Influence of IUD perceptions on method discontinuation

Abstract

Objective: The study was conducted to assess how misbeliefs and fears about intrauterine contraceptive devices (IUDs) can influence the rate of early discontinuation of this method.

Study Design: This is a prospective survey conducted at the Family Planning Clinic at Al-Habibia Maternity Teaching Hospital (Baghdad, Iraq). Two hundred women presenting to the family planning clinic with requests for premature IUD removal were administered a structured questionnaire to ascertain demographic information and reasons for removal request. Careful and sympathetic questioning was essential in order to obtain correct information. The data were analyzed using descriptive and inferential statistics. Results: Slightly over half of the women (52.8%) gave only one reason for requesting removal, while the remaining (47.5%) women had two or three complaints. Side effects were the principal reason for request for removal in both groups (45.7% and 42.6%). In the group that offered only one reason, IUD side effects, device-related issues, fears about the device and pregnancy or seeking pregnancy were the reported reasons. In the group that offered more than one reason, each had two or three complaints. IUD side effects and fears about the device were the most prevalent (42.6% and 41.8%, respectively); these fears and perceptions were reported more frequently among younger users and among those requesting early removal.

Conclusion: Fears and misbeliefs about IUD contributed to discontinuation of use in almost half of the women requesting IUD removal. These elements were more common among younger women and, noticeably, among those who requested early removal. © 2008 Elsevier Inc. All rights reserved.

Keywords: IUD; Fears; Removal

Acceptability of Once-a-Month Injectable Contraceptives Cyclofemt and Mesigynat: Focus Group Discussion

N. El Nahal,* E.O. Hassan,* and M. El Houssinie†

This article presents the results of focus group discussion sessions conducted with a sample of continuers and discontinuers of the once-a-month injectable contraceptives Cyclofemt and Mesigynat, as well as with some of the physicians who participated in the clinical trial. The sessions helped explain certain aspects related to the clients as well as the service delivery setting that affected the acceptability of these contraceptive preparations. Providing counseling and presence of a dedicated clinic staff were very essential to the success of the clinical trial. Social support in the form of both husband knowledge, approval, and support as well as the presence of other close relative or friend users helped in increasing the woman’s tolerance of side effects and sometimes helped overcome adverse rumors. Reaction of the women to vaginal bleeding in an Islamic society is discussed and the need for health education in this aspect is strongly recommended. The two preparations are best suited for women who were satisfied with the use of combined hormonal contraceptive pills but had a problem with compliance, and users of other hormonal methods who are free from menstrual irregularities. On the whole, the two preparations had high acceptability among Egyptian women, provided that procedures for the selection of the appropriate candidate are adhered to, and that pre- and postservice counseling and social support are present.

CONTRACEPTION 1999;59:369–375 © 1999 Elsevier Science Inc. All rights reserved.
KEY WORDS: Cyclofem, Mesigyna, acceptability, focus group

Acceptability and clinical performance of a copper-containing

Ching Yin Grace Wong*, Wai Lan Ng, Seen Tsing Sue Lo, Yun Sun Susan Fan
Health Services Department, The Family Planning Association of Hong Kong, Wanchai, Hong Kong

Abstract

This is the first study conducted in Hong Kong to evaluate the acceptability and clinical performance of a copper-containing frameless intrauterine contraceptive device (IUCD; GyneFix/Ji Nik). Sixty-two women chose to use the frameless IUCD for contraception. A learning curve was demonstrated in the insertion technique of this new device. Pain associated with insertion was acceptable. No pregnancy was reported during the 1-year trial period. Objectively, the amount of menstrual loss did not change and dysmenorrhea improved, but the duration of menstrual flow was slightly prolonged during the use of this device. However, there was a 10.7% request rate for removal of the device because of its side effects. The expulsion rate during the first year was 5.3%, and the continuation rate at the end of the first year was 76.7%. It was found that 85% of the 40 subjects interviewed upon the completion of the 1-year trial period wished to replace the same device after the product expiry date and that 92.5% would recommend this device to their friends. In summary, the clinical performance of the frameless IUCD was comparable to its framed counterparts. The device was considered acceptable to a majority of the women. D 2005 Elsevier Inc. All rights reserved.
Keywords: GyneFix/Ji Nik; Frameless IUCD; Clinical performance; Acceptability; Hong Kong

Principles of contraceptive care: choice,

Unintended pregnancy, abortion and sexually transmitted infection rates are high in the UK. Research shows that women and men do know about contraception, but do not always use it or use it poorly and inconsistently. This chapter addresses the issues around contraceptive decision-making and choice, and the influences that affect uptake and use.

