Journal articles on the topic 'Contraception Australia'
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Concepcion, Kristine, Sarina Lacey, Kevin McGeechan, Jane Estoesta, Deborah Bateson, and Jessica Botfield. "Cost–benefit analysis of enhancing the uptake of long-acting reversible contraception in Australia." Australian Health Review 44, no. 3 (2020): 385. http://dx.doi.org/10.1071/ah18190.
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Objective Long-acting reversible contraception (LARC) is the most effective form of reversible contraception, but its use in Australia is low compared with other countries. The aim of this study was to evaluate the economic effect of an increase in LARC uptake to international rates. Methods An economic model was designed to assess two scenarios, namely increasing the current rate of LARC uptake of 12.5% to the international benchmark of 14.8% among: (1) women currently using the oral contraceptive pill (OCP); and (2) women at risk of pregnancy and not using contraception. Model inputs included cost of contraceptive methods, discontinuation rates and abortion and miscarriage costs associated with unintended pregnancies. Results Women who switch from an OCP to LARC would save A$114–157 per year. Those not currently using any contraception who adopt LARC would incur costs of A$36–194 per year, but would reap savings from the reduction in unintended pregnancies. Over 5 years there would be a net saving of A$74.4 million for Scenario 1 and A$2.4 million for Scenario 2. Conclusion Greater use of LARC would result in a net gain in economic benefits to Australia. These benefits are largely driven by women switching from an OCP to LARC who have reduced costs, as well as women wishing to avoid pregnancy who choose to use LARC rather than no method. This evidence will support women making an informed contraceptive choice and policy makers in increasing the accessibility of LARC. What is known about the topic? LARC is the most effective form of reversible contraception, but uptake in Australia is relatively low. What does this paper add? There are economic benefits to society for women who switch from an OCP to LARC, as well as for women who switch from no contraception to LARC. What are the implications for practitioners? The findings of this study will support women in making an informed contraceptive choice and policy makers in increasing the accessibility of LARC.
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Concepcion, Kristine, Sarina Lacey, Kevin McGeechan, Jane Estoesta, Deborah Bateson, and Jessica Botfield. "Corrigendum to: Cost–benefit analysis of enhancing the uptake of long-acting reversible contraception in Australia." Australian Health Review 44, no. 3 (2020): 501. http://dx.doi.org/10.1071/ah18190_co.
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ObjectiveLong-acting reversible contraception (LARC) is the most effective form of reversible contraception, but its use in Australia is low compared with other countries. The aim of this study was to evaluate the economic effect of an increase in LARC uptake to international rates.MethodsAn economic model was designed to assess two scenarios, namely increasing the current rate of LARC uptake of 12.5% to the international benchmark of 14.8% among: (1) women currently using the oral contraceptive pill (OCP); and (2) women at risk of pregnancy and not using contraception. Model inputs included cost of contraceptive methods, discontinuation rates and abortion and miscarriage costs associated with unintended pregnancies.ResultsWomen who switch from an OCP to LARC would save A$114–157 per year. Those not currently using any contraception who adopt LARC would incur costs of A$36–194 per year, but would reap savings from the reduction in unintended pregnancies. Over 5 years there would be a net saving of A$74.4 million for Scenario 1 and A$2.4 million for Scenario 2.ConclusionGreater use of LARC would result in a net gain in economic benefits to Australia. These benefits are largely driven by women switching from an OCP to LARC who have reduced costs, as well as women wishing to avoid pregnancy who choose to use LARC rather than no method. This evidence will support women making an informed contraceptive choice and policy makers in increasing the accessibility of LARC.What is known about the topic?LARC is the most effective form of reversible contraception, but uptake in Australia is relatively low.What does this paper add?There are economic benefits to society for women who switch from an OCP to LARC, as well as for women who switch from no contraception to LARC.What are the implications for practitioners?The findings of this study will support women in making an informed contraceptive choice and policy makers in increasing the accessibility of LARC.
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YUSUF, FARHAT, and STEFANIA SIEDLECKY. "PATTERNS OF CONTRACEPTIVE USE IN AUSTRALIA: ANALYSIS OF THE 2001 NATIONAL HEALTH SURVEY." Journal of Biosocial Science 39, no. 5 (November 23, 2006): 735–44. http://dx.doi.org/10.1017/s0021932006001738.
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SummaryThe purpose of this paper is to review the patterns of contraceptive use in Australia, using data from a nationally representative sample of 5872 women aged 18 to 49. This survey was conducted by the Australian Bureau of Statistics in 2001 as part of the National Health Survey. Results of the analysis indicate that the oral contraceptive pill and condom were the two most frequently used methods. More than 76% of the respondents reported having ever used the pill. Over 23% of women were currently using condoms; of these 80% of the condom users used them for contraception – this included 36% who used condoms for both protection against infection and for contraception – and the remainder used them only for protection. Withdrawal was the third most popular non-surgical method up to age 40. Few women used IUDs, injections or diaphragms. Just over 3% of the respondents were using natural methods with the highest rate reported among those in their 30s. The ‘morning-after pill’ was reported mostly by women aged 18–24; however, there was no evidence to suggest that it was being used as a primary method of birth control. Contraceptive use declined in older women who turned to sterilization for themselves and/or their partners. Use of the contraceptive pill was somewhat higher among better-educated women, but lower among less-educated women and those from non-English-speaking backgrounds.
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Bracher, Michael, and Gigi Santow. "Premature Discontinuation of Contraception in Australia." Family Planning Perspectives 24, no. 2 (March 1992): 58. http://dx.doi.org/10.2307/2135467.
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Milosavljević, Jelena, Katarina Ilić, and Dušanka Krajnović. "Mechanism of Action, Efficacy and Safety of Emergency Hormonal Contraception (levonorgestrel and ulipristal acetate) and Attitudes of Pharmacists." Acta Facultatis Medicae Naissensis 31, no. 3 (September 1, 2014): 155–61. http://dx.doi.org/10.2478/afmnai-2014-0019.
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Summary Emergency hormonal contraception is used to prevent unintended pregnancy postcoitally. The mechanism of action of the most frequently used hormonal preparations for emergency contraception, levonorgestrel (LNG) and ulipristal acetate (UPA), is still not fully known, but clinical trials indicate that they act by inhibiting or delaying ovulation. LNG has a long history of use for emergency contraception, proven safety and high efficacy if administered in the preovulation period. The newest emergency contraceptive, UPA, available only with a prescription, is indicated within this period of 120 hours after sexual intercourse and the data indicate that UPA does not lose efficacy within this period. Clinical trials showed its noninferiority versus LNG and its effect on the potentially occurring pregnancy is being additionally monitored. However, many misconceptions and controversial opinions about emergency contraception are still present, even among pharmacists. A search of Medline database identified 20 papers published from January 1993 to December 2012, on pharmacists’ knowledge, attitudes and practices related to emergency contraception. In these papers, the attitudes of pharmacists pertaining to the dispensing regime of emergency contraception were different. Research in Australia has shown that personal attitudes and religious convictions influence the practice of dispensing emergency contraception. In the research conducted in New Mexico, 30% of pharmacists were against prescribing emergency contraception for religious or moral reasons. There were no published data in regards to pharmacists’ knowledge, attitudes and dispensing practice in Serbia and such research is highly recommended.
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Garrett, Cameryn C., Henrietta Williams, Louise Keogh, Qazi W. Ullah, Fabian Kong, and Jane S. Hocking. "Is there a role for practice nurses in increasing the uptake of the contraceptive implant in primary care?: survey of general practitioners and practice nurses." Sexual Health 13, no. 3 (2016): 241. http://dx.doi.org/10.1071/sh15229.
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Background: Uptake of long-acting reversible contraception (LARC) in Australia is low. With appropriate training, practice nurses (PNs) in general practice clinics could help increase LARC uptake. Methods: General practitioners (GPs) and PNs completed a postal survey to assess contraceptive implant knowledge and attitudes towards PNs providing contraception counselling and inserting the contraceptive implant. χ2 tests were used to detect differences between GPs and PNs. Unadjusted odds ratios (OR) for the association between demographic characteristics and knowledge and attitudes towards the contraceptive implant were calculated for GPs and PNs separately. Results: Four hundred and sixty-eight GPs and 1142 PNs participated. GPs had greater knowledge about LARC than PNs (59% vs 33%; P < 0.01). A similar proportion of GPs and PNs (70%) agreed that PNs could become involved in contraceptive counselling. Among GPs, urban-based GPs were less likely to agree that their clinic would be supportive of the PN inserting the implant (OR = 0.6; 95% CI: 0.4–0.9). Among PNs, older PNs (OR = 0.5; 95% CI: 0.4–0.7) were less likely to agree that the clinic would support PNs inserting the contraceptive implant, but those with Pap test training were more likely to agree (OR = 2.1; 95% CI: 1.5–3.0). Conclusions: This study found high levels of acceptability for PNs to provide contraceptive counselling and insertion of the contraceptive implant. Further research is needed to evaluate the impact of potential interventions that equip PNs with the skills to consult women about contraception and insert the contraceptive implant on LARC uptake.
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Santow, Gigi. "Trends in Contraception and Sterilization in Australia." Australian and New Zealand Journal of Obstetrics and Gynaecology 31, no. 3 (August 1991): 201–8. http://dx.doi.org/10.1111/j.1479-828x.1991.tb02781.x.
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Abigail, Wendy F., Charmaine Power, and Ingrid Belan. "Termination of pregnancy and the over 30s: what are trends in contraception use 1996 - 2006?" Australian Journal of Primary Health 16, no. 2 (2010): 141. http://dx.doi.org/10.1071/py09020.
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There is a shift in fertility patterns with more women commencing childbearing over 30 years of age. Little is known about trends in contraception use by women in this age group seeking a termination of pregnancy. This research presents a trend analysis to determine if there were significant changes in trends in contraception use pre- and post-termination of pregnancy for women over 30 years of age from 1996 to 2006 in South Australia. Data were collected from 1996 to 2006 from a service in South Australia. Data were examined using simple linear regression. At the time of conception, 53% of women reported using some form of contraception. Additionally, there was a significant decline in women using natural family planning methods at conception. Post-operatively, there was a significant decline in hormone methods being chosen, and a significant increase in women not using any contraception. Women over 30 years of age used contraception at the time of conception pre- and post-operatively of having a pregnancy terminated over the 10 year period of the study. Health promotion activities need to be further developed to cater for this age group and to take into consideration changing fertility patterns.
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Rowe, Heather, Sara Holton, Maggie Kirkman, Christine Bayly, Lynne Jordan, Kathleen McNamee, John McBain, Vikki Sinnott, and Jane Fisher. "Abortion: findings from women and men participating in the Understanding Fertility Management in contemporary Australia national survey." Sexual Health 14, no. 6 (2017): 566. http://dx.doi.org/10.1071/sh17004.
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Background There are few reliable Australian abortion data. The aim was to investigate prevalence, sexual experiences and socioeconomic characteristics of women and men who report having had or being a partner in an abortion. Methods: A cross-sectional survey of women and men aged 18–50 years randomly selected from the Australian Electoral Roll was used. Weighted multivariable analyses were conducted. Results: Data from 2235 returned (of 15 480) mailed surveys were analysed. One in six women and one in 10 men had experienced or been a partner in an abortion. In adjusted analyses, for women, experience of sexual coercion [adjusted odds ratio (AOR) 2.18, 95% confidence interval (CI) 1.46, 3.24] was associated with significantly increased odds of abortion, and socioeconomic advantage (AOR = 0.57; 95% CI 0.39, 0.84), being comfortable negotiating contraceptive use (AOR 0.26; 95% CI 0.09, 0.73) and importance of religion in fertility choices (AOR = 0.55; 95% CI 0.35, 0.87) were associated with significantly reduced odds. For men, sexual coercion (AOR = 3.05; 95% CI 1.51, 6.18) and metropolitan residence (AOR = 1.70; 95% CI 1.06, 2.75) significantly increased the odds of reporting being a partner in an abortion. Conclusions: The findings contribute to scarce information about abortion in Australia. The high prevalence of abortion suggests that effective contraceptive counselling and accessible contraception services are not sufficient, and that there is a continuing need for universal pregnancy advice and abortion services. The association between sexual coercion and abortion warrants further investigation.
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Dolan, Hankiz, Mu Li, Deborah Bateson, Rachel Thompson, Chun Wah Michael Tam, Carissa Bonner, and Lyndal Trevena. "Healthcare providers' perceptions of the challenges and opportunities to engage Chinese migrant women in contraceptive counselling: a qualitative interview study." Sexual Health 17, no. 5 (2020): 405. http://dx.doi.org/10.1071/sh19215.
