Unintended Pregnancy

Per capita alcohol consumption in Nigeria is high when compared with other countries in Africa. Alcohol induces social behaviors which include home violence, sexual harassment, unwanted pregnancy, and infidelity among couples. On the good side of it, couples who find themselves in alcohol consumption chose modern contraceptives use to prevent unwanted pregnancy. The objective of the paper is to examine the effect of alcohol consumption on modern contraceptive use in Nigeria. A probit
regression model using data from the 2018 Nigerian Demographic and Health Survey was employed. The paper found that alcohol intake among couples has a significant effect on their decision to use modern ontraceptives. The result also signified that educational level significantly affects the use of modern contraceptives. Other significant factors affecting modern contraceptive use were the partner's occupation, the
number of living children per couple, and the wealth index. The paper recommended that counseling should be made at social gatherings for those who take alcohol to use contraceptives.

How stable are women's pregnancy intentions across their reproductive lifespans? Are there demographic, social, or attitudinal characteristics that are associated with differing pregnancy intentions patterns? Patterns of intendedness across pregnancies were examined using a sample of 3,110 women ages 25-45 who have been pregnant at least twice from the National Survey of Fertility Barriers. Multinomial logistic regression analyses assessed associations between patterns of intentions and respondents' economic/social status, values and ideologies to determine if intentions are a stable characteristic or pregnancy-specific. The majority of women (60%) reported varying intendedness across individual pregnancies, indicating that intendedness tends to be pregnancy-specific. Sociodemographic status as well as values and ideologies were significantly associated with pregnancy intendedness patterns. Compared to women who intended each pregnancy, women who were ambivalent, did not intend each pregnancy, or had intermittent intendedness were more likely to be single, younger, Black, report lower importance of motherhood and religiosity and were less likely to be Hispanic. A substantial proportion of women report the intendedness of their pregnancies varied between pregnancies. Research and policy addressing unintended pregnancies should consider that pregnancy intentions are not a static characteristic of most women.

Background Reproductive coercion (RC), which includes contraceptive sabotage and pregnancy coercion, may help explain known associations between intimate partner violence (IPV) and poor reproductive health outcomes, such as unintended pregnancy. In Kenya, where 40% of ever-married women report IPV and 35% of ever-pregnant women report unintended pregnancy, these experiences are pervasive and co-occurring, yet little research exists on RC experiences among women and adolescent girls. This study seeks to qualitatively describe women’s and girls’ experiences of RC in Nairobi, Kenya and opportunities for clinical intervention. Methods Qualitative data were collected as part of the formative research for the adaptation of an evidence-based intervention to address reproductive coercion and IPV in clinical family planning counselling and provision in Nairobi, Kenya in April 2017. Focus group discussions (n = 4, 30 total participants) and in-depth interviews (n = 10) with family planning cl...

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BackgroundReproductive coercion (RC) and intimate partner violence (IPV) are prevalent forms of gender-based violence (GBV) associated with reduced female control over contraceptive use and subsequent unintended pregnancy. Although the World Health Organization has recommended the identification and support of GBV survivors within health services, few clinic-based models have been shown to reduce IPV or RC, particularly in low or middle-income countries (LMICs). To date, clinic-based GBV interventions have not been shown to reduce RC or unintended pregnancy in LMIC settings.InterventionARCHES (Addressing Reproductive Coercion in Health Settings) is a single-session, clinic-based model delivered within routine contraceptive counseling that has been demonstrated to reduce RC in the United States. ARCHES was adapted to the Kenyan context via a participatory process to reduce GBV and unintended pregnancy among women and girls seeking contraceptive services in this setting. Core elements...

This study based on BDHS-2007 data of 10,996 ever married women presents the current scenario of female age at marriage in Bangladesh and its noteworthy impact on fertility as epoch at first marriage has a chief upshot on childbearing as women who get married before time contain, on an average, a longer era of disclosure to the risk of fetching pregnant and a superior figure of lifetimes birth. Logistic regression model was conceded to this cram with the effects of the allied explanatory variables tested by chi-square test on early matrimony. Respondents’ work status, education level, religion, wealth index and partners’ educational level drastically guessed the early marriage. Women from the rural area be located to acquire married 1.50 period more anticipated than the women from inner-city.

Progress has been made to improve access to family planning services and contraceptive methods, yet many women still struggle to access contraception, increasing their risk for unintended pregnancy. This is also true for South Africa, where over fifty per cent of pregnancies are reported as unintended, even though contraception is freely available. There is also stagnation in the fertility rate indicators and contraceptive use data, indicating that there may be challenges to accessing contraception. This paper explores the evaluation of access to contraception from community and health care provider perspectives. This qualitative study explored factors affecting the uptake and use of contraception through focus group discussions (n = 14), in-depth interviews (n = 8), and drawings. Participants included male and female community members (n = 103) between 15 and 49 years of age, health care providers (n = 16), and key stakeholder informants (n = 8), with a total number of 127 particip...

Objectives: Women with substance use disorders have high unmet needs for HIV prevention and drug treatment and face challenges accessing care for other unique health issues, including their sexual and reproductive health. Methods: We did a cross-sectional evaluation of sexual and reproductive health behaviors and outcomes among women with substance use disorders, who were enrolled in one of two concurrent clinical trials of pre-exposure prophylaxis for HIV prevention. Descriptive analyses and bivariate logistic regression were used to assess factors driving contraceptive use, and other essential sexual and reproductive health services utilization and outcomes. Results: Among 226 women, 173 (76.5%) were of reproductive age. Most women had histories of unintended pregnancy (79.2%) or miscarriage (45.1%) and high HIV risk behaviors (53.5%). Most (61%) participants did not use any form of contraception at the time of assessment, although few (15%) reported pregnancy intentions. In bivar...

