Contraception Highlights February 2010

This month’s featured editorial

Reducing Maternal Mortality: A Global Imperative
Francine Coeytaux, Debra Bingham, Ana Langer
pages 95-98
A woman dies every 90 seconds from complications during pregnancy or childbirth — 86% of them in sub-Saharan Africa or South Asia. According to experts, an estimated one in 26 women in sub-Saharan Africa is at risk of dying during childbirth over her lifetime, compared with one in 7300 in developed regions. Girls are dying as well, since many are forced into marriages and pregnancies when they are as young as 11 years old. Maternal deaths are all the more tragic because they are nearly all preventable. read more >

Controversies in Reproductive Health

IUD use in HIV-positive women
Sheila M. Quinn, Courtney M. Schreiber
pages 99-101
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This Month’s Commentary

In-office retrieval of intrauterine contraceptive devices with missing strings
Sujatha Prabhakaran, Alice Chuang
pages 102-106
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Review Articles

Vaginal ring contraception
Jennifer Kerns, Philip Darney
pages 107-115
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Pain control in first-trimester and second-trimester medical termination of pregnancy: a systematic review
Emily Jackson, Nathalie Kapp
pages 116-126
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Original Research

Use of contraception among US women with frequent mental distress
Sherry L. Farr, Kathryn M. Curtis, Cheryl L. Robbins, Lauren B. Zapata, Patricia M. Dietz
pages 127-133
Background: This study examines whether a woman’s mental health is associated with use of contraception.
Conclusions: Contraceptive providers should consider mental health when providing counseling about contraception.
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Hormonal contraception use and pregnancy in adolescents with sickle cell disease: analysis of Michigan Medicaid claims
Sarah H. O’Brien, Jennifer Klima, Suzanne Reed, Deena Chisolm, Eleanor B. Schwarz, Kelly J. Kelleher
pages 134-137
Background: Access to effective family planning is of great importance for women with sickle cell disease (SCD) due to the increased frequency of pregnancy complications. However, little is known regarding use of hormonal contraception, complications of contraception, and pregnancy in young women with SCD.
Conclusions: In a publicly insured population of young women with SCD, pregnancy was more commonly identified than hormonal contraception use. Our work suggests that significant gaps may exist in family planning care for young women with SCD.
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Longitudinal influences of friends and parents upon unprotected vaginal intercourse in adolescents
Catherine Kim, Acham Gebremariam, Theodore J. Iwashyna, Vanessa K. Dalton, Joyce M. Lee
pages 138-144
Background: Both friends and parents may influence occurrence of adolescent sexual intercourse, but these influences have not been studied together and prospectively.
Conclusion: Having a friend who engages in sexual intercourse, unprotected or protected, increases the risk of unprotected intercourse. Parental attitudes are less influential after consideration of adolescent baseline attitudes and sexual practices, suggesting that parental influences are strongest before 15 years of age. Our results suggest that early intervention among both parents and adolescents may decrease the risk of unprotected intercourse.
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Survey of knowledge, attitudes and practices surrounding the intrauterine device in South Africa
Sarah A. Gutin, Regina Mlobeli, Margaret Moss, Geoffrey Buga, Chelsea Morroni
pages 145-150
Background: The Copper T intrauterine device (IUD) is a safe, effective, reversible contraceptive that is used widely worldwide but little in South Africa. This study assesses the knowledge, attitudes and practices of potential IUD users and health care providers to inform strategies for expanding IUD use in South Africa.
Conclusion: If IUD use is to be expanded in South Africa, potential users will need education about the method and providers will need training on counseling and provision.
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Pharmacy access to the emergency contraceptive pill: a national survey of a random sample of Australian women
Melissa K. Hobbs, Angela J. Taft, Lisa H. Amir, Kay Stewart, Julia M. Shelley, Anthony M. Smith, Colin B. Chapman, Safeera Y. Hussainy
pages 151-158
Background: The emergency contraceptive pill (ECP) has the potential to assist in reducing unintended pregnancy and abortion rates. Since its rescheduling to pharmacy availability without prescription in Australia in January 2004, there is little information about Australian women’s knowledge, attitudes and use of the ECP. The aim of this study was to measure the knowledge about the ECP and sociodemographic patterns of and barriers to use of the ECP.
Conclusion: Women in Australia have a high level of awareness of the ECP, but more information and education about how to use it and where to obtain it are still needed.
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Provision of the emergency contraceptive pill without prescription: attitudes and practices of pharmacists in Australia
Safeera Y. Hussainy, Kay Stewart, Colin B. Chapman, Angela J. Taft, Lisa H. Amir, Melissa K. Hobbs, Julia M. Shelley, Anthony M. Smith
pages 159-166
Background: As 5 years have elapsed since the emergency contraceptive pill (ECP) was made available without prescription in Australia, information was sought about the current attitudes and practices of pharmacists in relation to their increased role in ECP provision.
Conclusion: New information about Australian pharmacists’ current attitudes and practices towards ECP dispensing was identified. Pharmacists had stronger, more conservative attitudes than overseas pharmacists; however, the issues that emerged were similar to those reported overseas. To address these, revised training for local pharmacists is recommended.
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Potent spermicidal effect of oleanolic acid 3-beta-d-glucuronide, an active principle isolated from the plant Sesbania sesban Merrill
Nilanjana Das, Poornima Chandran, Smritinath Chakraborty
pages 167-175
Background: The spermicidal activity of oleanolic acid 3-β-d-glucuronide (OAG), an active principle isolated from root extracts of Sesbania sesban, was evaluated.
Conclusions: OAG has significant spermicidal activity that may be explored further.
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Emergency contraception in Australian community pharmacies: a simulated patient study
Katrina Queddeng, Betty Chaar, Kylie Williams
pages 176-182
Background: Australia joined the worldwide movement to increase the availability of the emergency contraceptive pill (ECP) by rescheduling from Prescription to Pharmacist Only status in 2004. However a protocol developed to aid in the provision of the ECP placed extensive requirements on the pharmacist. This study investigated the provision of the ECP by community pharmacists in Sydney, Australia.
Conclusions: This study highlighted a need to standardize procedures in regard to the ECP service to present a more consistent level of service to the public. Suggestions to improve the service include complete revision and simplification of the current protocol and improved training. Additionally, mandatory provision of private consultation areas and continuing professional education may facilitate and enhance quality counselling.
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Book Review

Management of unintended and abnormal pregnancy: comprehensive abortion care
06 October 2010
Jeffrey T. Jensen
page 183
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Letters to the Editor

Commentary: Lyus R, Lohr P, Prager S. Use of Mirena LNG-IUS and Paragard CuT380A intrauterine devices for nulliparous women
Dirk Wildemeersch
pages 184-186
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Reply: Use of Mirena LNG-IUS and Paragard CuT380A intrauterine devices for nulliparous women
Sarah W. Prager, Richard Lyus, Patricia A. Lohr
pages 186-187
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Emergency contraception: an unresolved issue
Crisitina Lopez-del Burgo, Rafael T. Mikolajczyk, Joseph B. Stanford
page 187
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Response to the Letter to the Editor
Gabriela Noé, Horacio B. Croxatto, Ana María Salvatierra, Verónica Reyes, Claudio Villarroel, Carla Muñoz, Gabriela Morales, Anita Retamales
pages 187-188
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