Academic literature on the topic 'Emergency contraceptives'
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Journal articles on the topic "Emergency contraceptives"
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Pokharel, Yagya Raj, Shaluja Pokharel, and Bharat Kumar Shrestha. "Assessment of knowledge towards emergency contraceptives among college students in Ramechhap district of Nepal." Journal of General Practice and Emergency Medicine of Nepal 9, no. 14 (December 30, 2022): 51–56. http://dx.doi.org/10.59284/jgpeman8.
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Introduction: A high rate of unintended pregnancy exists among college students as they belong to the sexually active age group. So, it is significant to know the knowledge of college students regarding emergency contraceptives.
Objectives: To assess the knowledge of students towards Emergency Contraceptives and to identify the association between male and female students towards knowledge of emergency contraceptives.
Method: An online survey in Ramechhap district among college students studying in bachelor’s and master’s level was conducted from March 15, 2022 to April 10, 2022 where total of 169 students participated. Non parametric test was used to find the result of the objectives.
Result: The study showed that 83.4% students had the knowledge of Emergency Contraceptive pills and 59.2% of students first heard about such pills in the last 5 Years. Among them 79.9% of students knew where to get Emergency Contraceptive pills, 24.2% of students know the Emergency Contraceptive pills works if there is menstrual delay. Only 56.9% of students know the time to take Emergency Contraceptives pills after unprotected sexual intercourse and 46.7% of students know that the Emergency Contraceptive pill is not used for regular contraception. Only 49.1% of students know the right number of tablets that needs to be consumed after unprotected intercourse.
Conclusion: Majority of the students are aware of the Emergency Contraceptive pills however they have limited understanding about it. In comparison to female students, male had better understanding about Emergency Contraceptives.
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Tenaw, Lebeza Alemu. "Practice and determinants of emergency contraceptive utilization among women seeking termination of pregnancy in Northwest Ethiopia—A mixed quantitative and qualitative study." PLOS ONE 17, no. 2 (February 11, 2022): e0263776. http://dx.doi.org/10.1371/journal.pone.0263776.
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Background Emergency contraceptives are used within 72 hours after unprotected sexual intercourse to prevent unwanted pregnancy. Although emergency contraceptives are widely available in Ethiopia, termination of pregnancy remains a public health problem indicating low uptake of emergency contraceptives after unprotected sexual intercourse. This study aimed to assess utilization and determinants of emergency contraceptives among women seeking termination of pregnancy in Northwest Ethiopia. Methods An institutional-based cross-sectional study was carried out, supplemented by phenomenologically approached in-depth interviews. Systematic random sampling was used to select study participants. A structured questionnaire and an in-depth interview guide were used to collect data. Data were entered by EPI-info and analyzed through SPSS version 23 to conduct logistic regressions. Thematic analysis was used to conduct qualitative interpretation. Results Almost one-fifth (78; 19.2%) of the study participants used emergency contraceptives to prevent their index pregnancy. Women who had secondary education (aOR 3.28; 95% CI 1.59, 6.79) and women who had no living children (aOR 4.52; 95% CI 1.40, 14.57) had a positive significant association with emergency contraceptive utilization. On the other hand, women who did not discuss contraceptives with their sexual partner (aOR 0.49; 95% CI 0.27–0.91) and women without a history of abortion (aOR 0.45; 95% CI 0.24–0.97) had a negative significant association with emergency contraceptive utilization. Conclusion and recommendation There is relatively low utilization of emergency contraception among pregnancy terminating women. Reproductive health programs should encourage women discussion with their partners about emergency contraceptives to decrease occurrence of unwanted pregnancy and termination of pregnancy.
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Matyanga, Celia M. J., and Blessing Dzingirai. "Clinical Pharmacology of Hormonal Emergency Contraceptive Pills." International Journal of Reproductive Medicine 2018 (October 4, 2018): 1–5. http://dx.doi.org/10.1155/2018/2785839.
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Emergency contraceptives play a major role in preventing unwanted pregnancy. The use of emergency contraceptives is characterized by myths and lack of knowledge by both health professionals and users. The main objective of this paper is to summarize the clinical pharmacology of hormonal methods of emergency contraception. A literature review was done to describe in detail the mechanism of action, efficacy, pharmacokinetics, safety profile, and drug interactions of hormonal emergency contraceptive pills. This information is useful to healthcare professionals and users to fully understand how hormonal emergency contraceptive methods work.
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Ghike, Sunita, Savita A. Somalwar, Sulbha A. Joshi, Anjali S. Kawthalkar, Sheela H. Jain, and Madhuri S. Gawande. "LNG Emergency Contraceptive Pills: Risk Factor for Ectopic Pregnancy." Journal of South Asian Federation of Obstetrics and Gynaecology 5, no. 2 (2013): 87–88. http://dx.doi.org/10.5005/jp-journals-10006-1233.
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ABSTRACT Hormonal emergency contraceptive drugs designed to prevent undesired pregnancy are available over the counter. In spite of availability of various contraceptive techniques, couple protection rate in our country is still inadequate. A large number of couples prefer to use emergency contraceptive pill instead of regular contraceptives. Though hormonal emergency contraceptives pills are highly effective and safe with fewer side effects, their failure rate is high when used in periovulatory period with increased chances of ectopic pregnancy. How to cite this article Jain SH, Ghike S, Gawande MS, Joshi SA, Kawthalkar AS, Somalwar SA. LNG Emergency Contraceptive Pills: Risk Factor for Ectopic Pregnancy. J South Asian Feder Obst Gynae 2013;5(2):87-88.
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Dahan-Farkas, N., and M. Vally. "The use of emergency hormonal contraception in South Africa: current and future perspectives." South African Family Practice 61, no. 2 (April 29, 2019): 46–48. http://dx.doi.org/10.4102/safp.v61i2.5003.
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Emergency hormonal contraceptives play an important role in preventing unplanned pregnancies in South Africa. In this review, we discuss the levonorgestrel emergency contraceptive, the combined estrogen and progestin regimen (also known as the Yuzpe method) and the use of Ulipristal acetate. The levonorgestrel and the combined estrogen, progestin regimen are available in South Africa. The specific mechanisms of action of each of these emergency hormonal contraceptives will be discussed as well as their efficacy, the side effects associated with each of these preparations and the drug interactions. Levonorgestrel can be used as a single dose (1.5 mg) instead of two doses (0.75 mg) 12 hours apart. Levonorgestrel is very effective, with fewer adverse effects than the combined estrogen and progestogen administration. Levonorgestrel and the Yuzpe method have demonstrated good efficacy when utilised within 72 hours after unprotected intercourse or contraceptive failure. These emergency hormonal contraceptives should not be used as regular contraception. It is essential that all health professionals and educators inform women of reproductive age about the risks and common side effects of emergency hormonal contraceptives.
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O. Raji, Mansur, Sahiha Wakkala, Ummu Salma Mustapha, Usman Danmalam, Ismail A Raji, Hadija O. Raji, and Ahunna Ezenwoko. "Emergency Contraceptives: Knowledge, Attitude and Prescription Practice of Primary Healthcare workers in Sokoto Metropolis, Northwest Nigeria." Annals of Basic and Medical Sciences 2, no. 1 (June 30, 2021): 46–51. http://dx.doi.org/10.51658/abms.202121.2.