Keywords: contraception, choice, acceptability, access, information, knowledge, use

Copper IUD and LNG IUS compared with tubal occlusion

Diana Mansour
Newcastle Contraception and Sexual Health Services, Graingerville Clinic, Newcastle General Hospital, Westgate Road, Newcastle upon Tyne, NE6 4BE, UK
Received 6 November 2006; revised 26 December 2006; accepted 27 December 2006

Abstract

This article will cover current contraceptive use around the world, then examine the advantages and disadvantages of female sterilization, the hormonal intrauterine system and the copper intrauterine device. Finally, the need for contraceptive choice will be discussed along with a discussion on the cost-effectiveness of these methods. D 2007 Elsevier Inc. All rights reserved.

Keywords: Tubal occlusion; Tubal ligation; Female sterilization; Hormonal intrauterine system; Copper intrauterine device

Acceptability of the long-term contraceptive levonorgestrel-releasing

Abstract

This study investigated the long-term acceptability of a levonorgestrel-releasing intrauterine system (LNG-IUS) in 165 women after 6 and 36 months of use. Changes in menstrual bleeding pattern were experienced by 161 (98%) women, with a cessation or transient absence of menstruation occurring in 75 (47%) and 14 (9%) women, respectively. Amenorrhea was considered by most women (81%) as a positive change. The proportion of women with menstrual pain was reduced from 60% before use to 29% after 36 months of use with the LNG-IUS. Fear of an unwanted pregnancy became less widespread with duration of use and the device had no disturbing effects on the women or their partners during sexual intercourse. The number of women expressing that they were very satisfied with the LNG-IUS was 69% and 77% after six months and 36 months of use, respectively. LNG-IUS is a well-accepted contraceptive method, without negative influences on the sexual relationship between users and their partners, and is suitable for women requiring long-term reversible contraceptive protection. © 2003 Elsevier Science Inc. All rights reserved.

Keywords: Levonorgestrel; Intrauterine system; Long-term contraception; Patient-satisfaction

Does labor influence neonatal and neurodevelopmental outcomes of extremely-low-birth-weight infants who are born by cesarean delivery?

General Obstetrics and Gynecology

American Journal of Obstetrics & Gynecology. 189(2):501-506, August 2003.
Wadhawan, Rajan MD *; Vohr, Betty R. MD; Fanaroff, Avroy A. MD; Perritt, Rebecca L. MS; Duara, Shahnaz MD; Stoll, Barbara J. MD; Goldberg, Ronald MD; Laptook, Abbot MD; Poole, Kenneth PhD; Wright, Linda L. MD; Oh, William MD

Abstract:
OBJECTIVE: The purpose of this study was to examine the influence of labor on extremely-low-birth-weight infants who were born by cesarean delivery with reference to neonatal and neurodevelopmental outcomes. We hypothesized that infants who are born by cesarean delivery without labor will have better outcomes than those infants who are born by cesarean delivery with labor.

STUDY DESIGN: This was a retrospective cohort study of extremely-low-birth-weight infants (birth weight, 401-1000 g) who were born by cesarean delivery and cared for in the National Institute for Child Health and Human Development Neonatal Network, during calendar years 1995 to 1997. A total of 1606 extremely-low-birth-weight infants were born by cesarean delivery and survived to discharge. Of these, 1273 infants (80.8%) were examined in the network follow-up clinics at 18 to 22 months of corrected age and had a complete data set (667 infants were born without labor, 606 infants were born with labor). Outcome variables that were examined include intraventricular hemorrhage grade 3 to 4, periventricular leukomalacia, and neurodevelopmental impairment.

RESULTS: Mothers in the cesarean delivery without labor group were older (P <.001), more likely to be married (P <.05), less likely to be supported by Medicaid (P <.01), more likely to have preeclampsia/hypertension (P <.001), more likely to receive prenatal steroids (P <.005), and less likely to have received antibiotics (P <.001). Infants who were born by cesarean delivery without labor had higher gestational age (P <.001), lower birth weight (P <.01), and were less likely to be outborn (P <.001). By univariate analysis, infants who were born by cesarean delivery with labor had a higher incidence of grade 3 to 4 intraventricular hemorrhage (23.3% vs 12.1%, P <.001), periventricular leukomalacia (8.5% vs 4.7%, P <.02), and neurodevelopmental impairment (41.7% vs 34.6%, P <.02). Logistic regression analysis that controlled for all maternal and neonatal demographic and clinical variables that were statistically associated with labor or no labor revealed that the significant differences in grade 3 to 4 intraventricular hemorrhage, periventricular leukomalacia, and neurodevelopmental impairment were no longer evident.

CONCLUSION: In extremely-low-birth-weight infants who were born by cesarean delivery and after control for other risk factors, labor does not appear to play a significant role in adverse neonatal outcomes and neurodevelopmental impairment at 18 to 22 months of corrected age.