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- Aneblom, Gunilla
(författare)
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The Emergency Contraceptive Pill – a Second Chance : Knowledge, Attitudes and Experiences Among Users and Providers
- 2003
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to study knowledge, attitudes and experience of emergency contraceptive pills among women and providers. Both quantitative and qualitative methods were used. Focus-group interviews were conducted with teenage-girls (I) and with women who had purchased ECP without prescription (IV). Self-administered waiting-room questionnaires were administered to women presenting for induced abortion in three large hospitals (II, III), and after the deregulation of ECP, a postal questionnaire was sent to pharmacy staff and nurse-midwives in three counties in mid-Sweden (V). Overall, women showed high basic awareness of ECP although specific knowledge such as the level of effectiveness, time-frames and how the method works was lacking. Approval of the method was high and most women were positive to use the method if they needed. Contradictory views as to whether ECP undermines contraceptive behavior were expressed. As many as 43% of women requesting induced abortion had a history of one or more previous abortions. Among the abortion applicants, one out of five, 22%, had previously used ECP and 3% had used it to prevent the current pregnancy. Media and friends were the two most common sources of information on ECP. Half of the women, 52%, were positive to having ECP prescription-free. Those women who had purchased ECP in a pharmacy without prescription, appreciated this possibility, and the major benefits expressed were time saving aspects. No severe side-effects were reported. The women's experiences of interaction with pharmacy staff were both positive and negative. The importance of up-to-date information about ECP and the OTC-availability from the health care providers was emphasized. Both pharmacy staff and nurse-midwives had positive attitudes towards ECP and the OTC availability. Of pharmacy staff, 38% reported that they referred women to nurse-midwives/gynecologists for further counseling and follow-ups. The need for increased communication and collaboration between pharmacies and local family planning clinics was reported by both study groups with suggestions of regular meetings for information and discussions. The results suggest that ECP is still underused and that more factual information is needed before the method is becoming a known, accepted and integrated back-up method to the existing family planning repertoire. Longitudinal research to assess the long-term effects of ECP is needed.
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| 2. |
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| 3. |
- Gemzell-Danielsson, Kristina, et al.
(författare)
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Comprehensive counseling about combined hormonal contraceptives changes the choice of contraceptive methods : results of the CHOICE program in Sweden
- 2011
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 90:8, s. 869-877
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To study the influence of counseling on women's contraceptive decisions. Design. A cross-sectional multicenter study. Setting. Seventy Swedish family planning clinics. Population. Women aged 15-40 years attending for a contraceptive consultation who expressed interest in a combined hormonal contraceptive (CHC) method. Methods. Structured counseling about three CHCs and questionnaires completed after counseling from the healthcare professional. Main Outcome Measures. Method originally requested, perceptions of CHC attributes, method chosen and reasons for the choice. Results. In all, 173 healthcare professionals and 1 944 women participated. The mean standard deviation (SD) age of the women was 22.6(6.1) years. After structured counseling, a majority of women (56.0%; n=1 069; 95% confidence interval (CI) 53.1-58.9) chose the daily pill, 6.2% (n=118; 95% CI 4.9-7.8) chose the weekly patch, and 22.5% ( n=430; 95% CI 20.2-25.1) chose the monthly ring. The weekly patch was chosen more often after counseling (6.2 vs 2.4% before counseling; p<0.0001). The greatest change was in the proportion of women who chose the contraceptive ring after counseling (22.5% vs. 8.5% before counseling; p<0.0001). The proportion of undecided women after counseling was reduced considerably (3.9% vs. 27.8% before counseling). Among the 523 women who were undecided before counseling, 50.6% chose the pill, 10.2% the patch and 24.6% the ring, while 20.9% of women who initially requested the pill changed to another method. Conclusions. Structured counseling facilitated choice of contraceptive method for most women, leading to changes in women's selection of a CHC method.
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| 4. |
- Makenzius, Marlene, et al.