The impact of underuse of modern methods of contraception among adolescents with unintended pregnancies in 12 low-and middle-income countries Background In spite of the last decade increase in availability of contraception, around half of the annual 21 million pregnancies notified in low-and middle-income countries in individuals aged 15-19 years are unintended. We sought to explore the contribution of the underuse of modern methods of contraception (MMC) to the annual incidence of unintended pregnancies among adolescent women. We used Demographic and Health Survey (DHS) data from 12 low-and middle-income countries. The pooled analysis exploring the risk of unintended pregnancy included 7268 adolescent women with a current unintended pregnancy and 121 894 currently not pregnant 15-to 19-year-old sexually active women who did not desire pregnancy. For each country and the pooled analysis, the odds ratio of unintended pregnancy was calculated in relation to the type of contraception (MMC, Traditional Methods, and No Contraception). Expected unintended pregnancies and population attributable fraction (PAF) of unintended pregnancies attributable to not using MMC were calculated for each country. The use of traditional methods was associated with a 3.4 (95% confidence interval (CI) = 2.1-4.7) time increased odds of having an undesired pregnancy compared with the use of MMC of contraception while not using any method of contraception was associated with a 4.6 (95% CI = 2.6-6.6) times increased odds. The population attributable fraction (PAF) of not using MMC accounted for 86.8% of the estimated unintended pregnancies (9 464 654 in total in the 12 countries) in the pooled analysis. PAF ranged from 65.8% (1 022 154) for Bangladesh to 95.1% (540 176) for Niger and the estimated number of unintended pregnancies because of the use of traditional methods or non-use of contraception ranged from 18 638 in Namibia to 4 303 872 in India. Conclusions Eight million out of 9.5 million unintended pregnancies occurring annually in twelve countries could have been prevented with the optimal use of MMC of contraception. MMC need to be further supported in order to further prevent unintended pregnancies globally.

Introduction: Long-acting reversible contraceptives (LARC, Intrauterine contraceptives devices and Implants) stand on 1st regards to safety and effectiveness. It is an easily accessible variety for spacing birth as well as preventing unintended pregnancy soon after childbirth in Nepal due to free supply by the Government under safe motherhood program of Reproductive health policy. Despite free supply, LARC is not routinely implemented in practice among immediate post-partum lady as single approach contraceptives concern to unintended pregnancy due to unmet need. To find out the choice of LARC by antenatal and immediate postpartum women after delivery. Methods: A descriptive cross-sectional study was conducted among 200 women in antenatal clinic and obstetric ward of College of Medical Science and Teaching Hospital using non probability convince sampling technique. Ethical approval was taken form Institutional Review Committee of College of Medical Sciences and Teaching Hospital and ...

ObjectiveThis study examines how women's chances of having an unintended birth is related to gender inequalities in education, employment, intra‐household decision‐making, and norms at individual, household, and community levels in sub‐Saharan Africa (SSA).BackgroundWomen in SSA have the highest rates of unintended births in the world, often with severe implications for the health and well‐being of families. A comprehensive understanding of how gender dynamics are associated with their chances of unintended birth is however lacking.MethodMultilevel binomial logistic regression models of unintended birth were estimated with harmonized data from 123 Demographic and Health Surveys including 534,533 married women living in 43,136 communities within 39 SSA countries over the period 1992–2019.ResultsThe odds of unintended birth are higher among higher‐educated women, women with a small age difference with their husband, and women living in communities with more higher‐educated women, ...

Teenage pregnancy rates in the USA have declined for over 20 years, primarily due to increased access to highly effective contraceptive methods. Despite these encouraging trends, US teen pregnancy rates still remain higher than most other developed nations. There are significant medical, psychological, and financial implications and morbidities associated with unintended teen pregnancy and thus primary prevention strategies to decrease rates of teen pregnancy should be a focus for clinicians. New data shows significant benefit of long-acting reversible contraception (LARC)-intrauterine devices or subdermal implants-over shorter acting methods such as the birth control pill. Despite these data, along with policies from the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics supporting provision of LARC to adolescents, there is a lag among clinicians to communicate this information to their adolescent patients as standard of care. Many providers continue to utilize only short-acting methods such as the pill. Until clinicians more comprehensively adopt use of LARC methods as firstline agents for teenagers, rates of unintended pregnancy within this age group will likely remain high. Working to recognize and decrease barriers to contraceptive access should be a public health priority.

We would like to express our gratitude to the faculty and leadership of St. Paul's Hospital Millennium Medical College in Addis Ababa and the University of Michigan. Our sincere thanks goes to all the trainees, medical students, interns, and residents who participated in this innovative program and willingly provided their feedback through surveys and interviews, which provided the basis for the content of this report. We are grateful for the Ministry of Health of the Federal Democratic Republic of Ethiopia for its commitment to family planning and comprehensive abortion care and for creating a conducive environment for the pre-service integration program to be successfully implemented at St. Paul's. This case study was made possible through the generous financial support of an anonymous donor through the Center for International Reproductive Health Training (CIRHT) at the University of Michigan. The authors gratefully acknowledge the editorial support of Michigan Publishing. vii

Background Short inter-pregnancy interval is an interval of <24 months between the dates of birth of the preceding child and the conception date of the current pregnancy. Despite its direct effects on the perinatal and maternal outcomes, there is a paucity of evidence on its prevalence and determinant factors, particularly in Ethiopia. Therefore, this study assessed the prevalence and associated factors of short inter-pregnancy interval among pregnant women in Debre Berhan town, Northern Ethiopia. Methods A community based cross-sectional study was conducted among a randomly selected 496 pregnant women in Debre Berhan town from February 9 to March 9, 2020. The data were collected by using an interviewer-administered questionnaire and analyzed using STATA (14.2) statistical software. To identify the predictors of short inter-pregnancy interval, multivariable binary logistic regression was fitted and findings are presented using adjusted odds ratio (AOR) with 95% confidence interva...

Background This cross-sectional was aimed to assess the prevalence of pre-pregnancy care services usage and its determinant factors among women of reproductive age in Kedah, Malaysia. Methods Overall, 1347 respondents who attended 24 government health clinics, were chosen using systematic multistage random sampling. A validated self-administered questionnaire which consisted of sections including socio-demographic characteristics, social support, knowledge on pre-pregnancy care, perception on risk of pregnancy, health status, as well as intention and awareness on pre-pregnancy care services were distributed. Results The prevalence of utilization of pre-pregnancy care services was still low i.e. 44.0%. Bivariate and multivariate analysis showed consistent significant level between all factors and pre-pregnancy care usage except for family planning practice. The factors that showed significant difference with the usage of pre-pregnancy care services were age of more than 35 (P<0.00...

Background The burden of early sexual engagement among young people is enormous. It raises the risk of sexually transmitted infections(STIs), such as HIV/AIDS, unintended pregnancy, unsafe abortion, premature childbirth, and psychosocial issues. The aim of this paper was to estimate the timing of sexual debut and examine the factors influencing the timing of first sexual intercourse following menarche among female youth aged between 15 and 24 in Uganda. Method Self-reported data were extracted from the 2016 Uganda Demographic and Health Survey (UDHS), with a sub-sample of 7964 female youth from the individual woman file. Kaplan-Meier survival curves, decrement life-table analysis, and the discrete-time logit model were used to examine the timing of sexual debut and associated factors. Results About 67% of the female youth had experienced first sexual initiation. Overall, the meantime to sexual debut was 4.4 years and the median time was 4.3 years, and all the female youth had experi...

