Put a Ring in It: Exploring Women's Experiences with the Contraceptive Vaginal Ring in Ontario.

BACKGROUND: Although the contraceptive vaginal ring (CVR) has been available in Canada since 2001, overall use and availability remain low compared with other combined hormonal contraceptive methods. We aimed to explore women's experiences with the CVR in Ontario as well as factors that influenced their decisions to choose the method and continue/discontinue use. METHODS: We conducted a multimethod qualitative study that consisted of an anonymous online survey and in-depth telephone interviews with a subset of survey participants. We used descriptive statistics to analyze the survey data and analyzed our interviews for content and themes using both deductive and inductive techniques. RESULTS: From May to July 2015, we received 103 survey responses and conducted 29 in-depth interviews. Many participants described positive experiences with the CVR and found it to be an especially convenient method. Women who discontinued use of the CVR cited high costs, access barriers, and negative media reports as important factors in their decision. Our participants primarily relied on their physicians for contraceptive information but did not feel fully informed about potential side effects. Several women identified the CVR as an "in between" method in the transition from oral contraceptive pills to the intrauterine device. CONCLUSIONS: Our findings suggest that the CVR represents a convenient and desirable contraceptive option for some women. However, participants expressed a desire for health care providers to provide more comprehensive information about a full range of contraceptive methods. Improving access to a full range of low-cost contraceptives in Ontario seems to be warranted.

A lifetime of campaigning: Ettie Rout, emancipationist beyond the pale.

H.G. Wells called her 'that unforgettable heroine'. But she was forgotten, most particularly in New Zealand, where she was banned from mention in the newspapers under the War Regulations for her 'safe sex' work during the First World War - a very hypocritical move as it happened just as her work was officially taken on by the army. For this work she was dubbed the 'guardian angel of the ANZACs' by a French venereal disease specialist and awarded the Reconnaissance Franaise by the French. After the war she settled in London, marrying her long-time friend and wartime colleague, physical culturist Fred Hornibrook. Rout went on with her venereal disease prophylaxis campaign after the war. She also entered the birth control movement in the 1920s, playing a major role in the last big birth control court case, a role often attributed to Dora Russell, while Rout again is 'forgotten'. In her books, like the best selling Safe Marriage, a safe sex guide (which was banned in New Zealand), she encouraged women to own their own bodies and take responsibility for their own sexual health. She linked exercise and sex, arguing in books like Sex and Exercise, that exercise would enhance women's sex lives. She and Hornibrook, who wrote a best-selling book entitled The Culture of the Abdomen, presaging the current obsession with rocklike 'abs', made a pair, teaching fitness techniques, holding 'native dance' evenings, and being hailed as modern dance proponents. Rout also wrote books on vegetarianism, wholemeal cookery and Maori culture. The word most commonly used by people describing her throughout her life was 'energy'. She herself was very fit. But she did not fit in. Once her marriage to Hornibrook was over, in 1936, she returned to New Zealand, was rebuffed by former friends. She sailed for Rarotonga and died there, of a self-administered overdose of quinine that September. As she had remarked to H.G. Wells, 'It is a mixed blessing to be born too soon'. She anticipated many of the enthusiasms of our own time - in diet, in dance, in ideas about exercise and sexuality. But because she was so far ahead of her own time in her 'safe sex' campaign, she became persona non grata in her own country. With the advent of AIDS her contribution snaps into focus - and the AIDS clinic in the city of Christchurch where she used to live has been named after her.