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Contraception Journal
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Contraception Highlights September 2011

This month’s featured editorial

Title X: A Proud Past, An Uncertain Future
Clare Coleman, Kirtly Parker Jones
pages 209-211
In the mid and late 1960s, the United States was at war, both abroad and at home. Amidst the battles being fought in Vietnam and in our cities and on the greens of our campuses, President Lyndon Johnson declared war on an entirely different kind of enemy: poverty. President Johnson and a politically divided Congress found the common ground to pass laws for the benefit of the people of the United States that we take for granted today as our inherent, civil rights: the Civil Rights Act, Medicaid and Medicare. They committed resources for the improvement of our natural resources: the Clean Air Act, the Clean Rivers Act and the National Environmental Policy Act, which created the Environmental Protection Agency. read more >

Commentary

Removing the black box warning for depot medroxyprogesterone acetate
Andrew M. Kaunitz, David A. Grimes
pages 212-213
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Review Article

Termination of second-trimester pregnancy by mifepristone combined with misoprostol versus intra-amniotic injection of ethacridine lactate (Rivanol): a systematic review of Chinese trials
Shu-Ping Hou, Ai-Hua Fang, Qin-Fang Chen, Yong-Mei Huang
pages 214-223
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Original research articles

Medical vs. surgical abortion: the importance of women's choice
Caroline Moreau, James Trussell, Julie Desfreres, Nathalie Bajos
pages 224-229
Background: Using a large national sample of women undergoing an abortion in France, we explore the factors associated with medical or surgical abortion. We draw particular attention to the influence of women's preferences in the decision-making process.
Conclusions: In this sample of French women who participated in a national survey on abortion, those who were involved in the decision-making process as to whether to have a medical or surgical procedure showed a strong preference for the medical procedure.
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Ovulation resumption after medical abortion with mifepristone and misoprostol
Courtney A. Schreiber, Stephanie Sober, Sarah Ratcliffe, Mitchell D. Creinin
pages 230-233
Background: As an antiprogestin, mifepristone may have an impact on the return to ovulation in a manner that is not only attributable to its abortifacient activity. Our aim was to measure the time-to-ovulation in women who received mifepristone 200 mg orally and misoprostol 800 mcg vaginally for abortion up to 63 days of gestation.
Conclusion: Return to ovulation following medical abortion with mifepristone and misoprostol occurs on average 3 weeks postabortion. Mifepristone 200 mg does not appear to have a lasting effect on ovarian function. Our results should be contextualized by the small sample size, although this is one of the larger studies on return to ovulation after abortion.
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Effects of prophylactic misoprostol administration prior to intrauterine device insertion in nulliparous women
Alison B. Edelman, Elizabeth Schaefer, Amanda Olson, Laura Van Houten
pages 234-239
Background: This study was conducted to examine the effects of prophylactic misoprostol prior to intrauterine device (IUD) placement in nulliparous women.
Conclusions: Prophylactic misoprostol prior to IUD placement in nulliparous women did not reduce patient perceived pain, but it did appear to increase preinsertion side effects.
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Immediate postplacental insertion of an intrauterine contraceptive device during cesarean section
Şevki Çelen, Ayhan Sucak, Yasemin Yıldız, Nuri Danışman
pages 240-243
Background: An intrauterine device (IUD) is an effective reversible form of contraception. We determined the efficacy and safety of immediate postplacental IUD insertion during cesarean section.
Conclusion: Immediate postplacental IUD insertion during cesarean section provides adequate protection against pregnancy. However, greater than one fourth of the participants discontinued IUD use due to spontaneous expulsion or other medical reasons.
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Postpartum insertion of levonorgestrel–intrauterine system at three time periods: a prospective randomized pilot study
Joshua D. Dahlke, Eric R. Terpstra, Abigail M. Ramseyer, Jeanne M. Busch
pages 244-248
Background: The study was conducted to determine the feasibility of levonorgestrel–intrauterine system (LNG-IUS) insertion at three different times postpartum.
Conclusions: Insertion of LNG-IUS ≤48 h postpartum is feasible in our institution and may be associated with similar utilization at 6 months, increased expulsion rates and decreased pain at insertion when compared to placement after 6 weeks.
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Unintended pregnancy among women in the US military
Laura Duberstein Lindberg