(författare)
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Women's decision-making related to induced abortion : a cross sectional study during a period of Covid-19 pandemic, in Sweden.
- 2023
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Ingår i: European journal of contraception & reproductive health care. - : Taylor & Francis Group. - 1362-5187 .- 1473-0782. ; 28:1, s. 44-50
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To investigate women's decision-making on induced abortion.MATERIALS AND METHODS: A multi-centre cross-sectional survey among 623 abortion-seeking women in Sweden (2021). The perceived difficulty to decide on abortion was measured using a 7-point Likert scale, and analysed with univariate and multivariate analysis (odds ratios [OR], 95% confidence intervals [CI]).RESULTS: About half (n = 322;52%) scored 1-4, suggesting the decision was perceived as easier compared to those (n = 292;48%) who scored 5-7. Reasons for the abortion were: poor economy (n = 166;27%), too early in the relationship (n = 154;25.1%), want to work first (n = 147;23.9%), want to study first (n = 132;21.5%), uncertain about the relationship (104;16.9%), and too young (n = 104;16.9%). Predictors for perceiving the decision as difficult: partner's hesitance (OR = 3.18, CI:1.76-5.73), being born outside the Nordic countries (OR = 2.23, CI:1.28-3.87), having discussed the decision with someone (OR = 2.42, CI:1.67-3.50), age ≥30 (OR = 2.22, CI:1.03-4.76), the Covid-19 pandemic (OR = 2.08, CI:1.20-3.59), and the desire to have children in the future (OR = 1.96, CI:1.18-3.28). After confirmed pregnancy, poor mental well-being was more common among those who scored 5-7 (n = 140;47.9%) compared to those who scored 1-4 (n = 122;37.9), p = .029.CONCLUSION: Women's decision-making on abortion is complex; in times of crises, the decision procedure may be even more difficult. This valuable knowledge could be used to improve and promote satisfactory counselling beyond medical routines.
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| 6. |
- Stern, Jenny, 1987-
(författare)
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Preconception Health and Care : A Window of Opportunity
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Women’s health and lifestyle before pregnancy can influence both the fertility and the health of mother and child. The overall aim of this thesis was to explore current preconception health and care and evaluate a new tool for preconception care.Study I was a qualitative descriptive analysis of preconception recommendations in six European countries. All six countries had guidelines for high-risk women, but guidelines for healthy women were fragmented and inconsistent. Guidelines regarding nutrition and lifestyle differed between countries. Preconception care was offered to high-risk women but otherwise on an opportunistic basis.Study II was a cross sectional study measuring pregnancy planning among 3390 pregnant women at antenatal clinics. Three out of four pregnancies were very or fairly planned and 12 % fairly or very unplanned. Women with planned pregnancies were more likely to have a higher socioeconomic status and to have longer relationships than women with unplanned pregnancies. The level of pregnancy planning was associated with planning behavior, such as information seeking and intake of folic acid, but without a reduction in alcohol consumption.Study III was a randomized controlled trial evaluating the Reproductive Life Plan (RLP) as a health promoting tool in contraceptive counselling. Women (n=299) at a student health center were randomized to standard care or standard care plus RLP. RLP-based counselling increased women’s knowledge of both reproduction and folic acid intake prior to pregnancy, affected the women’s RLP and was appreciated by the women.Study IV explored the adaption of RLP among midwives using mixed methods with focus group interviews and a questionnaire. Midwives generally adopted the RLP in contraceptive counselling, had predominantly positive experiences of the RLP and considered it a feasible tool for promoting reproductive health.In conclusion, preconception care is a public health issue. Pregnancy planning is associated with socioeconomic background, and preventive measures could have great health benefits both for women of reproductive age and their future children. There is a need for both national and European cohesive evidence-based preconception care guidelines. The RLP is a feasible tool for promoting preconception health and can potentially form the missing link between contraceptive counselling and antenatal care.
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