Background: Unmet need includes a percentage of women who are not currently using any form of family planning methods and want to stop or delay their childbirth. Married women have an unmet need for spacing or limiting birth in developing countries is over 100 million. In Nepal, still, 24% of married women have an unmet need for family planning services. The reason for the gap is little understood at the Lumbini province level and among Terai janajaties of the Bardiya district. Therefore, this study was designed to assess factors associated with the unmet need of family planning and its prevalence among married Tharu women in the Bardiya district of Nepal. Methods: A community-based cross-sectional study was conducted in Bardiya district among 341 married Tharu women of age group 15-49 years. Out of eight local bodies of Bardiya district; Badhaiyatal rural municipality, Barabardiya municipality, Thakurbaba municipality and Geruwa rural municipality were selected and the household survey was done randomly for data collection. Westoff model was used for estimation of the prevalence of unmet needs for family planning. The relationship between unmet needs and other variables was assessed through bivariate and multivariate analysis using SPSS version 22. Results: In the study area, the unmet need for family planning was 27%. The Number of living children (AOR=1.966, 95% CI=1.046-3.695), the number of living sons (AOR=2.877, 95% CI=1.114-7.430) wealth quintile (AOR=3.805, 95%CI=1.873-7.703) and spousal communication (=4.287, 95% CI=1.952-9.413) were found significantly associated with unmet need for family planning. Conclusion: Although the knowledge of FP methods among study participants was excellent (94.7%), more than half of them felt fear of side effects (51.6%). So, to mitigate the fear of family planning's negative impacts among Tharu women, competent family planning counseling should be provided in an easily understood language, such as Tharu or Nepali.

Background In low-income countries, women with disabilities have limited access to essential sexual and reproductive health services and are disadvantaged socioeconomically. Even though some studies have been conducted previously, there are scanty findings on contraceptive use and associated factors among women with disabilities. Thus, this systematic review aimed to assess contraceptive use and associated factors among women with disabilities of reproductive age in Ethiopia. Methods The Preferred Reporting Item for Systematic Review and Meta-Analyses [PRISMA] guidance is used to conduct this systematic review. Data were searched from electronic databases: PubMed/Medline, Scopus, Google Scholar, and other relevant sources. Studies screening was done using Rayyan software. The findings were narratively synthesized using a socio-ecological framework for health promotion. Result Ten cross-sectional studies and 4436 women with disabilities of reproductive age were included in this review. According to this review, women with disabilities are less likely to use contraceptives, with a prevalence of 21.7% in Gondor City and 44.4% in Addis Ababa. The associated factors were identified and themed at individual, interpersonal, community, and institutional levels. Conclusion Overall, the review findings revealed that women with disabilities continue to encounter challenges ranging from individual level to disability-unfriendly health facility infrastructure or institutional level. Therefore, health professionals and other relevant stakeholders should draw attention to creating awareness towards contraceptive use at individual and interpersonal levels, ensuring accessible contraceptive services and disability-friendly health facilities.

This study sheds light on the need for disability-inclusive and sensitive healthcare services. Therefore, to achieve universal access to sexual and reproductive healthcare targeted under the Sustainable Development Goals, the Minister of Women and Social Affairs, Ministry of Health, Regional Health Bureau, and health facilities authorities should pay attention to improving awareness on pregnancy intention and domestic violence and ensuring accessible, inclusive, and equitable maternal health care for women with disabilities.

Introduction Accessing quality and equitable contraceptive services is significant for reaching the recently announced Sustainable Development Goals. In Ethiopia, women with disabilities continue to confront several barriers to accessing adequate contraceptive services. Nevertheless, little is known about contraceptive uptake and associated factors among pregnant women with disabilities in Ethiopia. This study aimed to assess the contraceptive uptake and associated factors among pregnant women with disabilities in the Central Ethiopia Regional State, Ethiopia. Methods A community-based cross-sectional study was conducted, with 562 study participants recruited using a multistage random sampling procedure. Data were collected through face-to-face interviews using the Kobo Toolbox. A bivariate and multivariable logistic regression model was used to identify variables associated with contraceptive uptake. At p < 0.05, the association of variables was found to be statistically significant. Result In this study, only 38.1% (95% CI: 33.5, 42.3) of study participants used contraceptives. The significantly associated factors were: women's age (≥ 35 years, AOR = 0.17, 95% CI: 0.07, 0.46, p < 0.0001), marital status (AOR = 0.21, 95% CI: 0.12, 0.64, p < 0.0001), women education (tertiary and above, AOR = 8.44, 95% CI: 4.2, 13.2, p < 0.0001), number of pregnancies (AOR = 0.28, 95% CI: 0.17, 0.45, p < 0.0001), lack of contraceptives awareness (AOR = 0.12. 95% CI: 0.06, 0.24 p < 0.0001), contraceptive service accessibility (AOR = 6.02, 95% CI: 3.8, 9.54, p < 0.0001), and spousal support to use contraceptives (AOR = 4.52, 95% CI: 2.85, 7.2, p < 0.0001). Conclusion This finding concludes that there is a significant unmet need for contraceptive services among pregnant women with disabilities in the Central Ethiopia Regional State, Ethiopia. To enhance contraceptive uptake, it is suggested to engage husbands in health promotion initiatives, implement community-based awareness campaigns, train healthcare providers on the unique needs of women with disabilities and design disability-friendly health facilities.

ObjectiveTo compare the prevalence of contraception in breast cancer (BC) patients at risk of unintentional pregnancy (i.e. not currently pregnant or trying to get pregnant) and matched controls.DesignThe FEERIC study (Fertility, Pregnancy, Contraception after BC in France) is a prospective, multicenter case-control study. Data were collected through online questionnaires completed on the Seintinelles* research platform.SettingNot applicablePatient(s)BC patients aged 18-43 years, matched for age and parity to cancer-free volunteer controls in a 1:2 ratio.Intervention(s)NoneResultsIn a population of 1278 women at risk of unintentional pregnancy, the prevalence of contraception at study inclusion did not differ significantly between cases (340/431, 78.9%) and controls (666/847, 78.6%, p=0.97). However, the contraceptive methods used were significantly different, with a higher proportion of copper IUD use in BC survivors (59.5% versus 25.0% in controls p&lt;0.001). For patients at risk...