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Background: Emergency contraception refers to methods of contraception that can be used to prevent pregnancy after sexual intercourse. About thirty percent of all pregnancies, and 61% of all unintended pregnancies, ended in an induced abortion in Nigeria, and many women with unwanted pregnancies decide to end them by abortion. Healthcare providers' knowledge and attitude towards emergency contraception is very important for dissemination of awareness, consumer acceptance and use of contraceptives, as health care workers interact with large numbers of women and are reliable sources of information. This study aimed to assess healthcare workers' emergency contraception knowledge, attitude and prescription practice. Materials and Methods: The study was a cross-sectional study. Healthcare workers providing services in Primary Health care facilities of Sokoto metropolis were studied. Using formula for sample size estimation for crosssectional study, a total of 419 respondents were recruited into the study using systematic sampling technique. The instrument of data collection was a structured interviewer administered questionnaire and data was collected by means of Open Data Kit for android App and analysed using IBM SPSS statistical software package version 23. Univariate and bivariate analysis were conducted; level of significance was set at 5%. Results: Few (39.9%) respondents knew that Intra uterine contraceptive devices can be used for emergency contraception, only 15.4% knew how emergency contraceptives work. Most (75.4%) believed that emergency contraceptives should be available only on prescription; and 30.5% felt that emergency contraceptive pills promote irresponsible behaviour. More than half of the respondents (56.5%) had prescribed within the last one month, 48.7% of them prescribed less than 5 times within the month. Only 27(8.0%) have ever prescribed emergency contraceptive pills in advance of need. Conclusion: The study respondents had good knowledge of emergency contraceptives, albeit, with some misconceptions, they also demonstrated good attitude, however, the prescription practice was fair.
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Belachew, Sewunet Admasu, Dawit Kumilachew Yimenu, and Begashaw Melaku Gebresillassie. "Pharmacy Professionals’ Dispensing Practice, Knowledge, and Attitude towards Emergency Contraceptives in Gondar Town, Northwestern Ethiopia: A Cross-Sectional Study." International Journal of Reproductive Medicine 2017 (2017): 1–9. http://dx.doi.org/10.1155/2017/8754126.
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Background. Pharmacy professionals, as the most available members of medical team, have an important role in educating patients about the effective and appropriate use of contraceptives. The purpose of this study was to assess pharmacy professionals’ dispensing practice, knowledge, and attitude towards emergency contraceptives use in Gondar town, northwestern Ethiopia. Methods. An institution based cross-sectional study was employed from May 14 to June 14, 2016, on 60 pharmacy professionals, who have been working in 8 randomly selected pharmacies and 6 drug stores. The collected data was entered to and analyzed using Statistical Packages for Social Sciences (SPSS) version 20. Result. More than half 33 (55.0%) of the participants were druggist with 5–9 years of experience. About 56 (93.3%) of the participants knew about the dosing schedule (when and how much to take) and side effects of emergency contraceptives. More than two-thirds of the participants (39, 65%) agreed that the existence of emergency contraceptives is a positive thing and considered their use is ethical (42, 63.3%). The majority of participants (51, 85%) also reported that they counsel all women when dispensing emergency contraceptive pills (ECPs). Conclusion. This study revealed that knowledge, attitude, and dispensing practice of emergency contraceptives are very good even though there were variations with respect to different factors. Findings suggested that additional training and proper counseling technique on emergency contraceptives will improve the service delivery.
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Liao, Shao-Feng, Ching-Hsing Lee, Lung-Sheng Wu, Chih-Huang Li, and Hsien-Yi Chen. "Left ventricular thrombus and systemic embolism after painless myocardial infarction in a young female." Hong Kong Journal of Emergency Medicine 25, no. 2 (January 5, 2018): 110–12. http://dx.doi.org/10.1177/1024907917745233.
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Oral contraceptives are widely used because of their reliability. Although oral contraceptives are known to increase the risk of thromboembolic events, there are extremely few reports of oral contraceptive–induced left ventricular thrombus. Herein, we report a 37-year-old non-smoking female, who had regularly taken oral contraceptives for 14 years, developed an anterior myocardial infarction concomitant with left ventricular thrombus, bilateral segmental renal infarctions, and lower limb ischemia. Medical treatment with a combination of dual antiplatelet therapy and anticoagulants completely relieved her symptoms.
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Nayak, Ranjeeta, Manasi Panda, Sarmistha Padhy, and Kumar Guru Mishra. "Awareness regarding emergency contraception among married women attending urban health centre, Berhampur, Odisha, India." International Journal of Research in Medical Sciences 8, no. 2 (January 27, 2020): 524. http://dx.doi.org/10.18203/2320-6012.ijrms20200229.
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Background: In India unplanned pregnancy and illegal abortions still remains a problem. Unintended early pregnancy and frequent childbearing contribute to high pregnancy related morbidity and mortality which can be prevented by use of suitable contraceptives. In circumstances where women are unable to exercise sexual and reproductive decision making, introduction of emergency contraceptive pills may provide important back up option to enable women to control their fertility.Methods: A cross-sectional study was conducted between August- October 2016 among 215 married women of reproductive age group attending the Urban Health Center, Berhampur, to study the awareness about most common methods of contraception, decision-making regarding contraceptive and knowledge and practice of emergency contraceptive pills.Results: This study concludes that most commonly used method was Oral contraceptive pills (28.3%) and major source of information regarding different methods of contraception were through friends and relatives (44.6%). Awareness about emergency contraception mostly came through television. Of those aware of ECPs (14.4%) only 16.1% had used it in their lifetime.Conclusions: Although there is awareness about contraceptives methods, knowledge and practice of emergency contraception is low.
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Sonubi, S. A., and Lushiku Nkombua. "Contraceptive usage in women requesting emergency contraception in Swaziland." South African Family Practice 57, no. 3 (May 1, 2015): 4. http://dx.doi.org/10.4102/safp.v57i3.3981.
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Background: The Kingdom of Swaziland, following the introduction of the National Family Planning Programme in 1973, has witnessed insufficient scientific publications on the contraceptive practices in the country despite documented high fertility rates and low contraceptive prevalence rates. This study was conducted to understand the practices and potential determinants of contraception among Swazi women who requested emergency contraception.Methods: The data were collected over a period of one month and analysed using simple descriptive analysis to summarise the data and bivariate analysis to determine relevant factors associated with the use of contraception.Results: The majority of participants (79%) use contraceptives. Reasons given for not using contraception previously ranged from medical conditions to not being sexually active. Widely used contraceptives are male condoms, injectable hormones and combined oral contraceptives while the least popular are implants, and post-coital pills. Knowledge of contraceptives came mainly from the health facilities, peers and mass media while parents are the least consulted sources. A high percentage (97%) are aware of sexually transmitted diseases (STDs) and that male and female condoms are the best forms of protection against STDs. Demographic and socio-economic variables are not significantly related to the use of contraceptives.Conclusion: The study established that the majority of the participants used some form of contraception and they also delayed their sexual debut up to the age of 18–20 years. The observed changes of increased contraceptive use and later age of sexual debut could be associated with increased levels of education of the participants and the predominant relaxed approach by Protestants and Zionists who are usually tolerant of contraception. The recommendations, based on the findings of this study, would assist with the planning and implementation of future family planning programmes for which this study serves as a foundation.
