RATIONALE FOR SELECTION OF PLANNED CONTRACEPTIVE METHOD INTEGRATED WITH MEDICAL ASSISTANCE IN TERMINATING AN UNWANTED PREGNANCY


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

The purpose of the study was to assess the quality of health care for women regarding the choice of planned method of contraception due to unwanted pregnancy and abortion in the early stages in outpatient settings and identify ways to optimize the organizational measures and methodological approaches to its improvement. Outcomes of 760 cases of termination of pregnancy for up to 6 weeks of gestation performed in single outpatient clinic in Kurgan city in 2015 in women aged 20 to 45 years, and the choice of method of contraception for them were evaluated. The group of vacuum aspiration group consisted of 186 women; medication-induced abortion group included 574 women. Hormonal contraception, which was started immediately after vacuum aspiration and medication-induced abortion, was selected as a planned contraceptive method in 80.1% (149/186) and 79.9% (459/574) of cases in the respective groups. lUDs have been used only in 1.1% (2/186) and 1.2% (7/574) of the cases in the respective groups during the next menstrual period. Thus, the use of combined oral contraceptives was preferential (80%) planned method of contraception, but the choice was made doctor’s orders, not on the basis of the preferences and expectations of women, which increases the risk of refusal over time. The frequency of use of lUDs after an abortion seems unreasonably low - only 1%, and their deployment is performed in delayed terms after abortion, which increases the risk of unwanted pregnancy in «unprotected» period.

Full Text

Restricted Access

About the authors

A. M Katsay

FSBEI HE"First MSMU n.a. I.M.Sechenov" of RMH

Moscow

G. B Dikke

FSAEI HE "Peoples' Friendship University of Russia"

Email: galadikke@yandex.rn
Honored Worker of Science and Edatte, MD, Professor at the Department of Obstetrics, Gynecology and Reprod^^ Medicine of the Facdty of Advanced Training of Medical Practitioners Moscow