Background: In Senegal, unintended pregnancy has become a growing concern in public health circles. It has often been described through the press as a sensational subject with emphasis on the multiple infanticide cases as a main consequence, especially among young unmarried girls. Less scientific evidence is known on this topic, as fertility issues are rarely discussed within couples. In a context where urbanization is strong, economic insecurity is persistent and the population is globalizing, it is important to assess the magnitude of unintended pregnancy among urban women and to identify its main determinants. Methods: Data were collected in 2011 from a representative sample of 9614 women aged 15-49 years in six urban sites in Senegal. For this analysis, we include 5769 women who have ever been pregnant or were pregnant at the time of the survey. These women were asked if their last pregnancy in the last two years was 'wanted 'then' , 'wanted later' or 'not wanted'. Pregnancy was considered as unintended if the woman responded 'wanted later' or 'not wanted'. Descriptive analyses were performed to measure the magnitude of unintended pregnancies, while multinomial logistic regression models were used to identify factors associated with the occurrence of unintended pregnancy. The analyses were performed using Stata version 12. All results were weighted. Results: The results show that 14.3% of ever pregnant women reported having a recent unintended pregnancy. The study demonstrates important distinctions between women whose last pregnancy was intended and those whose last pregnancy was unintended. Indeed, this last group is more likely to be poor, from a young age (< 25 years) and multiparous. In addition, it appears that low participation of married women in decision-making within the couple (management of financial resources) and the lack of discussion on family planning issues are associated with greater experience of unintended pregnancy. This study suggests a need to implement more targeted programs that guarantee access to family planning for all women in need. In urban areas that are characterized by economic insecurity, as in Senegal, it is important to consider strategies for promoting communication within couples on fertility issues.

Background Female sex workers in sub-Saharan Africa face high unmet need for family planning and higher risk for unintended pregnancy. Community empowerment HIV prevention approaches have the potential to increase family planning uptake and present an opportunity to integrate HIV, reproductive health, and contraception. This article describes family planning use and pregnancy among female sex workers in Iringa, Tanzania and evaluates whether engagement in a community empowerment HIV prevention program is associated with contraceptive use. Methods This study consists of secondary analysis from a two-community randomized controlled trial following a longitudinal cohort over 18 months. We implemented a year-long community empowerment intervention consisting of 1) a community-led drop-in-center; 2) venue-based peer education, condom distribution, and HIV testing; 3) peer service navigation; 4) sensitivity trainings for providers and police; and 5) text messages to promote engagement. Ad...

In 2012 there were around 85 million unintended pregnancies globally. Unintended pregnancies unnecessarily expose women to the risks associated with pregnancy, unsafe abortion and childbirth, thereby contributing to maternal mortality and morbidity. Studies have identified a range of potential determinants of unplanned pregnancy but have used varying methodologies, measures of pregnancy intention and analysis techniques. Consequently there are many contradictions in their findings. Identifying women at risk of unplanned pregnancy is important as this information can be used to help with designing and targeting interventions and developing preventative policies. 4,244 pregnant women from Mchinji District, Malawi were interviewed at home between March and December 2013. They were asked about their pregnancy intention using the validated Chichewa version of the London Measure of Unplanned Pregnancy, as well as their socio-demographics and obstetric and psychiatric history. A conceptual hierarchical model of the determinants of pregnancy intention was developed and used to inform the analysis. Multiple random effects linear regression was used to explore the ways in which factors determine pregnancy intention leading to the identification of women at risk of unplanned pregnancies. 44.4% of pregnancies were planned. On univariate analyses pregnancy intention was associated with mother and father's age and education, marital status, number of live children, birth interval, socio-economic status, intimate partner violence and previous depression all at p<0.001. Multiple linear regression analysis found that increasing socio-PLOS ONE |

Objectives Retrospective, cross-sectional estimates of pregnancy intention, as used in the Demographic Health Survey (DHS), are the global norm. The London Measure of Unplanned Pregnancy (LMUP) is a newer, psychometrically validated measure which may be more reliable. This paper assesses the reliability of the LMUP and the DHS question over the first postnatal year and explores the effects of maternal characteristics or pregnancy outcome on reported pregnancy intention. Methods We compared the test-retest reliability of the LMUP (using the AC coefficient) and DHS question (using the weighted Kappa) over the first postnatal year using data from Malawian women. We investigated the effect of maternal characteristics and pregnancy outcome using t-tests, Chi squared or Fisher's exact tests, and calculated odds ratios to estimate effect size. The DHS question was associated with a statistically significant decrease in the prevalence of unplanned pregnancies from 1-to-12 months postnatally; the LMUP was not. The LMUP had moderate to substantial reliability (0.51-0.66); the DHS had moderate reliability (0.56-0.58). The LMUP's stability was not related to any of the factors examined; the stability of the DHS varied by marital status (p = 0.033), number of children (p = 0.048) and postnatal depression (p < 0.001). Both underestimated unintended pregnancy postnatally vis-à-vis the LMUP in pregnancy. The LMUP is a more reliable measure of pregnancy intention than the DHS in the first postnatal year and does not vary by maternal characteristics or pregnancy outcome. The LMUP should become the gold-standard for measuring pregnancy intention and should be collected in pregnancy or at the first postnatal opportunity.

Background: The London Measure of Unplanned Pregnancy (LMUP) is a new and psychometrically valid measure of pregnancy intention that was developed in the United Kingdom. An improved understanding of pregnancy intention in low-income countries, where unintended pregnancies are common and maternal and neonatal deaths are high, is necessary to inform policies to address the unmet need for family planning. To this end this research aimed to validate the LMUP for use in the Chichewa language in Malawi. Methods: Three Chichewa speakers translated the LMUP and one translation was agreed which was back-translated and pre-tested on five pregnant women using cognitive interviews. The measure was field tested with pregnant women who were recruited at antenatal clinics and data were analysed using classical test theory and hypothesis testing. Results: 125 women aged 15-43 (median 23), with parities of 1-8 (median 2) completed the Chichewa LMUP. There were no missing data. The full range of LMUP scores was captured. In terms of reliability, the scale was internally consistent (Cronbach's alpha = 0.78) and test-retest data from 70 women showed good stability (weighted Kappa 0.80). In terms of validity, hypothesis testing confirmed that unmarried women (p = 0.003), women who had four or more children alive (p = 0.0051) and women who were below 20 or over 29 (p = 0.0115) were all more likely to have unintended pregnancies. Principal component analysis showed that five of the six items loaded onto one factor, with a further item borderline. A sensitivity analysis to assess the effect of the removal of the weakest item of the scale showed slightly improved performance but as the LMUP was not significantly adversely affected by its inclusion we recommend retaining the six-item score. The Chichewa LMUP is a valid and reliable measure of pregnancy intention in Malawi and can now be used in research and/or surveillance. This is the first validation of this tool in a low-income country, helping to demonstrate that the concept of pregnancy planning is applicable in such a setting. Use of the Chichewa LMUP can enhance our understanding of pregnancy intention in Malawi, giving insight into the family planning services that are required to better meet women's needs and save lives.

Onset time varies between males and females as well as the same sex of same age group. In girls, the marker of puberty is menarche meaning the first menstruation but there is no such clear marker in boys. The mean age at menarche is 12-13 years in developed world, this is likely to be similar could be higher in developing countries. The male counterpart however shows signs of sexual maturation which becomes evident between 13-14 years of age. The start of puberty can vary by a mean age of four to five years between both girls and boys, according to United Nation. Hence this study aims to determine the prevalence of use of emergency birth control pills amongst adolescent following unprotected early sex among senior secondary school students in kano metropolis. 392 adolescent senior secondary school female students in kano metropolis were recruited for this study. Data were prospectively collected on a questionnaire. Continuous data such as age were expressed as mean, standard deviation, median and mode. Frequencies, percentages and ratios were used to summarize qualitative data such as sex, marital status and religion. Segment for knowledge, attitude and perception were also filled as appropriate. Analysis were done using Statistical Package for Social Sciences (SPSS) for Windows Version 20 (IBM Corp. Released 2011. IBM SPSS. The findings reveal that a substantial proportion of adolescents (53.5%) reported using emergency birth control pills after engaging in sexual activity. This prevalence aligns with the documented trend of adolescents relying on emergency contraception when other forms of contraception fail or are not used consistently.

Objective. Although importance of postpartum family planning is essential and immediate postpartum insertion of long acting and reversible contraceptives (LARC) is recommended, evidence on its uptake and associated factors is limited in Ethiopia. This study was conducted to assess utilization of immediate postpartum LARC among women who gave birth in selected public health facilities in eastern Ethiopia. Method. An institution-based cross-sectional study was conducted among randomly selected women who gave birth in selected public health facilities in eastern Ethiopia from 10 March to 09 April 2020. At discharge, all eligible women who gave birth in the facilities were interviewed using a pretested structured questionnaire. Data were entered using EpiData 3.1 and analyzed using SPSS 24. Bivariable and multivariable logistic regression analyses were conducted to identify factors associated with utilization of immediate postpartum LARC. Adjusted odds ratio (aOR) with 95% confidence in...

Introduction: South African women bear an intersecting burden of HIV, sexually transmitted infections (STIs) and unintended pregnancy. Multipurpose prevention technologies (MPTs) are a class of products that address multiple needs and have the potential to improve uptake and use of prevention products. Methods: Analysing survey data from 703 HIV-negative women 18-40 years in three provinces in South Africa, collected between July and November 2022, this study explores their preferences for prevention methods and factors influencing choice of hypothetical prevention methods, including MPTs. Descriptive statistics and multinomial regression analyses were conducted to determine prevention method preferences and factors associated with choosing a pill, injectable or MPT-implant type prevention method. Results: Most women wanted to prevent HIV, STIs and pregnancy. The most important factors when choosing a prevention product were whether it provided dual and long-term protection and if side effects were manageable. If choosing only one method, half of women would choose any MPT-implant and a quarter each would choose a pill or an injectable method, with method choices differing by population group. Discussion: Prevention method choices were influenced by sexual-behavioural factors and current and prior contraceptive method use. Providing a choice of prevention methods and a population specific approach to new method development and introduction with access to accurate information could enhance their ability to fill a gap in prevention needs.

Background: About 24% of married woman have unmet need for Family Planning in Sub-Saharan Africa and 25.3% of currently married women had unmet need for family planning in Ethiopia. To assess the level of unmet need for family planning and related factors among currently married 15-49 years old women in Sibu Sire District, November 2016. A cross-sectional study was conducted. Multi-stage sampling technique to select 616 study units was used. Qualitative data was collected by focus group discussion and in-depth interview. Quantitative data was entered into SPSS version 20 and transcripts of the recorded discussions have been coded and analyzed manually. A p-value<0.05 was considered as statistically significant. Result: Total unmet need for family planning among study group was 20.94%, and (13.14%, 7.8% for spacing and limiting respectively). Educational status of respondent (AOR=2.6, 95% CI: 1.3, 5.1), visiting health facility (AOR=3.6, 95% CI:1.9, 6.8), visited by health care workers at their home (AOR=3.7, 95% CI: 2.1, 7.3), attitude of respondents towards Family Planning use (AOR=9.1 95% CI: 4.9, 16.5), discussion with partners about Family planning (AOR=2.9, 95% CI: 4.1, 5.7), number of living children (AOR=5.5, 95% CI: 1.2, 25.1) and exposure to medias (radio/television) (AOR=4.7 95% CI: 2.8, 8.5) were predictors of unmet need for Family Planning. The total unmet need for family planning is still high. Integrating family planning with other health care service in health facility and emphasizing on delivery of important messages through public media were recommended activities to overpass the gap demand and unmet need for family planning.

Dedicated to saving lives, icddr,b is an international public health research organisation located in Bangladesh. Through the generation of knowledge and translation of research into treatment, training, and policy advocacy, icddr,b addresses some of the most critical health concerns facing the world today. The Population Council confronts critical health and development issues-from stopping the spread of HIV to improving reproductive health and ensuring that young people lead full and productive lives. Through biomedical, social science and public health research in 50 countries, we work with our partners to deliver solutions that lead to more effective policies, programs and technologies that improve lives around the world. Established in 1952 and headquartered in New York, the Council is a nongovernmental, nonprofit organization governed by an international board of trustees. www.popcouncil.org

Dedicated to saving lives, icddr,b is an international public health research organisation located in Bangladesh. Through the generation of knowledge and translation of research into treatment, training, and policy advocacy, icddr,b addresses some of the most critical health concerns facing the world today. www.icddrb.org The Population Council confronts critical health and development issues-from stopping the spread of HIV to improving reproductive health and ensuring that young people lead full and productive lives. Through biomedical, social science and public health research in 50 countries, we work with our partners to deliver solutions that lead to more effective policies, programs and technologies that improve lives around the world.