Dissertations / Theses on the topic "Emergency contraceptives"
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Dallman, Rebecca. "Disparities in the Use of Emergency Contraceptives." VCU Scholars Compass, 2007. http://hdl.handle.net/10156/2056.
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Novikova, Natalia. "Mechanism of action of emergency contraceptive pill." Thesis, The University of Sydney, 2007. http://hdl.handle.net/2123/2151.
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The number of unwanted pregnancies has not decreased in recent years and this should be addressed. Emergency contraception may be effective when used correctly having the advantage that it can be used after an episode of unprotected sexual intercourse (when regular contraception has failed or was not used). In this research project I set out to explore some of the major reasons why there are still many unwanted pregnancies in Australia. I decided to focus on the use and non-use of emergency contraception, e.g. emergency contraception pill (ECP) “method failures” are not well understood because the actual mechanisms of action are still unclear. There is evidence ECP can effectively interfere with follicle growth and ovulation. It is much less clear is whether ECP is able to interfere with fertilization and implantation, in a way, which may make it acceptable to those who have strong religious beliefs in fertilization being the start of new life. Emergency contraception has the potential to prevent many unwanted pregnancies when unprotected intercourse has occurred. It has relatively high efficacy in many studies, but true method failures are not well understood. By contrast, many unwanted pregnancies occur for “social reasons” where emergency contraception has not been used. I set out to study changes in knowledge and usage of emergency contraception in these groups of Australian women seeking termination of pregnancy: 1. Before a dedicated emergency contraception pill (ECP) pack (Postinor) became available in Australia 2. One year after dedicated ECP became available on prescription 3. One year after the ECP pack became available “over the counter” without prescription. Ninety-nine women were recruited during their presentation with a request for ECP at the six Family Planning Clinics in Australia. All women took LNG 1.5mg in a single dose during the clinic consultation. A blood sample was taken immediately prior to ingestion of the ECP for estimation of serum LH, oestradiol and progesterone levels to calculate the day of the menstrual cycle. Based on these endocrine data we estimated the timing of ovulation to within a ±24-hour period with an accuracy of around 80%. Women were followed up 4-6 weeks later to ascertain pregnancy status. The effectiveness of ECP when taken before and after ovulation was determined. Three women in this study became pregnant despite taking the ECP (pregnancy rate 3%). All three women who became pregnant had unprotected intercourse between day -1 and 0 and took the ECP on day +2, based on endocrine data. Day zero was taken as ovulation day. Among seventeen women who had intercourse in the fertile period of the cycle and took the ECP after ovulation occurred (on day +1 to +2) we could have expected 3 or 4 pregnancies, based on Wilcox et al data. Three pregnancies were observed. Among 34 women who had intercourse on days –5 to –2 of the fertile period, and took ECP before or around ovulation, four pregnancies could have been expected, but none were observed. The major discrepancies between women’s self-report of stage of the cycle and the dating calculation based on endocrine data were observed in this study. These data are supportive of the concept that the LNG ECP has little or no effect on post-ovulation events, but is highly effective before ovulation. Our interpretation of the data in terms of timing of treatment relative to ovulation may explain why EC with LNG works sometimes and fails at other times. A larger study is needed to prove this hypothesis. To investigate other reasons for such a high rate of unwanted pregnancy, which probably has a larger impact we looked into womens knowledge of and attitude towards ECP. Seven hundred and eighteen women participated in this study by answering a questionnaire consisting of 15 questions on their demographic and reproductive characteristics as well as the knowledge about the ECP, e.g. 208 women were enrolled before the ECP was marketed in Australia in 2001, 308 after it was marketed and 202 after it became available over the counter (Group 1, 2, and 3, respectively). We found that the participants who have heard about ECP were significantly younger (p<0.005). The mean age of women who have never heard about of ECP was 29.8 years compared to 26.3 years in women who have heard about ECP. More women were aware about the ECP after it became available over the counter. Women in group 2 had higher educational level in comparison to women in group 2 and 3 (p<0.005). There was significant trend in increased use of ECP in women of higher educational level (p<0.005). The use of ECP did not increase significantly with improved availability and access to the ECP amongst women presenting for termination of pregnancy. Wider availability of he ECP pack in Australia and an easier access to it has increased women’s awareness about the ECP. However, the use of ECP has not increased. This study provides better understanding of mechanism of action of LNG ECP and an explanation to the method failure. It also reveals poor knowledge about ECP despite its wider availability and accessibility. Improving these is a worldwide challenge for family planners and all health professionals.
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Novikova, Natalia. "Mechanism of action of emergency contraceptive pill." University of Sydney, 2007. http://hdl.handle.net/2123/2151.
