RESUMEN
INTRODUCTION: Globally an estimated 1 in 16 women per year experience an unwanted pregnancy (UWP). In the Netherlands, general practitioners (GPs) play an important role in providing care for women with UWP; however, it is unknown how many of these women consult their GP about the pregnancy. UWPs are a major life experience with a possible influence on mental health. Data that GPs register about UWPs, psychosocial problems, and contraceptive use could give more insight into care needs. AIMS: To create an overview of (i) the prevalence of UWPs in general practice, (ii) the prevalence of psychosocial problems in women with UWP, and (iii) contraceptive use of women with UWP. METHODS: GP registration data were analysed from 58 general practices located in Northern Netherlands between 2015 and 2019. Patient files were checked for registration of ICPC and ATC codes concerning pregnancy, psychosocial health, and contraceptive use. Chi-square and Fisher's exact test were used to calculate differences between women with a UWP and women with a wanted pregnancy (WP). An analysis of registration dates was conducted to determine when the psychosocial problems were registered in relation to the pregnancy. RESULTS: Of female patients of reproductive age, 1.6% had a UWP and 11.8% had a WP. Women with a UWP reported statistically significantly more psychosocial problems. Furthermore, statistically significantly more contraceptive methods were prescribed to women with UWP compared with both women with WP and women without pregnancy. DISCUSSION AND CONCLUSION: The finding that women with UWP experience more psychosocial problems can be used to improve aftercare and can be incorporated into current guidelines for GPs.
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Anticonceptivos , Embarazo no Deseado , Embarazo , Femenino , Humanos , Lactante , Países Bajos/epidemiología , Sistema de Registros , Atención Primaria de SaludRESUMEN
BACKGROUND: This study aims to address the lack of information about the long-term wellbeing of (former) teenage mothers in the Netherlands. It provides data which policymakers can use to ensure that support programmesmeet the needs of teenage mothers. METHODS: Women who had given birth before the age of twenty were recruited online by Fiom, expertise centre on unintended pregnancy (December 2018-February 2019; N = 248). Survey data were obtained to assess how they perceived their wellbeing, employment, education, housing, and social support. Respondents were divided into three groups: 0-3 years after teenage childbearing (short term), 4-12 years (medium term), >12 years (long term). Results were analysed using univariate and bivariate descriptions in SPSS. RESULTS: Almost 80% of respondents reported that they were doing well and were satisfied with their lives, 63% had a job, and 17% were students. Short-term mothers worked fewer hours per week, received more benefits, and were less satisfied with their living conditions compared to medium- and long-term mothers. 36% Of the respondents smoked cigarettes. Most support was given by family (83%), mainly by female relatives. About 24% received formal support from social workers or institutions. CONCLUSIONS: Respondents, on average, reported they were doing well and were satisfied with their lives, in both the short and long term. These results suggest that as the years pass, teenage mothers overcome difficulties. Regarding income and housing, however, short-term mothers were in a less favourable position. Tailored interventions are recommended to address smoking among (former) teenage mothers.
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Embarazo en Adolescencia , Embarazo , Adolescente , Femenino , Humanos , Madres Adolescentes , Madres , Embarazo no Planeado , Apoyo SocialRESUMEN
BACKGROUND: Girls with a mild intellectual disability generally receive less sexuality education than their non-disabled peers, while their needs for sexual knowledge are possibly greater. This study aimed to evaluate the effect and process of a new sexuality education programme (Girls' Talk+), focused on sexual health among girls with a mild intellectual disability in the Netherlands. METHODS: A mixed methods approach was applied, using participant questionnaires (n = 249), logs written by trainers (n = 17) and interviews with trainers (n = 10). Descriptive statistics and linear regression models were used to analyse the quantitative data. Several coding phases were used to analyse the interviews. RESULTS AND CONCLUSIONS: This study provides some indication that Girls' Talk+ has positive results on improving knowledge, attitude, and self-efficacy in relation to sexual health as well as trainer and participant satisfaction with the programme.
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Discapacidad Intelectual , Educación Sexual , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Conducta Sexual , SexualidadRESUMEN
Introduction: Unintended pregnancies are a worldwide health issue, faced each year by one in 16 people, and experienced in various ways. In this study we focus on unintended pregnancies that are, at some point, experienced as unwanted because they present the pregnant person with a decision to continue or terminate the pregnancy. The aim of this study is to learn more about the decision-making process, as there is a lack of insights into how people with an unintended pregnancy reach a decision. This is caused by 1) assumptions of rationality in reproductive autonomy and decision-making, 2) the focus on pregnancy outcomes, e.g. decision-certainty and reasons and, 3) the focus on abortion in existing research, excluding 40% of people with an unintended pregnancy who continue the pregnancy. Method: We conducted a narrative literature review to examine what is known about the decision-making process and aim to provide a deeper understanding of how persons with unintended pregnancy come to a decision.Results: Our analysis demonstrates that the decision-making process regarding unintended pregnancy consists of navigating entangled layers, rather than weighing separable elements or factors. The layers that are navigated are both internal and external to the person, in which a 'sense of knowing' is essential in the decision-making process. Conclusion: The layers involved and complexity of the decision-making regarding unintended pregnancy show that a rational decision-making frame is inadequate and a more holistic frame is needed to capture this dynamic and personal experience.