All rights reserved.
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| 42. |
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| 43. |
- Rönnerdag, Maria, et al.
(författare)
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Late bleeding problems with the levonorgestrel-releasing intrauterine system : evaluation of the endometrial cavity
- 2007
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Ingår i: Contraception. - : Elsevier BV. - 0010-7824 .- 1879-0518. ; 75:4, s. 268-270
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Tidskriftsartikel (refereegranskat)abstract
- Background: This study was conducted to determine causes of abnormal bleeding patterns occurring after at least 6 months of successful use of the levonorgestrel-releasing intrauterine system (LNG-IUS). Study Design: Matched-pair, case-control study. Fifteen users of the device with unacceptable bleeding problems (cases) and 15 controls using the device but without such problems were recruited. All women had vaginal ultrasonography and hysteroscopy performed to evaluate the endometrial cavity. Results: An abnormality demonstrated by ultrasonography or hysteroscopy (either device displacement or leiomyomas) was more common among cases than controls. The McNemar's test for discordant case-control pairs yielded a p value of .046. After removal of the device and reinsertion of another levonorgestrel-releasing device, all cases reported improvement of the bleeding pattern. Conclusions: Displacement of the device and intracavitary leiomyomas are commonly associated with unacceptable bleeding in women after prolonged use of the LNG-IUS. Ultrasonography and hysteroscopy may be useful in evaluating bleeding complaints in long-term users of this device.
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| 44. |
- Samir, Raghad, et al.
(författare)
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Oral contraceptive and progestin-only use correlates to tissue tumor marker expression in women with cervical intraepithelial neoplasia
- 2012
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Ingår i: Contraception. - : Elsevier BV. - 0010-7824 .- 1879-0518. ; 85:3, s. 288-293
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Tidskriftsartikel (refereegranskat)abstract
- Background: The study was conducted to investigate correlations between combined oral contraceptive (COC), any progestin-only contraceptive, medicated intrauterine device (MID) or systemic progestin-only (Syst-P) use and tumor marker expression in cervical intraepithelial neoplasia compared to nonusers.Study Design: One-hundred ninety-five women of fertile age with cervical biopsies ranging histologically from normal epithelium to carcinoma in situ were recruited consecutively. Combined oral contraceptive, Syst-P and MID users were investigated according to the expression of 11 tumor markers.Results: Overexpression of cyclooxygenase-2 (Cox-2) was observed in COC users, while interleukin 10 was underexpressed. When users of progestogen-only contraceptives were analyzed, there was a lower expression of cytokeratin 10 and interleukin 10. When only MID users were analyzed, a high expression of p53 was found. Expression of Cox-2, p53 and retinoblastoma protein differed between COC and MID users.Conclusion: The study showed molecular alterations, which, in general, have not been studied previously in COC users and have never been studied in progestogen-only users. These biological events might be involved in epidemiological correlations found between hormonal contraceptive use and cervical neoplasms.
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| 45. |
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| 46. |
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| 47. |
- Segebladh, Birgitta, et al.
(författare)
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Prevalence of psychiatric disorders and premenstrual dysphoric symptoms in patients with experience of adverse mood during treatment with combined oral contraceptives
- 2009
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Ingår i: Contraception. - : Elsevier BV. - 0010-7824 .- 1879-0518. ; 79:1, s. 50-55
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Negative mood symptoms remain one of the major reasons for discontinuation of combined oral contraceptive pills (COCs). The primary aim of this study was to compare the prevalence of mood and anxiety disorders in women with different experience of COCs. STUDY DESIGN: Thirty women currently on COCs with no report of adverse mood symptoms, 28 women currently on COCs and experiencing mood-related side effects, 33 women who had discontinued COC use due to adverse mood effects and 27 women who had discontinued COC use for reasons other than adverse mood symptoms were included. Ongoing psychiatric disorders were evaluated by a structured psychiatric interview and prevalence rates of premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) were assessed by daily prospective ratings on the Cyclicity Diagnoser scale. RESULTS: Women with ongoing or past experience of COC-induced adverse mood, more often suffered from mood disorders than women with no reports of adverse mood while on COC. The prevalence of prospectively defined PMS or PMDD did not differ between prior users with positive or negative experience. Women who had discontinued COC use due to adverse mood symptoms more often had had a legal abortion in the past. CONCLUSION: Women with ongoing or past self-reported adverse mood effects from COCs had a significantly increased prevalence of mood disorders.
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| 48. |
- Sjöström, Susanne, 1967-, et al.
(författare)
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Medical students' attitudes and perceptions on abortion : a cross-sectional survey among medical interns in Maharastra, India
- 2014
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Ingår i: Contraception. - : Elsevier BV. - 0010-7824 .- 1879-0518. ; 90:1, s. 42-46
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Although abortion care has been an established routine since decades in India, 8% of maternal mortality is attributed to unsafe abortion. Increased knowledge and improved attitudes among health care providers have a potential to reduce barriers to safe abortion care by reducing stigma and reluctance to provide abortion. Previous research has shown that medical students' attitudes can predict whether they will perform abortions. The objective of our study was to explore attitudes toward abortion among medical interns in Maharastra, India. Study Design: A cross-sectional survey was carried out among 1996 medical interns in Maharastra, India. Descriptive and analytical statistics were used to interpret the study instrument. Results: Almost one quarter of the respondents considered abortion to be morally wrong, one fifth did not fund abortions for unmarried women acceptable and one quarter falsely believed that a woman needs her partner or spouse's approval to have an abortion. Most participants agreed that unsafe abortion is a serious health problem in India. A majority of the respondents rated their knowledge of sexual and reproductive health as good, but only 13% had any clinical practice in abortion care services. Conclusion: Disallowing attitudes toward abortion and misconceptions about the legal regulations were common among the surveyed medical students. Knowledge and attitudes toward abortion among future physicians could be improved by amendments to the medical education, potentially increasing the number of future providers delivering safe and legal abortion services. Implication Paragraph: Abortion is legal in India since decades, but maternal mortality due to unsafe abortions remains high. This survey of attitudes toward abortion among medical interns in Maharastra indicates that disallowing views prevail. Improved knowledge and clinical training can increase numbers of potential abortion providers, thus limit unsafe abortion.
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| 49. |
- Suhonen, Satu, et al.
(författare)
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Clinical performance of a levonorgestrel-releasing intrauterine system and oral contraceptives in young nulliparous women : A comparative study
- 2004
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Ingår i: Contraception. - : Elsevier BV. - 0010-7824 .- 1879-0518. ; 69:5, s. 407-412
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Tidskriftsartikel (refereegranskat)abstract
- This 1-year randomized study was carried out at family-planning clinics of two university hospitals to compare the safety and acceptability of a levonorgestrel-releasing intrauterine system (LNG IUS) and oral contraceptives (OCs) in young nulliparous women. The study population consisted of 200 women aged 18-25 years seeking contraception. Ninety-four women entered the LNG IUS group and 99 entered the OC group. Continuation rates, reasons leading to discontinuation, adverse events, menstrual questionnaires, subjective well-being and sexual behavior were evaluated. Nineteen women (20%) in the LNG IUS group discontinued the study during the 1-year observation period, and 27 discontinued (27%) in the OC group. The most common reason (31%) for discontinuation in the IUS group was pain. In the OC group, hormonal side effects were the predominant medical reason for study termination. The safety and acceptability of the LNG IUS for contraception was observed to be as good as with OCs, with a high continuation rate.
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| 50. |
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