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Master of MedicineThe number of unwanted pregnancies has not decreased in recent years and this should be addressed. Emergency contraception may be effective when used correctly having the advantage that it can be used after an episode of unprotected sexual intercourse (when regular contraception has failed or was not used). In this research project I set out to explore some of the major reasons why there are still many unwanted pregnancies in Australia. I decided to focus on the use and non-use of emergency contraception, e.g. emergency contraception pill (ECP) “method failures” are not well understood because the actual mechanisms of action are still unclear. There is evidence ECP can effectively interfere with follicle growth and ovulation. It is much less clear is whether ECP is able to interfere with fertilization and implantation, in a way, which may make it acceptable to those who have strong religious beliefs in fertilization being the start of new life. Emergency contraception has the potential to prevent many unwanted pregnancies when unprotected intercourse has occurred. It has relatively high efficacy in many studies, but true method failures are not well understood. By contrast, many unwanted pregnancies occur for “social reasons” where emergency contraception has not been used. I set out to study changes in knowledge and usage of emergency contraception in these groups of Australian women seeking termination of pregnancy: 1. Before a dedicated emergency contraception pill (ECP) pack (Postinor) became available in Australia 2. One year after dedicated ECP became available on prescription 3. One year after the ECP pack became available “over the counter” without prescription. Ninety-nine women were recruited during their presentation with a request for ECP at the six Family Planning Clinics in Australia. All women took LNG 1.5mg in a single dose during the clinic consultation. A blood sample was taken immediately prior to ingestion of the ECP for estimation of serum LH, oestradiol and progesterone levels to calculate the day of the menstrual cycle. Based on these endocrine data we estimated the timing of ovulation to within a ±24-hour period with an accuracy of around 80%. Women were followed up 4-6 weeks later to ascertain pregnancy status. The effectiveness of ECP when taken before and after ovulation was determined. Three women in this study became pregnant despite taking the ECP (pregnancy rate 3%). All three women who became pregnant had unprotected intercourse between day -1 and 0 and took the ECP on day +2, based on endocrine data. Day zero was taken as ovulation day. Among seventeen women who had intercourse in the fertile period of the cycle and took the ECP after ovulation occurred (on day +1 to +2) we could have expected 3 or 4 pregnancies, based on Wilcox et al data. Three pregnancies were observed. Among 34 women who had intercourse on days –5 to –2 of the fertile period, and took ECP before or around ovulation, four pregnancies could have been expected, but none were observed. The major discrepancies between women’s self-report of stage of the cycle and the dating calculation based on endocrine data were observed in this study. These data are supportive of the concept that the LNG ECP has little or no effect on post-ovulation events, but is highly effective before ovulation. Our interpretation of the data in terms of timing of treatment relative to ovulation may explain why EC with LNG works sometimes and fails at other times. A larger study is needed to prove this hypothesis. To investigate other reasons for such a high rate of unwanted pregnancy, which probably has a larger impact we looked into womens knowledge of and attitude towards ECP. Seven hundred and eighteen women participated in this study by answering a questionnaire consisting of 15 questions on their demographic and reproductive characteristics as well as the knowledge about the ECP, e.g. 208 women were enrolled before the ECP was marketed in Australia in 2001, 308 after it was marketed and 202 after it became available over the counter (Group 1, 2, and 3, respectively). We found that the participants who have heard about ECP were significantly younger (p<0.005). The mean age of women who have never heard about of ECP was 29.8 years compared to 26.3 years in women who have heard about ECP. More women were aware about the ECP after it became available over the counter. Women in group 2 had higher educational level in comparison to women in group 2 and 3 (p<0.005). There was significant trend in increased use of ECP in women of higher educational level (p<0.005). The use of ECP did not increase significantly with improved availability and access to the ECP amongst women presenting for termination of pregnancy. Wider availability of he ECP pack in Australia and an easier access to it has increased women’s awareness about the ECP. However, the use of ECP has not increased. This study provides better understanding of mechanism of action of LNG ECP and an explanation to the method failure. It also reveals poor knowledge about ECP despite its wider availability and accessibility. Improving these is a worldwide challenge for family planners and all health professionals.
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Meng, Chun-Xia. "Levonorgestrel emergency contraception effects on endometrial development and embryo implantation /." Stockholm : Division of Obstetrics and Gynecology, Karolinska Institutet, 2009. http://diss.kib.ki.se/2009/978-91-7409-662-0/.
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Weisberg, Edith. "Postcoital emergency contraception." Thesis, The University of Sydney, 1995. https://hdl.handle.net/2123/26903.
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Fertility control is not a modern concept. In virtually every culture of historical importance there is evidence of a desire to control fertility by artificial means ( Dickinson 1970 ). The desire for, as distinct from the achievement of, reliable contraception has been characteristic of many societies widely removed in time and place, even in societies dominated by mores and religious codes demanding that people increase and multiply( Hines 1970 ). Today fertility control is widely seen as a basic right, a right of the individual to the knowledge and means to procreate only when desired.
The right to fertility control
The right to family planning was first made explicit at an international forum in 1953 to ratify the constitution of the International Planned Parenthood Federation. In 1968 it was enshrined in the United Nations' body of rights declarations at the United Nations Conference on Human Rights. In 1969 the United Nations Declaration on Social Progress and Development expanded the basic right to choose the number and spacing of children, to include access to adequate family planning education, information and methods. This right has since been reaffirmed in many fora, including the United Nations Convention on the Elimination of All Forms of Discrimination Against Women.
The recent International Conference on Population and Development held in Cairo in September 1994 reaffirmed the basic right of all women, men and adolescents to make free and informed choices regarding their own sexual and reproductive health and to have the means to exercise this right.
Implicit in the right to family planning is the right to choice of method. This means that all medically approved methods should be available, with complete information on advantages and disadvantages to enable people to make a free choice. This includes access to postcoital methods. Health professionals, who deny women information or access to postcoital contraception based on their own moral or ethical beliefs are infringing a woman's human rights.
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Lo, Seen-tsing Sue, and 羅善清. "Novel use of emergency contraceptive pills in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48273570.
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Emergency contraception is an effective backup for contraceptive failure. In
Hong Kong, levonorgestrel emergency contraceptive pill is a prescription drug.
In most developed countries, it is provided in advance or over-the-counter to
eliminate the barrier to access. The objective of this thesis is to evaluate the
feasibility and acceptability of these novel delivery modes in Hong Kong. Four
studies were conducted to study pertinent subject matters.
A retrospective review on 11014 clinical records of The Family Planning
Association of Hong Kong on emergency contraception prescription between
2006 and 2008 was performed to delineate the characteristics of emergency
contraceptive users. One-year follow-up data was available in 4728 records,
with 89.4% used emergency contraception once and 8.5% used it twice. The
proportion of subjects not using ongoing contraceptives reduced from 20.6% at
the emergency contraception visit to 4.5% at post-treatment follow-up, 3.9% at
6th month and 3.3% at 12th month. Young age was not associated with not
using ongoing contraceptives and repeat use of emergency contraceptives.
A randomized controlled trial with 1030 women was conducted to compare the
behavior of those given three courses of levonorgestrel emergency
contraceptive pills in advance against those who had to get them from clinics
when needed. After one year, 29.9% of women in the advanced provision
group had used the pills versus 12.9% in the control group (odds ratio 2.87,
95% confidence interval 2.07-3.97). The advanced provision group used three
times more pills than the control group (278 versus 95 courses, p<0.001). The
median coitus-treatment interval in the advanced provision group was
significantly shorter than the control group (11 h versus 20 h; p<0.001). Most
women used condoms before (90%) and during (89%) the study. In both
groups, consistency of use was higher after emergency contraception (65%)
than before (60%) (p<0.001). This study confirmed that advanced provision
increased the utilization of emergency contraceptive pill, facilitated its early
use and did not hamper ongoing contraceptive use.
A questionnaire survey was conducted to evaluate the acceptability of novel
use of emergency contraceptive pill among women practicing contraception.
Of the 1405 questionnaires analyzed, 46.3% of women supported more
advertising on emergency contraception; 48.7% supported advanced provision
of emergency contraceptive pill and 25.7% supported over-the-counter
provision. Another questionnaire survey assessed the attitude of physicians
who provide family planning services. Half (54.2%) of them supported
advanced provision of emergency contraceptive pill; 32.5% supported
advanced provision to girls aged 16 and below and 40.2% supported over-thecounter
provision. Among 352 physicians who provided emergency
contraception, only 21.7% of private family physicians and 15.9% of private
obstetrician-gynaecologists prescribed emergency contraceptive pills in
advance.
In conclusion, local women used emergency contraception responsibly and
remained vigilant with ongoing contraception even when they got pills in
advance. Minority of physicians practice advanced provision. The acceptance
of advanced provision, among women and physicians who do not know much
about it, is around 50%. It is thus possible to improve when more education on
advanced provision is provided. The support for over-the-counter provision
was too weak to boost.published_or_final_version
Medicine
Master
Doctor of Medicine
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Byamugisha, Josaphat Kayogoza. "Emergency contraception among young people in Uganda : user and provider perspectives /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-433-4/.
