Reproductive Life Planning and Preconception Care 2015: Attitudes of English-Speaking Family Planning Patients

Nelson, Anita L.; Shabaik, Salma; Xandre, Pamela; Awaida, Joseph Y

doi:10.1089/jwh.2015.5323

Cited by 15 publications

(8 citation statements)

References 65 publications

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“…Despite significant public health campaigns to help women develop personal reproductive life plans, 128 recent work has shown that many at-risk women have not developed such plans to guide them in making contraceptive choices. 129 , 130 …”

Section: Residual Patient Concernsmentioning

confidence: 99%

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New developments in intrauterine device use: focus on the US

Nelson¹,

Massoudi²

2016

OAJC

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Many more women in the US today rely upon intrauterine devices (IUDs) than in the past. This increased utilization may have substantially contributed to the decline in the percentage of unintended pregnancies in the US. Evidence-based practices have increased the number of women who are medically eligible for IUDs and have enabled more rapid access to the methods. Many women enjoy freedom to use IUDs without cost, but for many the impact of the Affordable Care Act has yet to be realized. Currently, there are three hormonal IUDs and one copper IUD available in the US. Each IUD is extremely effective, convenient, and safe. The newer IUDs have been tested in populations not usually included in clinical trials and provide reassuring answers to older concerns about IUD use in these women, including information about expulsion, infection, and discontinuation. On the other hand, larger surveillance studies have provided new estimates about the risks of complications such as perforation, especially in postpartum and breastfeeding women. This article summarizes significant features of each IUD and provides a summary of the differences to aid clinicians in the US and other countries in advising women about IUD choices.

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Section: Residual Patient Concernsmentioning

confidence: 99%

“…Several studies have shown that even when women are deliberately trying to avoid pregnancy, there is a great mismatch between the efficacy of methods used by women and their desire to prevent pregnancy. 129 , 130 Against this background, it may be understood that women are not impressed with the low failure rates of IUDs.…”

Section: Residual Patient Concernsmentioning

confidence: 99%

New developments in intrauterine device use: focus on the US

Nelson¹,

Massoudi²

2016

OAJC

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“…Surveys of 900 women in Jamaica and India found that only 46% of women knew that COCs are more effective than condoms and only 50% knew that IUDs are more effective than condoms [ 19 ]. It is possible that this misinformation contributes to understanding why so many women use methods that are inconsistent with their stated reproductive life plans [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Women’s perceptions of contraceptive efficacy and safety

Kakaiya

Lopez

Nelson

2017

Contracept Reprod Med

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BackgroundAdoption of contraceptive implants and intrauterine devices has been less than might be expected given their superior efficacy and convenience. The purpose of this study was to assess knowledge and beliefs held by women, which may influence their contraceptive choices and theirongoing utilization of contraceptive methods.MethodsEnglish speaking, nonpregnant, reproductive-age women, who were not surgically sterilized, were individually interviewed to obtain limited demographic characteristics and to assess their knowledge about the efficacy of various contraceptive methods in typical use and about the relative safety of oral contraceptives.ResultsA convenience sample of 500 women aged 18–45 years, with education levels that ranged from middle school to postdoctoral level was interviewed. The efficacy in typical use of both combined oral contraceptives and male condoms was correctly estimated by 2.2%; over two-thirds of women significantly overestimated the efficacy of each of those methods in typical use. Oral contraceptives were thought to be at least as hazardous to a woman’s health as pregnancy by 56% of women.ConclusionsThe majority of reproductive aged women surveyed substantially overestimated the efficacy of the two most popular contraceptive methods, often saying that they were 99% effective. Women with higher education levels were most likely to overestimate efficacy of oral contraceptives. Women of all ages and education levels significantly overestimated the health hazards of oral contraceptives compared to pregnancy. Overestimation of effectiveness of these methods of contraception, may contribute to lower adoption of implants and intrauterine devices. When individualizing patient counselling, misperceptions must be identified and addressed with women of all educational backgrounds.Trial registrationNot applicable.

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“…Pregnancy intention and associated actions may be shaped by factors such as the degree of female reproductive autonomy, socioeconomic status, pro-natalist norms and attitudes and values towards available contraceptive options [8]. Traditional theories of reasoned action have been challenged in this space [9], highlighting the need for individual consideration of planning, intention, desire and action when discussing pregnancy intention.…”

Section: Introductionmentioning

confidence: 99%

Pregnancy intentions in a group of remote-dwelling Australian Aboriginal women: a qualitative exploration of formation, expression and implications for clinical practice

et al. 2019

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Background Unintended pregnancies are associated with poorer obstetric outcomes and are sometimes measured at a population level as a surrogate marker for reproductive autonomy and access to health services, including contraception. Aboriginal Australians face many disparities in health outcomes, including in reproductive health and antenatal care. We aimed to explore the formation and expression of pregnancy intentions in an Aboriginal population to inform health service improvements. Methods Semi-structured interviews were conducted with 27 remote-dwelling Aboriginal women, aged 18–49 years. Content analysis was conducted; key themes were discussed with groups of women from participating communities to refine interpretation. Results Most (19/27) participants expressed pregnancy intentions congruent with reported contraceptive behaviour while eight expressed ambivalent or uncertain intentions. Intentions were shaped by traditional kinship practices, reproductive autonomy and desired family formation. Younger women tended to aspire to smaller family sizes than older women and support was expressed for the postponement of first pregnancy to achieve other life goals. Women in these communities hold strong traditional beliefs, including regarding conception, but did not use traditional methods of contraception in place of modern methods. Reproductive coercion, in the form of pressure to fall pregnant, was recognised as an important issue by women in the community. Conclusion Consultation strategies that promote rapport, allow space for uncertainty and are inclusive of important personal and cultural contexts are likely to improve shared understanding of pregnancy intention. Universal screening for reproductive coercion and broad counselling on contraceptive options (including discrete methods) may reduce unmet need for contraception. Community approaches supporting reproductive autonomy that is inclusive of men, and enhanced educational and occupational opportunities for young women are needed.

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Reproductive Life Planning and Preconception Care 2015: Attitudes of English-Speaking Family Planning Patients

Cited by 15 publications

References 65 publications

New developments in intrauterine device use: focus on the US

New developments in intrauterine device use: focus on the US

Women’s perceptions of contraceptive efficacy and safety

Pregnancy intentions in a group of remote-dwelling Australian Aboriginal women: a qualitative exploration of formation, expression and implications for clinical practice

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