pages 249-251
Background: The study was conducted to examine the extent of unintended pregnancy among female active-duty military personnel in the US Armed Forces.
Conclusion: Further efforts are needed to reduce unintended pregnancy among women in the military.
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Adherence to dual-method contraceptive use
Jeffrey F. Peipert, Qiuhong Zhao, Laura Meints, Benjamin J. Peiper
pages 252-258
Background: Patient characteristics associated with adherence to dual-method contraceptive use are not known.
Conclusions: To effectively prevent sexually transmitted diseases and unplanned pregnancies, dual-method use must be consistent and sustained. Future interventions to promote dual-method use should focus on high-risk groups and additional dual-method combinations (e.g., barrier plus intrauterine devices or implants).
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Adolescents, contraception and confidentiality: a national survey of obstetrician–gynecologists
Ryan E. Lawrence, Kenneth A. Rasinski, John D. Yoon, Farr A. Curlin
pages 259-265
Background: Given recent legislative efforts to require parental notification for the provision of reproductive health care to minors, we sought to assess how obstetrician–gynecologists (Ob/Gyns) respond to requests for confidential contraceptive services.
Conclusions: Most obstetrician-gynecologists will provide adolescents with contraceptives without notifying their parents.
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Sexual, relationship, contraceptive and personal factors influencing emergency contraception use: a qualitative study
Amy Neustadt, Sabrina Holmquist, Shawna Davis, Melissa Gilliam
pages 266-272
Background: The FDA approval of mifepristone in 2000 broadened the available options for abortion. The aim of this study was to evaluate whether physicians in New Mexico have integrated the use of mifepristone into their practice.
Conclusions: The number of physicians offering any abortion or medical abortion in New Mexico has not changed since the FDA approval of mifepristone. Residency training programs in FM and in Ob-gyn should include training in medical abortion.
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Perceived racial, socioeconomic and gender discrimination and its impact on contraceptive choice
Karla Kossler, Lindsay M. Kuroki, Jenifer E. Allsworth, Gina M. Secura
pages 273-279
Background: The study was conducted to determine whether perceived racial, economic and gender discrimination has an impact on contraception use and choice of method.
Conclusions: Discrimination negatively impacts a woman's use of contraception. However, after financial and structural barriers to contraceptive use were eliminated, women with EOD overwhelmingly selected effective methods of contraception. Future interventions to improve access and utilization of contraception should focus on eliminating barriers and targeting interventions that encompass race-, gender- and economic-based discrimination.
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Changing depot medroxyprogesterone acetate access at a faith-based institution
Maryam Guiahi, Moira McNulty, Gretchen Garbe, Sarah Edwards
pages 280-284
Background: Loyola University Medical Center is a Jesuit faith-based hospital that previously offered immediate postpartum depot medroxyprogesterone acetate (DMPA) for noncontraceptive indications.
Conclusion: Limits on access to DMPA for noncontraceptive indications during the postpartum period resulted in significant increases in pregnancy rates for adolescents and young adult women at this faith-based institution.
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The effects of condom choice on self-reported condom use among men in Ghana, Kenya and South Africa: a randomized trial
Mark A. Weaver, Carol Joanis, Cathy Toroitich-Ruto, Warren Parker
pages 291-298
Background: Male condoms are readily available and affordable in many settings, but risky sexual acts still go unprotected.
Conclusion: Providing one type of male condom in public sector programs appears justified. Programs should not focus on the number of brands available, but should encourage effective promotion and consistent and correct use of available brands.
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Mechanism of action of the Adiana device: a histologic perspective
Thierry G. Vancaillie, Douglas C. Harrington, James M. Anderson
pages 299-301
Background: The study was conducted to confirm the mechanism of action of the Adiana permanent contraception device by means of histologic analysis of long-term specimens.
Conclusion: Histologic analysis of long-term specimens supports the mechanism of action of the Adiana permanent contraception device.
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Letters to the Editor

Pain and abortion
Kazim Emre Karasahin, Ugur Keskin
pages 337
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Comments to Assistant Professors Kazim Emre Karasahin and Ugur Keskin
Timo Kauppila, Satu Suhonen, Marja Tikka, Seppo Kivinen
pages 337-338
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