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Curran, Brian. "The Relationship between Risky Behaviors and the Utilization of Emergency Contraception." The University of Arizona, 2005. http://hdl.handle.net/10150/624721.
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Class of 2005 AbstractObjectives: Describe the prevalence of alcohol and tobacco use in college women who use emergency contraception (EC) or oral contraceptives. Methods: This study was a descriptive, retrospective study that utilized patient charts to obtain clinical data including emergency contraception utilization, hormonal contraception utilization, alcohol and tobacco use. The primary dependent variables were smoking status and alcohol use. The overall prevalence of alcohol and tobacco use was calculated by counting the total number and percentage for each substance. Determining if descriptive variables vary according to type of contraception, groups were compared using a t-test for independent groups and a Chi square, respectively. The a priori alpha level is 0.05. Results: The most important finding in this study is students that obtained EC reported drinking alcohol at a significantly higher level than students who used hormonal contraception. 49% of students who used EC reported drinking 5 or more drinks a week. The data for the alcohol use was the only data that was found to be statistically significant (p<0.05). In this study 22% of students who requested EC had unprotected sex. A positive result seen in this study was that only 2% of the EC students requested EC more than once in the spring semester. Freshman composed 54% of the students that used EC during this study. Other data that was of interest was that 33% of students that used EC were currently using oral contraception but only 25% claimed that oral contraception incompliance was the reason for EC utilization. Implications: Prevalence of alcohol use is significantly higher in students who use EC than students who used hormonal contraception. This leads to the conclusion that students that use alcohol are more likely to engage in unprotected sex and therefore request EC. This study also has shown that nurses and physicians need to get more accurate information from students regarding tobacco and alcohol use.
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Chiwandire, Desire. "Conscientious objection and South African medical practitioners' constructions of termination of pregnancy and emergency contraception." Thesis, Rhodes University, 2015. http://hdl.handle.net/10962/d1017863.
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Aim: The 1996 Choice on Termination of Pregnancy Act decriminalized abortion in South Africa and the South African Medicines Control Council in 2000 approved the dispensing of emergency contraceptive methods by pharmacists to women without a doctor's prescription. This legislation has been hailed as among the most progressive in the world with respect to women's reproductive justice. However the realisation of these rights in practice has not always met expectations in part due to medical practitioners' ethical objections to termination of pregnancy and the provision of related services. The aim of this study was to interpret the varying ways in which medical practitioners frame termination of pregnancy and emergency contraceptive services, their own professional identities and that of their patients/clients. Methods: Sample of 58 doctors and 59 pharmacists drawn from all nine provinces of South Africa. Data collected using an anonymous confidential internet-based self-administered questionnaire. Participants were randomly recruited from online listings of South African doctors and pharmacists practicing in both private and public sectors. Data were analysed using theoretically derived qualitative content analysis. Results: Participants drew on eight frames to justify their willingness or unwillingness to provide termination-of-pregnancy related services: the foetal life frame, the women's rights frame, the balancing frame, the social justice frame, the do no harm frame, the legal and professional obligation frame, the consequences frame and the moral absolutist frame. Conclusion: Health professionals' willingness or unwillingness to provide termination of pregnancy related services is highly dependent on how they frame or understand termination of pregnancy, and how they understand their own professional identities and those of their patients/clients.
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Seutlwadi, Lebogang. "Adolescents' knowledge about abortion and emergency contraception a survey study." Thesis, Rhodes University, 2012. http://hdl.handle.net/10962/d1002561.
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Adolescents have become focal points of discussions and debates regarding sexuality and reproductive health matters. However, little research has been done particularly in South Africa to examine their knowledge concerning abortion and emergency contraception. Research indicates that a substantial proportion of adolescent pregnancies are unintended or unwanted. Abortion and emergency contraception are both time-sensitive services. Thus having accurate and comprehensive knowledge about both abortion and emergency contraception is pivotal, in the case of unintended or unwanted pregnancy or when engaging in unprotected sex or experiencing contraceptive failure that could lead to pregnancy. The 1994 International Conference on Population and Development (ICPD) defined reproductive health rights for both men and women as the right to "decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so" (p. 60). That is, men and women should "have the right to make decisions concerning their reproduction free of discrimination, violence and coercion" (ICPD, 1994, p.60). Based on these definitions, it is rather evident that comprehensive and accurate knowledge are at the core of one's ability to make an informed consent. This is confirmed by Adler's (1992, p. 289) definition of informed consent or choice "a) access to sufficient information b) understanding the information c) competence to evaluate potential consequences d) freedom to make a choice and e) the ability to make and express that choice". It is from this framework that this study emerged. The aim of this study was to examine adolescents' knowledge concerning abortion and emergency contraception. The participants were Grade 11 learners between the ages of 15-24 years from five different schools in the Buffalo City Municipality. A sample of 514 was achieved. Data were analysed using descriptive cross-tabulation, chi-square and qualitative methods where appropriate. The results revealed that most of the participants did not have sufficient accurate knowledge concerning the Choice on Termination of Pregnancy Act, consequences of legal abortion and emergency contraceptive pills to make informed decisions. Furthermore, data also revealed that the participants' schools playa role in their sexual activity, their knowledge about the Choice on Termination of Pregnancy Act and about emergency contraceptive pills. Although this method made it feasible for the researcher to make general assumptions, non-responses were one of the limitations of the study. Similar research in various municipalities/cities in and outside the Eastern Cape is recommended so as to increase further awareness concerning the level of knowledge that adolescents have about contraceptive pills particularly emergency contraceptive pills, the Choice on Termination of Pregnancy Act and abortion in general.
Books on the topic "Emergency contraceptives"
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(Organization), Family Health International, ed. Emergency contraceptive pills: Contraceptive technology. Research Triangle Park, NC: Family Health International, 1998.
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David, Paintin, and Royal College of Obstetricians and Gynaecologists. Faculty of Family Planning & Reproductive Health Care., eds. The provision of emergency hormonal contraception. London: Published for the Royal College of Obstetricians and Gynaecologists and the Faculty of Family Planning and Reproductive Health Care by the RCOG Press, 1995.
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Guzmán, José López. La píladora del día siguiente: Aspectos farmacológicos, éticos y jurídicos. Madrid: laCAJA edita, 2002.
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(Peru), Defensoría del Pueblo, ed. La anticoncepción oral de emergencia. Lima: Defensoría del Pueblo, 2003.
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Camp, Sharon L. A study-tour report on emergency contraception in seven European countries. Washington, DC: Reproductive Health Technologies Project, 1994.
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Maharaj, Pranitha. Reproductive health and emergency contraception in South Africa: Policy context and emerging challenges. Durban: School of Development Studies, University of Kwazulu-Natal, 2007.
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Institute, Alan Guttmacher, ed. Readings on emergency contraception: From Family planning perspectives and International family planning perspectives, 1992-1996. New York: Alan Guttmacher Institute, 1996.