Pregnancy in young girls negatively affects their health, their unborn and later-born child, and their social and psychological life. Effective use of Emergency Contraceptives (EC) significantly decreases abortion-related morbidity and mortality. This study aimed to assess knowledge and practices towards EC among female secondary school students in Geita Town Council in the Geita Region, Tanzania. This was a descriptive cross-section study design that used an interviewer-administered questionnaire to gather information from 384 participants who were advanced secondary school-level female students in Geita. Multistage sampling was used to select study participants. Data was analysed using Stata software version 14.0. Frequency was estimated for categorical variables and mean, and standard deviation were used to summarize continuous variables. The Chi-Square test was used to establish the relationship between knowledge of EC and independent variables such as demographic characteristics and practices on EC. The majority, 336 (87.5%) of study participants had never heard of EC, and 208 (61.9%) had adequate knowledge of EC. Pills were the most reported form of EC 266 (79.2%) while 231 (68.7%) mentioned the correct dose of EC pill. More than half 198 (58.9%) agreed that using EC lowers the risk of getting pregnant and only 99 (29.5%) knew the correct timing of taking EC. The school was reported to be the most source of information 135 (40.2%). Students aged 15-19 years have a higher proportion, 138 (66.3%) of adequate knowledge than those aged 19 years and above. Students in form five classes were more knowledgeable (51.4%) about EC compared to form six classes (48.6%). Students with mothers who have a primary level of education have a higher proportion of 82 (39.4%) of adequate knowledge compared to other categories. Respondents whose fathers have ordinary college/University levels of education have a higher proportion of adequate knowledge than others. Female secondary school students in Geita have adequate knowledge of EC, but very few have ever used it. More education and information on EC are needed for female students and the general population.

Background: Family planning services have important role in improving the quality of the lives of a couple and their economic welfare. The objective of the study was to assess the level of awareness and acceptance of different family planning methods among women undergoing to medical termination of pregnancy (MTP). Methods: This study was done at IGMC KNSHM&C Shimla on 1168 women who reported for MTP in department of Obstetrics and Gynaecology. This study was conducted to find out the awareness about the contraceptive practices, source of information and knowledge, the most preferred method and impact of MTP on acceptance of contraception. Results: Majority about 97.5% had knowledge about the contraceptive methods and only 2.5% were unaware of any method. Source of information was health and family planning staff. The next source was friends, relatives and mass media, teaching institutions had least role. In spite of knowledge only about 49% were practicing contraception prior to MTP that too OCP and CC only. Conclusions: Majority of women had optimal knowledge but only less than half of them were using contraceptives. Lacuna is still there, we need to educate and motivate couples to improve family planning services. There is a great need to strengthen the awareness, education and communication regarding various family planning methods in women of reproductive age group.

Background: Family planning services have important role in improving the quality of the lives of a couple and their economic welfare. The objective of the study was to assess the level of awareness and acceptance of different family planning methods among women undergoing to medical termination of pregnancy (MTP). Methods: This study was done at IGMC KNSHM&C Shimla on 1168 women who reported for MTP in department of Obstetrics and Gynaecology. This study was conducted to find out the awareness about the contraceptive practices, source of information and knowledge, the most preferred method and impact of MTP on acceptance of contraception. Results: Majority about 97.5% had knowledge about the contraceptive methods and only 2.5% were unaware of any method. Source of information was health and family planning staff. The next source was friends, relatives and mass media, teaching institutions had least role. In spite of knowledge only about 49% were practicing contraception prior to MTP that too OCP and CC only. Conclusions: Majority of women had optimal knowledge but only less than half of them were using contraceptives. Lacuna is still there, we need to educate and motivate couples to improve family planning services. There is a great need to strengthen the awareness, education and communication regarding various family planning methods in women of reproductive age group.

Unintended pregnancy is a condition where pregnancy occurs without the desire of want to have children. The high number of unintended pregnancies shows the need to research to find out the factors attributed to unintended pregnancy. Unintended pregnancy data used as a response variable includes imbalance binary data, which requires the use of logistics regression analysis. The imbalance of unintended pregnancy data causes a misclassification where a minority class sample can be classified as a majority class. One of the methods to overcome this imbalance is resampling. This research uses the Synthetic Minority Over-sampling Technique-Nominal (SMOTE-N) to overcome the imbalance. This technique synthesizes a new sample to balance the dataset by resampling the minority class sample. The data used in the research is the 2019 East Java data of the Accountability and Performance Survey. The sample is 8327 women of reproductive age. The variables which are expected to affect unintended pregnancy are age, education, occupation, residence, marital status, number of living children, and contraceptive knowledge. The best model obtained from the performance through accuracy, sensitivity, specificity, and G-mean. The results show the average accuracy between the model without imbalance treatment shows 89.7 % accuracy compared to only 65.3 % accuracy of the logistics regression model using SMOTE-N. However, the sensitivity of the model without imbalance treatment is lower than that using SMOTE-N. Moreover, the specificity and the G-mean show a not available value (N.A.), which indicates there is an imbalance that cannot classify data of the minority class sample. The results of the regression based on the Odds Ratio (OR) show that women aged 25-34, aged 35, have higher education, working, married, living in rural areas, have more than two children, and have good contraception knowledge are at high risk of having an unintended pregnancy.

Background: Abortion remains among the leading causes of maternal death worldwide. Post-abortion contraception is significantly effective in preventing unintended pregnancy and abortion if provided before women leave the health facilty. However, the status of post-abortion family planning (PAFP) utilization and the contributing factors are not well studied in Tigray region. So, we conduct study aimed on family planning utilization and factors associated with it among women receiving abortion services. Methods: A facility based cross-sectional study design was conducted among women receiving abortion services in central zone of Tigray from December 2015to February 2016 using a total of 416 sample size. Women who came for abortion services were selected using systematic random sampling technique.. The data were collected using a pre-tested interviewer administered questionnair. Data were coded and entered in to Epi info 7 and then exported to SPSS for analysis. Descriptive statisticslike frequencies and mean were computed to display the results. Both Bivariable and multivariable logistic regression was used in the analysis. Variables statistically significant at p < 0.05 in the bivariable analysis were checked in multivariable logistic regration to identify independently associated factors. Then variables which were significantly associated with post abortion family planning utilization at p-value < 0.05 in the multivariable analysis were declared as significantly associated factors. Results: A total of 409 abortion clients were interviewed in this study with 98.3% of response rate. Majority 290 (70. 9%) of study participants utilized contracepives after abortion. Type of health facility, the decision maker on timing of having child, knowledge that pregnancy can happen soon after abortion and husband's opposition towards contraceptives were significantly associated with Post-abortion family planning ustilization. Conclusions: About one-third of abortion women failed to receive contraceptive before leaving the facility. Private facilities should strengthen utilization of contraceptives on post abortion care service. Health providers should provide counseling on timing of fertility-return following abortion before women left the facility once they receive abortion care. Women empowerment through enhancing community's awareness focusing on own decision making in the family planning utilization including the partner should be strengthened.

The Population Council confronts critical health and development issues-from stopping the spread of HIV to improving reproductive health and ensuring that young people lead full and productive lives. Through biomedical, social science, and public health research in 50 countries, we work with our partners to deliver solutions that lead to more effective policies, programmes, and technologies that improve lives around the world. Established in 1952 and headquartered in New York, the Council is a nongovernmental, nonprofit organization governed by an international board of trustees.

A utilização de recursos audiovisuais no âmbito acadêmico é uma prática antiga que tem ganhado notoriedade ante as tendências pedagógicas de formação baseada em competências. O cinema cada vez mais se consolida como uma ferramenta de cartografia da contemporaneidade que incita a reflexão, o debate e o aprender colaborativo. Além de complementar sob diferentes ópticas temáticas usuais das ciências médicas, o cinema possibilita também a expansão da aprendizagem para searas poucas vezes exploradas no currículo médico formal, tais como altruísmo, compaixão e empatia. Na presente comunicação breve objetivamos traçar uma visão panorâmica sobre a aplicabilidade desta estratégia no curso de Medicina, lançando olhar sobre o que nossa experiência neste tocante nos tem desvelado até o momento. Desde a horizontalidade na curadoria dos filmes apresentados até a imprescindível presença de preceptores especialistas norteando e adequando as discussões, fica claro o engajamento dos alunos à proposta...

Introduction: Measures intended to curb COVID-19 transmission and mortality may have indirect effects on access to, provision, and uptake of essential healthcare services including sexual and reproductive health (SRH). These indirect effects may disproportionately affect women and vulnerable groups through impaired delivery of contraception, antenatal and HIV care services. In Botswana, SRH needs were significant prior to the onset of the COVID-19 pandemic, with a high HIV prevalence, high rates of unintended pregnancy and a high maternal mortality ratio. We aimed to understand the impact of COVID-19 restrictions on SRH access and provision in Botswana.Methods: This observational, cross-sectional study was conducted in Botswana over a 5-week period in early 2021. Data were collected through an online survey disseminated as part of the International Sexual Health and REproductive Health (I-SHARE) Survey. Respondents answered questions on SRH, including sexual behaviours, access to co...

4.3% in 2009 and the prevalence of HIV in newborns was 23.3% in 2010. To date, no study has been done in the DRC, specifically Kinshasa, to explore the PMTCT national protocol. Purpose The study aimed at evaluating compliance with the PMTCT national protocol in the selected PMTCT sites of Kinshasa Methodology A quantitative approach was employed in this study with a total of 76 health care providers, specifically nurses, and 179 records of HIV+ women in 18 PMTCT sites selected in Kinshasa. A health care provider self-reporting questionnaire and review of the records of HIV+ women were used for compliance assessment. Data collected was analysed using the SSPS package, Version 19.0 and MS Excel 2007. Results This study found that nurses and HIV+ women were non-compliant (less than 80%) with the PMTCT national protocol. The score of compliance/non-compliance decreased through the continuum of PMTCT care with a peak in labour and delivery for HIV+ women. Some factors were associated with nurses and HIV+ women's compliance or non-compliance with PMTCT national protocol. The non-compliancy of nurses and HIV+ women found in this study goes beyond the improvement of compliance with PMTCT national protocol and necessitates full and sustainable integration of PMTCT in maternal, newborn and child health services.

Although malaria in pregnancy predisposes women to increased perinatal mortality and morbidity, complex issues underlie its persistence. To develop a better understanding of the factors affecting women&#39;s access to Intermittent Preventive Treatment in Benin, we used the theoretical lens of &quot;sensemaking&quot; to clarify policy makers&#39;, health professionals&#39; and women&#39;s perspectives concerning preventive policies and barriers to access. Several assumptions were found to underlie Benin&#39;s malaria preventive policy that contributes to the unintended effect of deterring pregnant women in poverty from accessing preventive treatment. Health system dysfunctions including drug shortages and deficiencies in health care professionalism exacerbate the unintended effect.Received 18 Feb 2016.

Introduction Unintended teenage pregnancies have become a global public health challenge, particularly in sub-Saharan Africa. There is a notably high prevalence of unintended pregnancies among unmarried teenagers in Uganda. This study will develop an intervention programme using mobile money shops (vendors) as a platform to deliver sexual and reproductive health and rights (SRHR) services to teenagers and assess its effectiveness and scalability in Uganda. Methods and analyses This hybrid study comprises two integral components: an intervention study to assess the effectiveness of vendor-mediated intervention and implementation research to evaluate the implementation process. 30 vendors will be recruited for both intervention and control arms in 2 municipalities in Eastern Uganda, which have a high unintended pregnancy prevalence rate among unmarried teens aged 15-19 years. A preintervention and postintervention repeated survey involving 600 participants for each arm will be conducted over 4 months. The primary outcome is the rate of condom users among teenage vendor users. The secondary outcomes include the rate of preference for receiving SRHR services at vendors and knowledge regarding SRHR. A difference-in-differences analysis will be used to determine the effectiveness of the intervention. The Bowen model will be employed to evaluate the implementation design. Ethics and dissemination Ethical approval was obtained from the Ethics Review

Objective: Due to the Covid-19 pandemic crisis, which causes stress and threatens health, especially in vulnerable groups including pregnant women, the present study was conducted to determine the effect of individual counseling on the pregnant women’s stress of Covid-19. Materials and methods: In this randomized controlled clinical trial, 66 pregnant women in 24 to 28 weeks were randomly divided into two groups of intervention (33 participants) and control (33 participants). At the beginning of the study, both groups completed the questionnaires of demographic information and pandemic related pregnancy test. Then, the intervention was performed in 3 sessions with the interval of one week, in the form of individual counseling by BELIFE method for the experimental group. The control group received only the routine services of the centers. The post-test was performed two weeks after the last consultation session for both groups. Data were analyzed using Stata-13 software. Significance...

