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1.
Ideggyogy Sz ; 73(05-06): 161-169, 2020 05 30.
Artículo en Húngaro | MEDLINE | ID: mdl-32579305

RESUMEN

Family planning is an exceptionally important question in multiple sclerosis, as women of childbearing age are the ones most often affected. Although it is proven that pregnancy does not worsen the long-term prognosis of relapsing-remitting multiple sclerosis, many patients are still doubtful about having children. This question is further complicated by the fact that patients - and often even doctors - are not sufficiently informed about how the ever-increasing number of available disease-modifying treatments affect pregnancies. Breastfeeding is an even less clear topic. Patients usually look to their neurologists first for answers concerning these matters. It falls to the neurologist to rationally evaluate the risks and benefits of contraception, pregnancy, assisted reproduction, childbirth, breastfeeding and disease modifying treatments, to inform patients about these, and then together come to a decision about the best possible therapeutic approach, taking the patients' individual family plans into consideration. Here we present a review of relevant literature adhering to international guidelines on the topics of conception, pregnancy and breastfeeding, with a special focus on the applicability of approved disease modifying treatments during pregnancy and breastfeeding. The goal of this article is to provide clinicians involved in the care of MS patients with up-to-date information that they can utilize in their day-to-day clinical practice.


Asunto(s)
Servicios de Planificación Familiar/métodos , Conocimientos, Actitudes y Práctica en Salud , Factores Inmunológicos/efectos adversos , Esclerosis Múltiple Recurrente-Remitente/tratamiento farmacológico , Esclerosis Múltiple/tratamiento farmacológico , Adulto , Lactancia Materna , Anticoncepción , Femenino , Humanos , Factores Inmunológicos/uso terapéutico , Esclerosis Múltiple/psicología , Esclerosis Múltiple Recurrente-Remitente/psicología , Embarazo
2.
Eur J Contracept Reprod Health Care ; 25(3): 231-232, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32436739

RESUMEN

Purpose: The Italian Society of Contraception identified as one of its priorities the need to give recommendations on management of contraception during Coronavirus-Covid 19 pandemiaMaterials and methods: A concise communication was produced which summarises in an easy-to-read format suitable for clinicians the management of the different contraceptives mostly used. Information how to manage contraception in different conditions is presented.Results: Women may, in general, continue to use either intrauterine and or hormonal contraceptives. The use of condom should be added to any hormonal contraceptive, when the contraceptive efficacy is reduced or when women stop the contraceptive method.Conclusion: At the present time, during the Coronavirus-Covid 19 pandemia, no data contraindicate the use of intrauterine or hormonal contraceptives. Conversely the use of an appropriate contraception is advocate to prevent unintended pregnancies.


Asunto(s)
Anticoncepción/normas , Infecciones por Coronavirus , Coronavirus , Pandemias , Neumonía Viral , Guías de Práctica Clínica como Asunto , Anticonceptivos Femeninos/normas , Femenino , Humanos , Comunicación Interdisciplinaria , Italia , Sociedades Médicas/normas
6.
South Med J ; 113(5): 213-218, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32358615