G. S Shestakov

FSBEI HE"First MSMU n.a. I.M.Sechenov" of RMH

Moscow

References

  1. Safe abortion: technical and policy guidance for health systems. Second edition. World Health Organization, Department of Reproductive Health and Research. 2012. 132 р.
  2. Дикке Г.Б., Яроцкая Е.Л., Ерофеева Л.В. Стратегическая оценка политики, программ и услуг в сфере непланируемой беременности, абортов и контрацепции в Российской Федерации. Совместное исследование МЗ и СР РФ и ВОЗ. Проблемы репродукции. 2010;3:92-108.
  3. Steinberg T.N. Abortion counseling: to benefit maternal health. Am. J. Law Med. 1989; 15(4):483-517.
  4. Vandamme J., Wyverkens E., Buysse A., Vrancken C., Brondeel R. Pre-abortion counselling from women's point of view. Eur. J. Contracept. Reprod. Health Care. 2013;18(4):309-18.
  5. Gould H., Foster D.G., Perrucci A.C., Barar R.E., Roberts S.C.M. Predictors of Abortion Counseling Receipt and Helpfulness in the United States. Jacobs Institute of Women's Health. 2013;23(4):249-55.
  6. Дикке Г.Б., Яроцкая Е.Л., Ерофеева Л.В. Внедрение современных методов прерывания беременности в отечественную практику Акушерство и гинекология. 2014;2:67-73.
  7. Артымук Н.В., Дикке Г.Б., Марочко Т.Ю., Зеленина Е.М., Рыбников С.В., Черняева В.И. Консультирование перед медицинским абортом: методические рекомендации. Кемерово, 2015. 35 с.
  8. Сакевич В.И. Планирование семьи в России. Демоскоп Weekly № 465-6, 14 марта 2010. Электронный ресурс. Режим доступа: http:// www.demoscope.ru
  9. Benson J., Andersen K., Brahmi D., Healy J., Mark A., Ajode A., Griffin R. What contraception do women use after abortion? An analysis of 319,385 cases from eight countries. Global Public Health. 2016 May 18:1-16.
  10. Ранние сроки беременности Под ред. Радзинского В.Е., Оразмурадова А.А. М., 2009.
  11. Прилепская В.Н., Назарова Н.М., Тарасова М.А., Летуновская А.Б. Международный проект «CHOICE»: краткий обзор результатов исследования. Гинекология. 2010;4:26-8.
  12. Secura G.M., Allsworth J.E., Madden T., Mullersman J.L., Peipert J.F The Contraceptive CHOICE Project: reducing barriers to long-acting reversible contraception. Am. J. Obstet. Gynecol. 2010;203(2):115.e1-7.
  13. Hooper D.J. Attitudes, awareness, compliance and preferences among hormonal contraception users: a global, cross-sectional, self-administered, online survey. Clin. Drug Investig. 2010; 30 (11):749-63.
  14. Дикке Г.Б., Плотко Е.Э., Кочев Д.М., Кацай А.М. Информирование и консультирование перед медикаментозным прерыванием беременности с использованием электронных ресурсов. Акушерство и гинекология. 2016;11.
  15. Bender S.S., Geirsson R.T Effectiveness of preabortion counseling on postabortion contraceptive use. Contraception. 2004;69(6):481-87.
  16. Bianchi-Demicheli F., Perrin E., Bianchi P.G., Dumont P, Lüdicke F., Campana A. Contraceptive practice before and after termination of pregnancy: a prospective study. Contraception. 2003;67(2):107-13.
  17. Thompson K.M., Speidel J.J., Saporta V., Waxman N.J., Harper C.C. Contraceptive policies affect postabortion provision of long-acting reversible contraception. Contraception. 2011;83(1):41-7.
  18. Trussel J. Contraceptive efficacy. In: Hatcher R.A., Trussel J., Stewart F., Nelson A., Gates W., Guest F., Kowal D. Contraceptive Technology. Eighteenth Revised Edition. New York, NY, Ardent Media, 2007:747-826.
  19. Long-acting reversible contraception the effective and appropriate use of long-acting reversible contraception. National Collaborating Centre for Women's and Children's Health. RCOG, 2013. http://www.acog.org/
  20. Faculty of Sexual and Reproductive Healthcare -Professional Association. Contraceptive choices for young people. Guideline Summary. 2010. NGC:008192. http://www.guideline.gov/
  21. Winner B., Peipert J.F., Zhao Q., Buckel C., Madden T., Allsworth J.E., Secura G.M. Effectiveness of Long-Acting Reversible Contraception. N Engl. J. Med. 2012;366(21):1998-2007.
  22. Peipert J.F., Madden T., Allsworth J.E., Secura G.M. Preventing Unintended Pregnancies by Providing No-Cost Contraception. Obstet. Gynecol. 2012;120(6):1291-97.
  23. Faculty of Sexual and Reproductive Healthcare -Professional Association. Postnatal sexual and reproductive health. Guideline Summary. 2009. NGC:007644. http://www.guideline.gov/
  24. American College of Obstetricians and Gynecologists. Long-acting reversible contraception: implants and intrauterine devices. Guideline Summary. 2011 Jul. NGC:008627. http://www. guideline.gov/
  25. Mestad R., Kenerson J., Peipert J. Reversible Contraception Update: The Importance of Long-Acting Reversible Contraception. Postgrad. Med. 2009;121(4):18-25.
  26. Rowan S.P., Someshwar J., Murray P. Contraception for primary care providers. Adolesc. Med. State Art. Rev. 2012;23(1):95-110.
  27. Bednarek P.H., Creinin M.D., Reeves M.F., Cwiak C., Espey E., Jensen J.T.; Post-Aspiration IUD Randomization (PAIR) Study Trial Group. Immediate versus Delayed IUD Insertion after Uterine Aspiration. N. Engl. J. Med. 2011;364:2208-17.
  28. Bellagio consensus recommendations for action to increase access to highly effective, long-acting, reversible contraception. Statement. 2012. www. astra.org

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies