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Adolescents' experiences with early discontinuation of the contraceptive implant
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ABSTRACTS / Contraception 92 (2015) 359–414
felt that their providers wanted them to continue the IUD because they cared about them, they were upset when their providers did not respect their request for removal, and in several cases this hurt the doctor–patient relationship. The women who reported that their providers were neutral about IUD removal were more satisfied with their visit. Outcomes: Reasons for IUD removal are often complex. While reassurance is important when appropriate, resistance to early elective IUD removal has implications for both reproductive autonomy and the doctor–patient relationship. http://dx.doi.org/10.1016/j.contraception.2015.06.194
P145 Adolescents' experiences with early discontinuation of the contraceptive implant
were generated as well as univariate analysis using chi-square and Fisher's Exact Tests. Results: Some 1232 providers were emailed, and 119 questionnaires were completed. Participants were predominately physicians (80%), males (59%) and younger than 45 (59%). Common practices were referrals (96%), EC prescriptions (77%) and non-EC prescriptions (40%). Common barriers were likelihood of follow-up (63%), risk of complications (58%) and side-effects (51%). More than 70% of participants identified highly effective methods with typical use, 3% identified the maximum EC initiation time and 42% chose pregnancy as having a higher risk for pulmonary embolism versus hormonal contraception. Outcomes: Most ED providers referred patients for contraception; however, there was no universal contraceptive counseling and management. Many ED providers had incorrect understandings of the efficacy, risks and eligibility associated with contraceptive methods, which may affect patient access.
Lunde B Icahn School of Medicine at Mount Sinai, New York, NY, USA
http://dx.doi.org/10.1016/j.contraception.2015.06.196
Littman L, Stimmel S, Rana R, Jacobs A, Horowitz C
P147
Objectives: The objectives of this qualitative study were to develop a deeper understanding of adolescents' reasons for and experiences with early discontinuation of the contraceptive implant and to identify areas of improvement in implant counseling. Methods: Semistructured interviews were conducted with adolescents aged 13–24 presenting for removal of the contraceptive implant within the first 6 months of placement. The interview guide consisted of questions that explored decision making regarding placement and removal of the implant, recollection of counseling, differences between anticipated and experienced side-effects and recommendations for counseling. Interview transcripts were analyzed and coded to identify themes. Results: Sixteen interviews were performed. The participants experienced significant side-effects, which led to frustration, disappointment and the decision to have the implant removed. Few adolescents felt comfortable discussing problems with the implant with their health care providers or knew when to obtain follow-up care. Instead, they reported relying on the Internet, friends or other sources of information to decide which side-effects could be due to the implant and when to get it removed. After removal, half of the participants did not start a new method. Outcomes: The adolescents who chose to stop using the contraceptive implant were highly motivated to avoid pregnancy and were unhappy that this method did not work for them. A clear need for continued support during the experience of side-effects and decision making about removal was identified.
Factors influencing fertility preferences and contraceptive use among reproductive-age married women in Dire Dawa, Eastern Ethiopia
http://dx.doi.org/10.1016/j.contraception.2015.06.195
P146 Contraception initiation in the emergency department: providers' knowledge, attitudes, and practices Liles I University of Connecticut, Farmington, CT, USA Haddad L, Hankin A, Lathrop E Objectives: Almost half of pregnancies in the United States are unintended; these pregnancies are associated with adverse outcomes. Many reproductive-aged women seek care in the emergency department (ED), are at risk of pregnancy and are amenable to contraceptive services in this setting. We sought to assess ED providers' current practices, attitudes and knowledge of emergency contraception (EC) and nonemergency contraception (non-EC) as well as barriers to contraceptive initiation. Methods: ED physicians and associate providers in Georgia were emailed a link to an anonymous Internet questionnaire using state professional databases and contacts. The questionnaire included Likert scales with multiple choice questions to assess study objectives. Descriptive statistics
Tesfaye G Haramaya University, Harar, Ethiopia Gebru H, Siyoum B, Damena M Objectives: We assessed fertility preference and contraceptive use among reproductive-age married women in Dire Dawa, Eastern Ethiopia. Methods: We conducted a cross-sectional study, which included 421 married women of reproductive age. Quantitative data were collected using an interviewer-administered structured questionnaire; the in-depth interview consisted of a semistructured questionnaire. Data processing and analysis were done using SPSS version 16. Univariate, bivariate and multivariate analysis were employed. Results: About 245 (58.2%) of women wanted to have more children, and 221 (52.5%) were current contraceptive users. Fertility preference was significantly associated with respondent's age, history of child death and number of living children. Contraceptive use was associated with religion and age at first birth. Outcomes: Younger women, those who had no history of child death and women with fewer surviving children were more likely to desire additional children. Women who were older at first birth and identified as Protestant were more likely to use contraceptives. http://dx.doi.org/10.1016/j.contraception.2015.06.197
P148 College women's knowledge of and perceived barriers to long-acting reversible contraceptive methods Hall K University of Michigan, Ann Arbor, MI, USA Ela E, Zochowski M, Challa S, McAndrew L, Steel M, Dalton VK, Ernst S Objectives: We aimed to comprehensively assess college women's knowledge of and perceived barriers to LARC methods. Methods: We conducted an Internet-based survey of 1982 female undergraduates at a large midwestern university to identify barriers to IUD and implant uptake on college campuses. The 55-item survey measured multiple dimensions of women's LARC understanding, attitudes, experiences and reasons for nonuse. We present results as descriptive statistics.
ABSTRACTS / Contraception 92 (2015) 359–414
felt that their providers wanted them to continue the IUD because they cared about them, they were upset when their providers did not respect their request for removal, and in several cases this hurt the doctor–patient relationship. The women who reported that their providers were neutral about IUD removal were more satisfied with their visit. Outcomes: Reasons for IUD removal are often complex. While reassurance is important when appropriate, resistance to early elective IUD removal has implications for both reproductive autonomy and the doctor–patient relationship. http://dx.doi.org/10.1016/j.contraception.2015.06.194
P145 Adolescents' experiences with early discontinuation of the contraceptive implant
were generated as well as univariate analysis using chi-square and Fisher's Exact Tests. Results: Some 1232 providers were emailed, and 119 questionnaires were completed. Participants were predominately physicians (80%), males (59%) and younger than 45 (59%). Common practices were referrals (96%), EC prescriptions (77%) and non-EC prescriptions (40%). Common barriers were likelihood of follow-up (63%), risk of complications (58%) and side-effects (51%). More than 70% of participants identified highly effective methods with typical use, 3% identified the maximum EC initiation time and 42% chose pregnancy as having a higher risk for pulmonary embolism versus hormonal contraception. Outcomes: Most ED providers referred patients for contraception; however, there was no universal contraceptive counseling and management. Many ED providers had incorrect understandings of the efficacy, risks and eligibility associated with contraceptive methods, which may affect patient access.
Lunde B Icahn School of Medicine at Mount Sinai, New York, NY, USA
http://dx.doi.org/10.1016/j.contraception.2015.06.196
Littman L, Stimmel S, Rana R, Jacobs A, Horowitz C
P147
Objectives: The objectives of this qualitative study were to develop a deeper understanding of adolescents' reasons for and experiences with early discontinuation of the contraceptive implant and to identify areas of improvement in implant counseling. Methods: Semistructured interviews were conducted with adolescents aged 13–24 presenting for removal of the contraceptive implant within the first 6 months of placement. The interview guide consisted of questions that explored decision making regarding placement and removal of the implant, recollection of counseling, differences between anticipated and experienced side-effects and recommendations for counseling. Interview transcripts were analyzed and coded to identify themes. Results: Sixteen interviews were performed. The participants experienced significant side-effects, which led to frustration, disappointment and the decision to have the implant removed. Few adolescents felt comfortable discussing problems with the implant with their health care providers or knew when to obtain follow-up care. Instead, they reported relying on the Internet, friends or other sources of information to decide which side-effects could be due to the implant and when to get it removed. After removal, half of the participants did not start a new method. Outcomes: The adolescents who chose to stop using the contraceptive implant were highly motivated to avoid pregnancy and were unhappy that this method did not work for them. A clear need for continued support during the experience of side-effects and decision making about removal was identified.
Factors influencing fertility preferences and contraceptive use among reproductive-age married women in Dire Dawa, Eastern Ethiopia
http://dx.doi.org/10.1016/j.contraception.2015.06.195
P146 Contraception initiation in the emergency department: providers' knowledge, attitudes, and practices Liles I University of Connecticut, Farmington, CT, USA Haddad L, Hankin A, Lathrop E Objectives: Almost half of pregnancies in the United States are unintended; these pregnancies are associated with adverse outcomes. Many reproductive-aged women seek care in the emergency department (ED), are at risk of pregnancy and are amenable to contraceptive services in this setting. We sought to assess ED providers' current practices, attitudes and knowledge of emergency contraception (EC) and nonemergency contraception (non-EC) as well as barriers to contraceptive initiation. Methods: ED physicians and associate providers in Georgia were emailed a link to an anonymous Internet questionnaire using state professional databases and contacts. The questionnaire included Likert scales with multiple choice questions to assess study objectives. Descriptive statistics
Tesfaye G Haramaya University, Harar, Ethiopia Gebru H, Siyoum B, Damena M Objectives: We assessed fertility preference and contraceptive use among reproductive-age married women in Dire Dawa, Eastern Ethiopia. Methods: We conducted a cross-sectional study, which included 421 married women of reproductive age. Quantitative data were collected using an interviewer-administered structured questionnaire; the in-depth interview consisted of a semistructured questionnaire. Data processing and analysis were done using SPSS version 16. Univariate, bivariate and multivariate analysis were employed. Results: About 245 (58.2%) of women wanted to have more children, and 221 (52.5%) were current contraceptive users. Fertility preference was significantly associated with respondent's age, history of child death and number of living children. Contraceptive use was associated with religion and age at first birth. Outcomes: Younger women, those who had no history of child death and women with fewer surviving children were more likely to desire additional children. Women who were older at first birth and identified as Protestant were more likely to use contraceptives. http://dx.doi.org/10.1016/j.contraception.2015.06.197
P148 College women's knowledge of and perceived barriers to long-acting reversible contraceptive methods Hall K University of Michigan, Ann Arbor, MI, USA Ela E, Zochowski M, Challa S, McAndrew L, Steel M, Dalton VK, Ernst S Objectives: We aimed to comprehensively assess college women's knowledge of and perceived barriers to LARC methods. Methods: We conducted an Internet-based survey of 1982 female undergraduates at a large midwestern university to identify barriers to IUD and implant uptake on college campuses. The 55-item survey measured multiple dimensions of women's LARC understanding, attitudes, experiences and reasons for nonuse. We present results as descriptive statistics.