RESUMEN

OBJECTIVES: Women with substance use disorders experience unique challenges to contraceptive obtainment and user-dependent method adherence, contributing to higher than average rates of unintended pregnancy. This study estimated the prevalence of barriers to contraception and their associations with contraceptive use and unwanted pregnancies among women receiving opioid agonist therapy (OAT) in northeast Tennessee. METHODS: A cross-sectional survey was piloted among female patients aged 18 to 55 years from 2 OAT clinics. Logistic regression was used to evaluate associations between contraceptive barriers and current contraceptive use and previous unwanted pregnancies among women receiving OAT. RESULTS: Of 91 participants, most experienced previous pregnancies (97.8%), with more than half reporting unwanted pregnancies (52.8%). Although 60% expressed a strong desire to avoid pregnancy, ambivalence toward becoming pregnant was common (30.0%). Most experienced ≥1 barriers to contraceptive use or obtainment (75.8%), the most prevalent being aversion to adverse effects (53.8%), healthcare provider stigmatization (30.7%), scheduled appointment compliance (30.3%), and prohibitive cost (25.0%). Experience of any contraceptive barrier (adjusted odds ratio [AOR] 8.64, 95% confidence interval [CI] 2.03-36.79) and access to a contraceptive provider (AOR 5.01, 95% CI 1.34-18.77) were positively associated with current use of prescribed contraceptives, whereas prohibitive cost was negatively associated (AOR 0.28, 95% CI 0.08-0.94). CONCLUSIONS: Although most participants desired to avoid pregnancy, ambivalence or uncertainty of pregnancy intention was common. Most experienced barriers to contraception, which were more strongly associated with previous unwanted pregnancy than current contraceptive use. The provision of long-acting reversible contraceptives and contraceptive education at OAT clinics represents an opportunity to reduce the incidence of neonatal abstinence syndrome.


Asunto(s)
Anticoncepción/estadística & datos numéricos , Anticonceptivos/uso terapéutico , Costos de la Atención en Salud , Accesibilidad a los Servicios de Salud , Tratamiento de Sustitución de Opiáceos , Trastornos Relacionados con Opioides/tratamiento farmacológico , Aceptación de la Atención de Salud , Estereotipo , Adolescente , Adulto , Citas y Horarios , Coerción , Anticonceptivos Orales/uso terapéutico , Implantes de Medicamentos , Femenino , Humanos , Violencia de Pareja , Dispositivos Intrauterinos , Modelos Logísticos , Anticoncepción Reversible de Larga Duración , Persona de Mediana Edad , Oportunidad Relativa , Embarazo , Embarazo no Deseado , Esterilización Reproductiva , Encuestas y Cuestionarios , Adulto Joven
7.
Reprod Health ; 17(1): 44, 2020 Apr 03.
Artículo en Inglés | MEDLINE | ID: mdl-32245521

RESUMEN

BACKGROUND: Family planning (FP) is one of the high impact public health interventions with huge potential to enhance the health and wellbeing of women and children. Yet, despite the steady progress made towards expanding access to family planning, major disparities across different regions exist in Kenya. This study explored the socio cultural factors influencing FP use among two Muslim communities in Kenya. METHODS: A qualitative study involving Focus Group Discussions (FGDs) and In-depth Interviews (IDIs) was conducted (from July to October 2018) in two predominant Muslim communities of Lamu and Wajir counties. Open ended questions explore key thematic areas around knowledge, attitudes and understanding of contraception, perceived FP barriers, and decision making for contraceptives, views on Islam and contraception, and fertility preference. All interviews were conducted in the local language, recorded, transcribed verbatim and translated into English. Data was analyzed using thematic content analyses. RESULTS: Although Islam is the predominant religion the two communities, perceptions and belief around FP use were varied. There were differing interpretations of Islamic teaching and counter arguments on whether or not Islam allows FP use. This, in addition to desire for a large family, polygamy, high child mortality and a cultural preference for boys had a negative impact on FP use. Similarly, inability of women to make decisions on their reproductive health was a factor influencing uptake of FP. CONCLUSION: Misinterpretation of Islamic teaching on contraception likely influences uptake of family planning. Cultural beliefs and lack of women's decision power on fertility preferences were a key inhibitor to FP use. Countering the negative notions of FP use requires active engagement of religious leaders and Muslim scholars who are in position of power and influence at community level.