Despite growing utilization of family planning in Ethiopia, many pregnancies in rural areas are still unintended and it remains the main global public and reproductive health challenges with devastating impact on women and child health and general public. Hence, this study was sought to determine the prevalence and associated factors of unintended pregnancy in rural women of Ethiopia. This study used the 2016 Ethiopian Demography and Health Survey data. Total weighted samples of 974 reproductive-aged rural women were included in the analysis. Multilevel mixed logistic regression analysis was employed to consider the effect of hierarchal nature of EDHS data by using stata version 14 to determine individual and community level factors. Variables signi cantly associated with unintended pregnancy were declared with adjusted odds ratio with 95% CI at p-value < 0.05. The prevalence of unintended pregnancy in rural women was 31.66%( 95%CI: 28.8%, 34.66%). Have no media exposure (AOR: 2.67, 95%CI: 1.48, 4.83), not working (AOR: 0.33, 95%CI: 0.21, 0.52), household size of one to three (AOR: 0.44 95%CI: 0.2, 0.96), primiparous (AOR: 0.41, 95%CI: 0.17, 0.99), poor women (AOR: 2.4, 95%CI: 1.24, 4.56), didn't have intention to use contraceptive (AOR: 0.24, 95%CI: 0.14, 0.44) were individual factors associated to unintended pregnancy. Large central region (AOR: 4.2, 95%CI: 1.19, 14.62) and poor community level (AOR: 4.3, 95%CI: 1.85, 10.22) were community level factors associated to unintended pregnancy. The present study prevalence of unintended pregnancy in rural women was high. Maternal occupation, household size, media exposure, parity, women wealth, intention to use contraceptive, region and community level wealth were factors statistically associated with unintended pregnancy. Hence, demographer and public health practitioners give great emphasis to set strategies to increase accessibility women to media and improve women nancial capacity, and strengthen availability of maternal health service to decrease unintended pregnancy adverse outcome in rural areas.

Postpartum depression is a mood disorder that occurs in some women after childbirth. It is one of the most frequent postpartum complications which usually appears 4-6 weeks after delivery and can persist for up to a year. Consequently, this study looked into the predictors of postpartum depression among nursing mothers in Calabar South Cross River State. A cross-sectional study was conducted among 254 mothers in Calabar South Local Government Area of Cross River State, Nigeria, attending seven primary health centers for infant immunization from four weeks to eleven months postpartum. A standardised questionnaire administered by an interviewer was used to gather the data. Data were analyzed using IBM SPSS 23.0 to generate descriptive and inferential statistics at a p < 0.05 level of significance. The mean score for knowledge was 5.93 ± 2.86. More than half (52.0%) of the respondents had a negative attitude toward postpartum depression, (52.4%) of the respondents had a high perception, and (53.1%) of respondents had high self-esteem. More than half (56.1%) of the respondents had low media influence, (53.1%) of the respondents had social support, and (65.4%) of the respondents had low enabling factors. There was a significant relationship (p= 0.000) between each respondent's independent variables and level of postpartum depression except for enabling factors. Social support was a predictor of postpartum depression among this study population. It is suggested that family members should be made more aware of the need for supporting nursing mothers so as to improve their mental health by reducing postpartum depression.

Objectives The postpartum period is a high-risk time for unintended pregnancy, and additional opportunities to provide contraception are needed. Our objective was to evaluate the acceptability of providing postpartum contraceptive counseling at a pediatric well baby visit, and compare it to counseling at the routine postpartum visit. Methods Postpartum women (100 per group) were recruited for this cohort study at pediatric well baby visits and obstetric postpartum visits at an academic medical center. Well baby participants completed a baseline survey followed by contraceptive counseling by an obstetrician or midwife and a post-counseling survey. Postpartum participants were surveyed after their visit only. Results All well baby visit participants completed the intervention and were enrolled earlier in the postpartum period than postpartum visit participants (mean = 4.1 vs. 6.6 weeks, respectively, p < 0.01). Following counseling, 95% of well baby participants reported being very comfortable discussing contraception, compared to 83% before counseling (RR 1.14, 95% CI 1.06, 1.25) and a higher proportion reported being very likely to use a contraception prescription obtained at the well baby visit (79% after counseling vs. 65% before; RR 1.23, 95% CI 1.08, 1.39). Similar proportions of postpartum and well baby participants were very comfortable discussing contraception at their visits (91 vs. 95%, respectively). Conclusions for practice Contraceptive counseling paired with well baby visits is acceptable among postpartum women. Acceptability increased further after the counseling intervention at the well baby visit. Obstetricians and Pediatricians can partner to offer contraceptive counseling at the well baby visit to increase opportunities for contraception education at an earlier time postpartum.

Objectives The postpartum period is a high-risk time for unintended pregnancy, and additional opportunities to provide contraception are needed. Our objective was to evaluate the acceptability of providing postpartum contraceptive counseling at a pediatric well baby visit, and compare it to counseling at the routine postpartum visit. Methods Postpartum women (100 per group) were recruited for this cohort study at pediatric well baby visits and obstetric postpartum visits at an academic medical center. Well baby participants completed a baseline survey followed by contraceptive counseling by an obstetrician or midwife and a post-counseling survey. Postpartum participants were surveyed after their visit only. Results All well baby visit participants completed the intervention and were enrolled earlier in the postpartum period than postpartum visit participants (mean = 4.1 vs. 6.6 weeks, respectively, p < 0.01). Following counseling, 95% of well baby participants reported being very comfortable discussing contraception, compared to 83% before counseling (RR 1.14, 95% CI 1.06, 1.25) and a higher proportion reported being very likely to use a contraception prescription obtained at the well baby visit (79% after counseling vs. 65% before; RR 1.23, 95% CI 1.08, 1.39). Similar proportions of postpartum and well baby participants were very comfortable discussing contraception at their visits (91 vs. 95%, respectively). Conclusions for practice Contraceptive counseling paired with well baby visits is acceptable among postpartum women. Acceptability increased further after the counseling intervention at the well baby visit. Obstetricians and Pediatricians can partner to offer contraceptive counseling at the well baby visit to increase opportunities for contraception education at an earlier time postpartum.

about 2-3 cm from the uterine cornua. The left ovary was also absent (Fig 2). The components of the mass were extensively necrotic; however remnants of ovarian histology were noted. The mass was excised from the omentum and the patient was discharged two days later.