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Foundation, Mass NARAL. Women's health care at risk: Barriers to abortion and emergency contraception in Massachusetts. Boston, MA: Mass NARAL Foundation, 2002.
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Skibiak, J. P. Emergency contraception in Zambia: Testing strategies to improve access to emergency contraception pills : prescription vs prophylactic distribution. Nairobi, Kenya: Population Council, 1999.
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New York (N.Y.). City Council. Emergency contraception: Available at your pharmacy yet? New York, New York: The Council of the City of New York, 2004.
Find full textBook chapters on the topic "Emergency contraceptives"
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Natavio, Melissa F. "Emergency Contraceptives." In The Handbook of Contraception, 203–13. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-20185-6_12.
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Bitzer, Johannes. "Contraception and Sexuality." In Midwifery and Sexuality, 235–47. Cham: Springer International Publishing, 2023. http://dx.doi.org/10.1007/978-3-031-18432-1_20.
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AbstractIn some countries, midwives play a large part in contraceptive care. In many other countries, contraception is not a part of the midwife’s scope of practice till the baby is born. They then have to counsel about contraception and eventually about intervals between pregnancies. For healthy motherhood and good parenthood, the young mother should not become pregnant within a year and a half after childbirth. So counselling or prescribing contraception is an integral part of good postpartum care and falls under the midwife’s responsibility.Every contraceptive method has advantages and disadvantages, whether physical, emotional, relational, or sexual. This chapter will address the sexual consequences of various contraceptive methods with up-to-date information on the pros and cons of each method. In the context of this book, contraception during postpartum and breastfeeding will get extra attention.The chapter will include information on emergency contraception and the situation when contraception has failed.This chapter is part of ‘Midwifery and Sexuality’, a Springer Nature open-access textbook for midwives and related healthcare professionals.
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Al Kindi, Rahma, Asma Al Salmani, Rahma Al Hadhrami, Sanaa Al Sumri, and Hana Al Sumri. "Modern Birth Control Methods." In Contraception [Working Title]. IntechOpen, 2022. http://dx.doi.org/10.5772/intechopen.103858.
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This chapter focuses on various modern birth control methods, including combined oral contraceptives, progestogen-only pills, progestogen-only injectables, progestogen-only implants, intrauterine devices, barrier contraceptives, and emergency contraceptive pills. Each contraceptive method is covered in detail, including mechanism of action, effectiveness, health benefits, advantages, disadvantages, risks, and side-effects.
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Chin, Jennifer, and Bliss Kaneshiro. "Hormonal Contraception." In Oxford Textbook of Endocrinology and Diabetes 3e, edited by John A. H. Wass, Wiebke Arlt, and Robert K. Semple, 1383–92. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198870197.003.0166.
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The birth control pill, the first hormonal contraceptive method widely available to the public, transformed the way society viewed childbearing and sexuality. Since the 1960s, many different types of hormonal contraceptives have been developed and are now available to women. There are two main categories of hormonal contraceptives, combined hormonal contraceptives, which consist of oestrogen and progestin, and progestin-only contraceptives. Within each category, various methods and formulations exist, each with a different mechanism of action, efficacy, and side effect profile. Emergency contraception offers a post-coital method that can be used in cases where women did not use contraception at the time of intercourse or had a method failure (i.e. condom breakage). Several contraceptive methods have non-contraceptive benefits. Most methods decrease the risk of endometrial cancer and combined hormonal contraceptives decrease the risk of ovarian cancer. Many methods have been used in the treatment of abnormal uterine bleeding, dysmenorrhoea, premenstrual syndrome, and acne.
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"Hormonal contraceptives—emergency contraception." In Meyler's Side Effects of Drugs: The International Encyclopedia of Adverse Drug Reactions and Interactions, 1639–41. Elsevier, 2006. http://dx.doi.org/10.1016/b0-44-451005-2/00957-8.
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"Hormonal contraceptives – emergency contraception." In Meyler's Side Effects of Drugs, 824–26. Elsevier, 2016. http://dx.doi.org/10.1016/b978-0-444-53717-1.00851-9.
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"Contraception." In Oxford Handbook of Obstetrics and Gynaecology, edited by Sally Collins, Sabaratnam Arulkumaran, Kevin Hayes, Kirana Arambage, and Lawrence Impey, 703–22. 4th ed. Oxford University PressOxford, 2023. http://dx.doi.org/10.1093/med/9780198838678.003.0020.
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Abstract This chapter covers contraceptive methods. It begins with the combined oral contraceptive pill, its indications and contraindications, and various potential regimens. It goes on to the progestogen-only pill, then long-acting reversible contraceptives. Barrier techniques are covered in detail, and fertility awareness contraception is included. The chapter goes on to female sterilization, including considerations and the procedure, and concludes with emergency contraception.
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Baldwin, Andrew, Nina Hjelde, Charlotte Goumalatsou, and Gil Myers. "Gynaecology." In Oxford Handbook of Clinical Specialties, 240–311. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198719021.003.0003.
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This chapter explores gynaecology. It includes history and examination, sexual health and dysfunction, gynaecological anatomy, genital abnormalities, female genital mutilation, normal menstruation, defining menstrual abnormalities, amenorrhoea, polycystic ovaries, menorrhagia, premenstrual syndrome, the menopause and hormone replacement therapy (HRT), termination of pregnancy, miscarriage, recurrent miscarriage, ectopic pregnancy, pregnancy of unknown location, gestational trophoblastic disease, the vulva, vulval lumps and ulcers, the cervix and cervical screening, management of CIN, cervical cancer, the uterus, vaginal cancer, fibroids in pregnancy, endometrial cancer, endometrial sampling, benign ovarian cysts, ovarian cancer, vaginal discharge, pelvic inflammatory disease, endometriosis, prolapse, subfertility (causes, tests, treatment), male subfertility, contraception, the ideal contraceptive, intrauterine contraceptive device and system, emergency contraception, combined hormonal contraceptives, progestogen-only contraceptives, sterilization, urinary incontinence, gynaecological surgery, pelvic pain, dyspareunia, and ovarian hyperstimulation syndrome.
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Sudano, Isabella, and Matthias Hermann. "Hypertensive Emergencies." In Manual of Cardiovascular Medicine, 23–28. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198850311.003.0003.
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Acute elevation of blood pressure is defined as a hypertensive crisis, if blood pressure is >220/120 mmHg or as a hypertensive emergency, if blood pressure is >220/120 mmHg with concomitant acute end organ damage. End organ damage may involve encephalopathy, acute coronary syndrome, acute heart failure, and aortic dissection among others. Triggers may be drugs, oral contraceptives, certain medications, renal disease, and pheochromocytoma among other conditions. Medical blood pressure lowering should be achieved rapidly or urgently, depending on clinical presentation.
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"Emergency Contraception." In Pediatric Collections: Adolescent Health Care Part 2: Reproductive Health, 108–16. American Academy of Pediatrics, 2023. http://dx.doi.org/10.1542/9781610027076-part02-emergency.
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Despite significant declines over the past 2 decades, the United States continues to have teen birth rates that are significantly higher than other industrialized nations. Use of emergency contraception can re-duce the risk of pregnancy if used up to 120 hours after unprotected intercourse or contraceptive failure and is most effective if used in the first 24 hours.
Conference papers on the topic "Emergency contraceptives"
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Palanikumar, S., R. M. A. P. M. Rathnayake, H. Wijedasa, C. D. K. Dassanayaka, K. Anthony, M. L. Guruge, and N. P. Edirisinghe. "Knowledge and Attitudes Regarding Emergency Contraceptive Pills among SLIIT Undergraduates in Sri Lanka- Preliminary Findings of a Descriptive Cross-sectional Study." In SLIIT INTERNATIONAL CONFERENCE ON ADVANCEMENTS IN SCIENCES AND HUMANITIES [SICASH]. Faculty of Humanities and Sciences, SLIIT, 2022. http://dx.doi.org/10.54389/uvqs3531.
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The chance of unwanted pregnancies is higher for young people in the reproductive age. The Emergency Contraceptive Pill (ECP) is a hormonal form of birth control recommended for unprotected sexual activities when standard contraceptive methods are not utilized. As a result, it is crucial to research this topic since unsafe abortions in Sri Lanka result in increased maternal mortality rates. This study aims to assess the knowledge and attitudes toward emergency contraceptive pills of undergraduates at the Faculty of Humanities and Sciences at Sri Lanka Institute of Information Technology (SLIIT). A descriptive cross-sectional study was conducted among the first, second, and third-year undergraduates who followed their course in English at the Faculty of Humanities and Sciences, SLIIT. Study participants were chosen by a stratified random sampling method. Data was collected using self-administered questionnaires distributed via Microsoft forms. Data was presented using descriptive statistics by frequencies and percentages. The analysis included 84 participants, mostly third-year students (56%) and females (79.8%). Most of the students, (73.8%), agreed with the idea that ECP should be easily accessible. A higher number of students, (76.2%), mentioned that they would recommend ECP to a friend or a relative if needed, while (23.8%) mentioned that they would not recommend it. In conclusion, the knowledge of ECP among the participants was satisfactory, and the attitudes toward ECPs were positive. Keywords: Emergency contraceptive pills (ECP); Knowledge; Attitudes
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Day, Sara, Sophie Jones, Emma Ostridge, Vanessa Apea, John White, Efejiro Ashano, and Adrian Kelly. "P021 An analysis of the day and time of orders for emergency hormonal contraception (EHC) through an online contraceptive service." In BASHH 2023 Abstracts. BMJ Publishing Group Ltd, 2023. http://dx.doi.org/10.1136/sextrans-bashh-2023.61.
Full textReports on the topic "Emergency contraceptives"
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Minkanic, Michelle, and Emily Tran. Socioeconomic and Cultural Factors Influencing Type of Hormonal Contraceptive Use in Women in Developed vs Under-Developed Geographic Areas. Science Repository, April 2024. http://dx.doi.org/10.31487/j.cei.2024.01.01.
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The intent of this study is to identify and compare sociocultural barriers in various geographic regions that impede access, type and use of hormonal contraception, and methods to improve restrictions in access. Understanding and addressing sociocultural barriers to hormonal contraception on a larger intercontinental scale can create a more effective and inclusive healthcare system. A search using PubMed, Cochrane, and Embase was conducted on current and past literature performed in various developmental countries. Terms such as “birth control access AND developed nations”, “barriers of hormonal contraception AND low-income countries” were used. Studies included ranged from RCTs, cross-sectional studies, literature reviews, and meta-analyses. Countries reviewed with lower levels of development in Africa, the Middle East, Southeast Asia, and Latin America have demonstrated a rise in long-acting hormonal contraception (LARCs) after injectables. Barriers in these regions include misconceptions fertility and contraception use, access to modern contraceptives (these include oral and emergency contraceptive pills, implants, injectables, contraceptive patches and rings, intrauterine devices, female and male sterilization, vaginal barrier methods and female condoms), stigma and patriarchal settings that result in male influence on women’s reproductive choices. More developed regions of the world like the United States and Europe demonstrated a range of contraceptive options with the most compliance for intrauterine implants (IUDs) in younger reproductive women. The greatest hindrances for developed regions were cost, difficulty obtaining appointments, and fallacies for future fertility. Contraceptive education and culturally sensitive counseling should be emphasized for healthcare employees serving women with ease of access, and to strengthen reproductive support services. Advocating to provide underdeveloped regions with better contraceptive resources highlights an importance to give women globally the empowerment to choose the direction of their own reproductive journey.
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Seme, Assefa, Solomon Shiferaw, Ayanaw Amogne, Anna Popinchalk, Leilena Shimeles, Ephrem Berhanu, Ricardo Mimbela, and Margaret Giorgio. Impact of the COVID-19 Pandemic on Adolescent Sexual and Reproductive Health in Ethiopia. Guttmacher Institute, November 2021. http://dx.doi.org/10.1363/2021.33198.
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Key Points The COVID-19 pandemic and its associated restrictions raised concerns that adolescents in Ethiopia may face reduced access to youth-friendly sexual and reproductive health services. Public and private service statistics data reveal that from March through the end of 2020, the COVID-19 pandemic had at least a short-term impact on adolescent sexual and reproductive health outcomes. The COVID-19 pandemic is estimated to have resulted in an annualized increase of: 20,738 adolescents with an unmet need for contraception 8,884 unintended pregnancies among adolescents Approximately 10.1 million Ethiopian birr (more than US$250,000) in costs for the Ethiopian health system for pregnancy-related and newborn care 438 adolescent women with major obstetric complications 14 adolescent maternal deaths Ethiopia’s Ministry of Health and private health providers could take several steps to ensure that access to sexual and reproductive health services for adolescents continues throughout the remainder of the COVID-19 pandemic: Adopt an emergency response plan that addresses adolescents’ sexual and reproductive health needs Support health care workers, particularly health extension workers, to increase access to contraceptives for adolescents Engage adolescents at all levels of the Ministry of Health decision-making process Support the expansion of youth-friendly services across regions with additional staff and resources
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Kumar, Shiv, Chander Shekhar, N. K. Gupta, Malabika Roy, M. E. Khan, Mary Sebastian, Rukma Idnani, Ardash Bhargava, and Vinita Salvi. Provision of emergency contraceptive services through paraprofessionals in India. Population Council, 2007. http://dx.doi.org/10.31899/rh4.1163.
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Hossain, Sharif, M. E. Khan, Ricardo Vernon, Jill Keesbury, Ian Askew, John Townsend, and Victoria Rumbold. ECP Handbook: Introducing and Mainstreaming the Provision of Emergency Contraceptive Pills in Developing Countries. Population Council, 2009. http://dx.doi.org/10.31899/rh13.1013.
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Khan, M. E., Gul Rashida, Sharif Hossain, Ali Mir, and Ubaidur Rob. Introduction of emergency contraceptive pills in the public health system of Pakistan: A south-to-south collaboration. Population Council, 2008. http://dx.doi.org/10.31899/rh4.1193.
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Mahmood, Arshad, and Yasir Nisar. Introduction of emergency contraceptive pills (ECPs) through lady health workers (LHWs) program in Pakistan: Findings of an evaluation study. Population Council, 2012. http://dx.doi.org/10.31899/rh2.1027.
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Keesbury, Jill, Mary Zama, and Sudha Shreeniwas. The Copperbelt model of integrated care for survivors of rape and defilement: Testing the feasibility of police provision of emergency contraceptive pills. Population Council, 2009. http://dx.doi.org/10.31899/rh3.1044.
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Saldanha, Ian J., Gaelen P. Adam, Ghid Kanaan, Michael L. Zahradnik, Dale W. Steele, Valery A. Danilack, Alex Friedman Peahl, Kenneth K. Chen, Alison M. Stuebe, and Ethan M. Balk. Postpartum Care up to 1 Year After Pregnancy: A Systematic Review and Meta-Analysis. Agency for Healthcare Research and Quality (AHRQ), June 2023. http://dx.doi.org/10.23970/ahrqepccer261.
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Objectives. This systematic review assesses postpartum care for individuals up to 1 year after pregnancy. We addressed two Key Questions (KQs) related to the comparative effectiveness and harms of: (1) alternative strategies for postpartum healthcare delivery and (2) extension of postpartum health insurance coverage. Data sources and review methods. We searched Medline®, Embase®, Cochrane CENTRAL, CINAHL®, and ClinicalTrials.gov from inception to November 16, 2022, to identify comparative studies in the United States and Canada (for KQ 1) and in the United States (for KQ 2). We extracted study data into the Systematic Review Data Repository Plus (SRDR+; https://srdrplus.ahrq.gov). We assessed the risk of bias and evaluated the strength of evidence (SoE) using standard methods. The protocol was registered in PROSPERO (registration number CRD42022309756). Results. We included 50 randomized controlled trials (RCTs) and 14 nonrandomized comparative studies (NRCSs) for KQ 1 and 28 NRCSs for KQ 2. Risk of bias was moderate to high for most RCTs and all NRCSs. KQ 1: Regarding where healthcare is provided, for general postpartum care (6 studies), whether the visit is at home/by telephone or at the clinic may not impact depression or anxiety symptoms (low SoE). For breastfeeding care (8 studies), whether the initial visit is at home or at the pediatric clinic may not impact depression symptoms up to 6 months postpartum, anxiety symptoms up to 2 months, hospital readmission up to 3 months (summary relative risk [RR] 1.38, 95% confidence interval [CI] 0.90 to 2.13; 4 studies), or other unplanned care utilization up to 2 months (low SoE, all outcomes). Regarding how care is provided, for general postpartum care (4 studies), integration of care (i.e., care provided by multiple types of providers) may not impact depression symptoms or substance use up to 1 year (low SoE). Regarding when care is provided, for contraceptive care (9 studies), compared with later contraception, earlier contraception start is probably associated with comparable continued IUD use at 3 and 6 months but greater implant use at 6 months (summary RR 1.36, 95% CI 1.13 to 1.64; 2 RCTs) (moderate SoE). Regarding who provides care, for breastfeeding care (19 studies), compared with no peer support, peer support is probably associated with higher rates of any breastfeeding at 1 month (summary effect size [ES] 1.13, 95% CI 1.03 to 1.24; 4 studies) and 3 to 6 months (summary ES 1.22, 95% CI 1.06 to 1.41; 4 studies) and of exclusive breastfeeding at 1 month (summary ES 1.10, 95% CI 1.02 to 1.19; 6 studies) but probably yields comparable rates of exclusive breastfeeding at 3 months and nonexclusive breastfeeding at 1 and 3 months (all moderate SoE). Compared with no lactation consultant, breastfeeding care by a lactation consultant is probably associated with higher rates of any breastfeeding at 6 months (summary ES 1.43, 95% CI 1.07 to 1.91; 3 studies) but not at 1 month or 3 months (all moderate SoE). Lactation consultant care may not be associated with rates of exclusive breastfeeding at 1 or 3 months (moderate SoE). Regarding coordination/management of care, provision of reminders for testing is probably associated with greater adherence to oral glucose tolerance testing up to 1 year postpartum but not random glucose testing or hemoglobin A1c testing (moderate SoE). Regarding use of information or communication technology (IT; 8 studies), IT use for breastfeeding care is probably associated with comparable rates of any breastfeeding at 3 months and 6 months and of exclusive breastfeeding at 3 months (all moderate SoE). Because of sparse evidence, inconsistent results, and/or the lack of reporting of prioritized outcomes, no conclusions related to interventions targeting healthcare providers are feasible (4 studies). KQ 2: Regarding health insurance (28 studies), more comprehensive health insurance is probably associated with greater attendance at postpartum visits (moderate SoE) and may be associated with fewer preventable readmissions and emergency room visits (low SoE). Conclusion. Most studies included in this systematic review enrolled predominantly healthy postpartum individuals. Researchers should therefore design studies that, either entirely or in part, enroll individuals at high risk of postpartum complications due to chronic conditions, pregnancy-related conditions, or incident or newly diagnosed conditions. New high-quality research is needed, especially for interventions targeting healthcare providers and the impact of more comprehensive or extended health insurance on postpartum health. Patient-reported outcomes, such as quality of life, should also be reported. Researchers should report separate data for various population subgroups, which could help close gaps in health outcomes among the races of postpartum individuals in the United States.
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Emergency Contraceptive Pills: South East Asia Regional Training Manual. Population Council, 2005. http://dx.doi.org/10.31899/rh16.1016.
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This manual aims to equip Master Trainers with appropriate knowledge on emergency contraceptive pills that can be used by a woman to prevent an unwanted pregnancy within three days of unprotected intercourse or a contraceptive accident such as condom leakage. The manual discusses emergency contraceptive pills and the provision of related services. After a day’s training, Master Trainers will have the knowledge and skills necessary to train service providers and workers on emergency contraceptive pills. Clinicians and program managers who would like to provide services or information on emergency contraceptive pills would also benefit from the manual. The manual is divided into four sessions. The first session provides an overview of the demographic and reproductive health situation in South Asia and discusses the role of emergency contraception as a reproductive health intervention. The second session defines emergency contraception and discusses details of when and how emergency contraceptive pills should be taken. Service delivery guidelines are covered in the third session. The fourth session covers counseling on emergency contraceptive pills and frequently asked questions.
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Comparing alternative products in the provision of emergency contraception. Population Council, 1999. http://dx.doi.org/10.31899/rh1999.1010.
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This report is the third in a series of summaries produced in connection with the operations research project “Enhancing Access to Family Planning Services through the Introduction of Emergency Contraception.” Launched in September 1997, the project explores the many issues surrounding the introduction and delivery of emergency contraception services in a developing country context. The study compares the introduction of two different emergency contraception pills—the combined oral contraceptive PC-4, introduced in Zambia in 1997, and the progestin-only contraceptive Postinor-2, introduced by this study in the following year. Client histories showed only minor differences in the attitudes of emergency contraception users toward the two methods, but the study highlights important differences between the two products, some of which could have implications for service delivery.