Asunto(s)
Conducta Anticonceptiva , Anticoncepción/métodos , Servicios de Planificación Familiar/organización & administración , Conocimientos, Actitudes y Práctica en Salud , Islamismo , Adolescente , Adulto , Conducta Anticonceptiva/etnología , Conducta Anticonceptiva/psicología , Cultura , Femenino , Grupos Focales , Humanos , Kenia , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Factores Socioeconómicos , Adulto Joven
8.
J Prev Med Public Health ; 53(2): 117-125, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32268466

RESUMEN

OBJECTIVES: This study investigated the role of information and communication technology and women's empowerment in contraceptive discontinuation in Indonesia. METHODS: The study used data from the 2017 Indonesia Demographic and Health Survey and monthly contraceptive calendar data. A Gompertz proportional hazards model was used for analysis. RESULTS: The 12-month contraceptive discontinuation rate was higher among women who had used the Internet in the past year, women who were mobile phone owners, and women who reported having fully participated in household decision-making than among their counterparts. These factors significantly impacted the risk of contraceptive discontinuation in Indonesia, even after controlling for contraceptive method, age, parity, contraceptive intent, education, work status, place of residence, and wealth status. CONCLUSIONS: After adjustment for the control variables, a higher risk of contraceptive discontinuation was associated with having used the Internet in the past year, owning a mobile phone, and not participating in household decision-making. Higher contraceptive discontinuation risk was also associated with using contraceptive pills, older age, lower parity, intent of spacing births, more education, current unemployment, and rural residence, and the risk was also significantly higher for those in the lowest household wealth quintile than for those in the fourth household wealth quintile. The association of contraceptive discontinuation with the use of modern information and communication technology and relatively disempowerment in household decision-making may imply that information regarding family planning and contraception should be conveyed via social media as part of setting up an eHealth system. This must include a strong communication strategy to empower and educate women in contraceptive decision-making.


Asunto(s)
Comunicación , Conducta Anticonceptiva/estadística & datos numéricos , Anticoncepción/métodos , Toma de Decisiones , Empoderamiento , Tecnología de la Información , Adolescente , Adulto , Anticoncepción/psicología , Conducta Anticonceptiva/psicología , Anticonceptivos/uso terapéutico , Servicios de Planificación Familiar , Femenino , Accesibilidad a los Servicios de Salud , Encuestas Epidemiológicas , Humanos , Indonesia , Pacientes Desistentes del Tratamiento/psicología , Embarazo , Factores Socioeconómicos
9.
Gac Med Mex ; 156(2): 150-155, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32285856

RESUMEN

Globally, adolescent pregnancy constitutes a serious public health problem of a multifactorial nature. Specifically for women, it entails various educational, economic and social implications that affect their life project and widen the social gaps in this age group. Furthermore, adolescent girls are more vulnerable because of the health risk involved with pregnancy at a younger age. According to the World Health Organization, "the probability of maternal death is twice as high in adolescents in comparison with women aged between 20 and 30 years, and for those younger than 15 years, the risks are five times higher". In general, adolescents are in great need for education on sexual and reproductive health issues, which should be aimed at increasing information and knowledge about correct use and access to modern contraceptive methods, as well as at demystifying fears and beliefs around their possible side effects. Ensuring proper counseling with trained personnel is equally vital. Public institutions have a social responsibility to support efforts aimed at preventing adolescent pregnancy, based on relevant lines of action and health policies.


Asunto(s)
Embarazo en Adolescencia , Adolescente , Adulto , Anticoncepción , Femenino , Humanos , México , Embarazo , Embarazo en Adolescencia/estadística & datos numéricos , Conducta Sexual , Factores de Tiempo , Adulto Joven
10.
Med Hist ; 64(2): 163-172, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32284632

RESUMEN

This special issue uses Catholicism as a thread to bring together five contributions to the transnational history of contraception. The articles, which cover examples from Western and East-Central Europe, East Africa and Latin America, all explore the complex interplay between users and providers of birth control in contexts marked by prevalence of the Catholic religion and/or strong political position of the Catholic Church. In the countries examined here, Brazil, Belgium, Poland, Ireland and Rwanda, Catholicism was the majority religion during the different moments of the long twentieth century the authors of this special issue focus on. Using transnationalism as a perspective to examine the social history of the entanglements between Catholicism and contraception, this special issue seeks to underscore the ways in which individuals and organisations used, adapted and contested local and transnational ideas and debate around family planning. It also examines the role of experts and activist groups in the promotion of family planning, while paying attention to national nuances in Catholic understandings of birth control. The contributions shed light on the motivations behind involvement in birth control activism and expertise, its modus operandi, networking strategies and interactions with men and women demanding contraceptive information and technology. Moreover, through the use of oral history, as well as other print sources such as women's magazines, this collection of articles seeks to illustrate 'ordinary' men and women's practices in the realm of reproductive health.


Asunto(s)
Catolicismo/historia , Anticoncepción/historia , Religión y Medicina , Historia del Siglo XX , Humanos
11.
Med Hist ; 64(2): 195-218, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32284634

RESUMEN

The twentieth-century history of men and women's attempts to gain access to reproductive health services in the Republic of Ireland has been significantly shaped by Ireland's social and religious context. Although contraception was illegal in Ireland from 1935 to 1979, declining family sizes in this period suggest that many Irish men and women were practising fertility control measures. From the mid-1960s, the contraceptive pill was marketed in Ireland as a 'cycle regulator'. In order to obtain a prescription for the pill, Irish women would therefore complain to their doctors that they had heavy periods or irregular cycles. However, doing so could mean going against one's faith, and also depended on finding a sympathetic doctor. The contraceptive pill was heavily prescribed in Ireland during the 1960s and 1970s as it was the only contraceptive available legally, albeit prescribed through 'coded language'. The pill was critiqued by men and women on both sides of the debate over the legalisation of contraception. Anti-contraception activists argued that the contraceptive pill was an abortifacient, while both anti-contraception activists and feminist campaigners alike drew attention to its perceived health risks. As well as outlining these discussions, the paper also illustrates the importance of medical authority in the era prior to legalisation, and the significance of doctors' voices in relation to debates around the contraceptive pill. However, in spite of medical authority, it is clear that Irish women exercised significant agency in gaining access to the pill.


Asunto(s)
Catolicismo/historia , Anticoncepción/historia , Anticonceptivos Orales/historia , Relaciones Médico-Paciente , Religión y Medicina , Anticoncepción/ética , Servicios de Planificación Familiar/historia , Servicios de Planificación Familiar/legislación & jurisprudencia , Femenino , Feminismo/historia , Historia del Siglo XX , Humanos , Irlanda , Masculino , Rol del Médico/historia , Derechos de la Mujer/historia
12.
Med Hist ; 64(2): 219-239, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32284635

RESUMEN

This article surveys the evolution of Rwandan family planning practices from the nation's mythico-historical origins to the present. Rwanda is typically regarded as a patriarchal society in which Rwandan women have, throughout history, endured limited rights and opportunities. However, oral traditions narrated by twentieth-century Rwandan historians, storytellers and related experts, and interpreted by the scholars and missionaries who lived in Rwanda during the nation's colonial period, suggest that gender norms in Rwanda were more complicated. Shifting practices related to family planning - particularly access to contraception, abortion, vasectomies and related strategies - are but one arena in which this becomes evident, suggesting that women's roles within their families and communities could be more diverse than the historiography's narrow focus on women as wives and mothers currently allows. Drawing upon a range of colonial-era oral traditions and interviews conducted with Rwandans since 2007, I argue that Rwandan women - while under significant social pressure to become wives and mothers throughout the nation's past - did find ways to exert agency within and beyond these roles. I further maintain that understanding historical approaches to family planning in Rwanda is essential for informing present-day policy debates in Rwanda aimed at promoting gender equality, and in particular for ensuring women's rights and access to adequate healthcare are being upheld.


Asunto(s)
Catolicismo/historia , Colonialismo/historia , Anticoncepción/historia , Servicios de Planificación Familiar/historia , Religión y Medicina , Bélgica , Femenino , Identidad de Género , Regulación Gubernamental/historia , Historia del Siglo XX , Humanos , Masculino , Misioneros/historia , Religión/historia , Rwanda
13.
Med Hist ; 64(2): 240-266, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32284636

RESUMEN

This paper scrutinises the relations between different models of family planning advice and their evolution in Poland between the mid-1950s and the late 1980s, focusing on their similarities and dissimilarities, conflicts and concordances. From 1956 onwards, the delivery of family planning advice became a priority for both the Polish Catholic Church and the party-state, especially its health authorities, which supported the foundation of the Society of Conscious Motherhood and aspired to mainstream birth control advice through the network of public well-woman clinics. As a consequence, two systems of family planning counselling emerged: the professional, secular family planning movement and Catholic pre-marital and marital counselling. We argue that reciprocal influence and emulation existed between state-sponsored and Catholic family planning in state-socialist Poland, and that both models used transnational organisations and debates relating to contraception for their construction and legitimisation. By evaluating the extent to which the strategies and practices for the delivery of birth control advice utilised by transnational birth control movements were employed in a 'second world' context such as Poland, we reveal unexpected supranational links that complicate and problematise historiographical and popular understandings of the Iron Curtain and Cold War Europe.


Asunto(s)
Catolicismo/historia , Anticoncepción/historia , Servicios de Planificación Familiar/historia , Religión y Medicina , Socialismo/historia , Femenino , Historia del Siglo XX , Humanos , Polonia , Servicios de Salud para Mujeres/historia
14.
Med Hist ; 64(2): 267-286, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32284637

RESUMEN

This paper looks at the journey of eleven counsellors in marital counselling centres in French-speaking Belgium, from the creation of the centres in 1953, to the 1970s, when contraception became legal, and abortion became a public issue. At the time of Humanae Vitae, groups of volunteers, working within Catholic organisations where counselling took place, began to structure their activity around Carl Rogers's ethics of client-centred therapy, placing their religious ideology in a secondary position to focus on the problems experienced by the couples and women they were receiving in the centres. These were often challenges they were experiencing themselves in their own lives. The reiteration of the Catholic orthodox view on contraception through Humanae Vitae marked a gap between the counsellors and the Church. This contribution questions the identity-related tension of Catholics working in conjugal counselling centres and the type of commitments they made to both the conjugal centres and the Church in a moment where family planning was debated both in the Church and politically.


Asunto(s)
Catolicismo/historia , Anticoncepción/historia , Consejo/historia , Servicios de Planificación Familiar/historia , Religión y Medicina , Bélgica , Anticoncepción/ética , Consejo/ética , Servicios de Planificación Familiar/ética , Femenino , Historia del Siglo XX , Humanos , Masculino
15.
Rinsho Ketsueki ; 61(3): 280-283, 2020.
Artículo en Japonés | MEDLINE | ID: mdl-32224591

RESUMEN

A fulfilling communication between healthcare professionals and patients is important during medical interviews, especially when asking sex-life-related questions in compliance with TERMS® (Thalidomide Education and Risk Management System) and RevMate® (procedures for proper management of Revlimid® (lenalidomide) and Pomalyst® (pomalidomide)). Educational systems for improving medical communications related to sexual issues remain to be developed. Therefore, we surveyed real views of healthcare professionals and patients involved in thalidomide treatment. We created an educational DVD and a side reader to improve medical communications under the aid from Japan Agency for Medical Research and Development (AMED).


Asunto(s)
Coito , Anticoncepción , Personal de Salud , Humanos , Japón , Lenalidomida
17.
Am J Nurs ; 120(5): 16, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32332348
18.
Sex Reprod Health Matters ; 28(1): 1723321, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32178594

RESUMEN

In Africa, high discontinuation of contraceptive use is thwarting goals for healthy birth spacing or limiting childbearing. This paper investigates how well the contraception program is addressing the needs of women and couples in the Arusha region, Tanzania by studying contraceptive use continuation. We measured the overall and method-specific discontinuation rate, reasons for discontinuation, post-discontinuation reproductive behaviours/outcomes, and examined the determinants of contraceptive discontinuation. We used data from a household survey conducted in Arusha from January to May 2018. Information on contraceptive use during the 31 months preceding the survey was recorded in a monthly calendar. Using the single- and multiple-decrement life-table approach, we calculated the overall and cause-specific discontinuation of contraceptive methods. Logistic regression was used to evaluate the determinants of discontinuation. The 12-month overall discontinuation of contraceptive use was 44.6%. Discontinuation was lowest for implants (12.3%) and highest for male condoms (60.1%), the most common reason being side effects (11.7%). 59.8% of women who discontinued did not switch to another method within 3 months following discontinuation and 20.9% experienced pregnancy. Longer distance to a health facility is associated with higher discontinuation of hormonal methods such as injectables, but lower discontinuation of non-hormonal methods such as condoms. Discontinuation due to side effects is not explained by most of the women's background characteristics other than the method they used. Discontinuation of contraception is high among Arusha women. Effective contraception programs, especially improved counselling, need to address the reasons for the discontinuation of contraceptive use.


Asunto(s)
Conducta Anticonceptiva/estadística & datos numéricos , Anticoncepción/métodos , Anticoncepción/estadística & datos numéricos , Anticonceptivos Femeninos/administración & dosificación , Servicios de Planificación Familiar/organización & administración , Accesibilidad a los Servicios de Salud , Cooperación del Paciente/estadística & datos numéricos , Adolescente , Adulto , Condones , Anticoncepción/psicología , Conducta Anticonceptiva/etnología , Conducta Anticonceptiva/psicología , Femenino , Humanos , Cooperación del Paciente/etnología , Cooperación del Paciente/psicología , Embarazo , Embarazo no Planeado , Embarazo no Deseado , Encuestas y Cuestionarios , Adulto Joven
20.
PLoS One ; 15(3): e0229586, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32134931

RESUMEN

BACKGROUND: The ECHO trial has relieved apprehension about intramuscular depot medroxyprogesterone acetate (DMPA-IM), however it is still important to understand how DMPA-IM affects the vaginal environment. We sought to describe how DMPA-IM initiation influences vaginal bacteria associated with HIV acquisition in postpartum women. METHODS: Vaginal swabs were collected for Nugent score determination and taxon-specific quantitative PCR of eight bacteria. Enrollment occurred at contraceptive initiation (DMPA-IM or non-hormonal contraception (non-HC)) and repeat vaginal swabs were collected after three months. Generalized estimating equations were used to estimate changes in Nugent score, total bacterial load, and taxa concentrations among contraceptive groups. RESULTS: Women who chose DMPA-IM (n = 33) were more likely to be married (97%vs.67%) and have resumed intercourse since delivery (52%vs.29%) compared to women who chose non-HC (n = 21). After three months, significant decreases in the concentrations of Sneathia species, Mycoplasma hominis, and Parvimonas species Type 1 were seen among non-HC users, however concentrations remained stable among DMPA-IM users; contraceptive method was associated with significantly different changes in M. hominis concentration between groups (p = 0.010). CONCLUSIONS: Our findings suggest that postpartum use of DMPA-IM and non-HC may have differential impacts on the vaginal concentrations of some bacteria that have previously been associated with HIV acquisition.


Asunto(s)
Infecciones Bacterianas/microbiología , Anticonceptivos Femeninos/administración & dosificación , Acetato de Medroxiprogesterona/administración & dosificación , Vagina/microbiología , Adulto , África , Bacterias/crecimiento & desarrollo , Anticoncepción/métodos , Femenino , Humanos , Periodo Posparto , Estudios Prospectivos , Adulto Joven
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