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Background In Australia, there are many culturally and linguistically diverse communities and Chinese migrants make up one of the largest. Yet, little is known about healthcare providers’ (HCPs) unique experiences in providing contraceptive care for Chinese migrant women. There is minimal research into the HCPs’ perceptions of challenges or opportunities in engaging Chinese migrant women in informed and shared decision-making processes during contraceptive counselling. The aim of this study is to explore HCPs’ experiences of providing contraceptive care for Chinese migrant women, their perceptions of women’s care needs when choosing contraceptive methods, as well as their own needs in supporting women’s decision-making. Methods: Semi-structured interviews were conducted with 20 HCPs in Sydney, Australia who had substantial experience in providing contraceptive services to Chinese women who were recent migrants. Transcribed audio-recorded data were analysed using thematic analysis. Results: Four main themes were identified, including: ‘Are you using contraception?’: the case for being proactive and opportunistic; ‘Getting the message across’: barriers to communication; ‘Hormones are unnatural?’: women favouring non-hormonal methods; and ‘Word of mouth’: social influence on contraceptive method choice. Conclusions: In order to facilitate informed choice and shared decision-making with Chinese migrant women during contraceptive counselling, broader health system and community-level strategies are needed. Such strategies could include improving HCPs’ cultural competency in assessing and communicating women’s contraceptive needs; providing professional interpreting services and translated materials; and improving women’s health literacy, including their contraceptive knowledge and health system awareness.
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Manderson, Lenore, Margaret Kelaher, Nicole Woelz-Stirling, Joy Kaplan, and Kirsten Greene. "Sex, contraception and contradiction among young Filipinas in Australia." Culture, Health & Sexuality 4, no. 4 (January 2002): 381–91. http://dx.doi.org/10.1080/1369105021000041034.
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Black, Kirsten I., Deborah J. Bateson, and Philip Goldstone. "Abortion statistics and long-acting reversible contraception in Australia." Australian and New Zealand Journal of Obstetrics and Gynaecology 58, no. 3 (June 2018): E6—E7. http://dx.doi.org/10.1111/ajo.12810.
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Mazza, Danielle, Christopher Harrison, Angela Taft, Helena Britt, Melissa Hobbs, Kay Stewart, Safeera Hussainy, and Bianca Brijnath. "Unplanned pregnancy and emergency contraception in Australia: unsolved dilemmas." Australian and New Zealand Journal of Public Health 38, no. 2 (April 2014): 110–11. http://dx.doi.org/10.1111/1753-6405.12200.
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Harvey, C. E. "35. OUT OF THE SPOTLIGHT: AN AUDIT OF FIVE YEARS OF IMPLANON® USE IN QUEENSLAND." Sexual Health 4, no. 4 (2007): 298. http://dx.doi.org/10.1071/shv4n4ab35.
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The progestogen contraceptive implant -Implanon� was launched into the Australian marketplace in May 2001, with intense marketing and extensive training programs for doctors. However, negative media focused on removal problems and unexpected pregnancies, followed by increased medical indemnity requirements for providers, resulted in restricted access for Australian women as many GPs ceased providing insertions. To date there is no published data on the use of this contraceptive implant in Australia. To identify trends in usage, continuation rates, side effects and acceptability of this method, a retrospective chart audit of clients attending Family Planning Queensland (FPQ) clinics for implant insertion and/or removal over a 5 year period was conducted. The audit examined1800 implant users from the two busiest FPQ clinics, one in a regional setting. Preliminary results from the audit indicate:- All age groups across the reproductive years are represented in the group. The major reason for removal is unacceptable bleeding patterns Many women have the device removed because they no longer require contraception. There have been no pregnancies identified with implants The last 2 years have seen significant numbers of women presenting for implant replacement, with these women providing valuable information on factors contributing to longer term acceptability of the method. This presentation will provide an analysis of the audit findings, particularly in relation to duration of use and implications for client acceptability of this contraceptive method. The information about Implanon� use in a clinical setting will be used to make recommendations on improvements in the appropriate selection and counselling of women considering this contraceptive method.
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Yang, Jenny M., Kate Cheney, Rebecca Taylor, and Kirsten Black. "Interpregnancy intervals and women’s knowledge of the ideal timing between birth and conception." BMJ Sexual & Reproductive Health 45, no. 4 (September 11, 2019): 249–54. http://dx.doi.org/10.1136/bmjsrh-2018-200277.
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BackgroundShort interpregnancy intervals (IPIs) are associated with adverse obstetric outcomes. However, few studies have explored women’s understanding of ideal IPIs or investigated knowledge of the consequences of short IPIs.MethodsWe performed a prospective questionnaire-based study at two hospitals in Sydney, Australia. We recruited women attending antenatal clinics and collected demographic data, actual IPI, ideal IPI, contraceptive use, and education provided on birth-spacing and contraception following a previous live birth. We explored associations between an IPI <12 months and a selection of demographic and health variables.ResultsData were collected from 467 women, of whom 344 were pregnant following a live birth. Overall, 72 (20.9%) women had an IPI <12 months only 7.5% of whom believed this was ideal, and the remaining stating their ideal IPI was over 12 months (52.3%) or they had no ideal IPI (40.3%). IPI <12 months following a live birth was significantly associated with younger age (p=0.043) but not with ethnicity, relationship status, education, religion, parity nor previous mode of delivery. IPI <12 months was associated with non-use of long-acting reversible contraception (LARC) (p<0.001), breastfeeding <12 months (p=0.041) and shorter ideal IPI (p=0.03). Less than half of the women (43.3%, n=149) reported having received advice about IPI and less than half about postnatal contraception (44.2%, n=147).ConclusionsYounger age and non-use of LARC are significantly associated with IPIs <12 months. A minority of women with a short IPI perceived it to be ideal. Prevention of short IPIs could be achieved with improved access to postnatal contraception.
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Yusuf, Farhat, and Dora K. Briggs. "Incidence of hysterectomy and tubal ligation in public hospitals in South Australia, 1980–82." Journal of Biosocial Science 20, no. 4 (October 1988): 453–59. http://dx.doi.org/10.1017/s0021932000017570.
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SummaryThis paper presents information on the incidence of hysterectomy and tubal ligation in South Australia in the period 1980–82, and on the age, marital status and ethnicity of women undergoing these procedures in public hospitals during the period. A typical woman undergoing one of these procedures was married or previously married and in her mid-40s for hysterectomy or mid-30s for tubal ligation. South Australian women had a lifetime chance of one in six of undergoing hysterectomy and of one in five of undergoing tubal ligation. The findings are consonant with the suggestion that increasing numbers of women are choosing forms of sterilization as means of contraception.
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Weisberg, Edith. "Practical Problems Which Women Encounter with Available Contraception in Australia." Australian and New Zealand Journal of Obstetrics and Gynaecology 34, no. 3 (June 1994): 312–15. http://dx.doi.org/10.1111/j.1479-828x.1994.tb01080.x.
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McEwan, Iain J. "Eve's curse: and the birth of the contraceptive pill." Biochemist 31, no. 2 (April 1, 2009): 16–20. http://dx.doi.org/10.1042/bio03102016.
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2010 sees the 50th anniversary of the introduction of the oral contraceptive pill in 1960. This development was made possible by the synthesis of the first orally active progestin some 9 years earlier. The contraceptive pill is the most popular means of family planning in developed countries, and arguably the most effective. It is the most common method of contraception in the USA (18%), Canada (14%), Australia (27%), New Zealand (20%) and most European countries, including the UK (26%)1. Reproductive health and success have in the past and continue today to be important contributors to our survival as a species. However, even from ancient times, there have been attempts to limit the effect of Eve's curse by reducing the number of children and spacing of successive pregnancies. However, it was only with advances in both scientific knowledge and understanding, together with social reforms, that information about birth control and the means to control fertility became widely available in the last century.
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Ngum Chi Watts, Mimmie C., Pranee Liamputtong, and Mary Carolan. "Contraception knowledge and attitudes: truths and myths among African Australian teenage mothers in Greater Melbourne, Australia." Journal of Clinical Nursing 23, no. 15-16 (September 13, 2013): 2131–41. http://dx.doi.org/10.1111/jocn.12335.
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McCarthy, Edwina, and Danielle Mazza. "Cost and Effectiveness of Using Facebook Advertising to Recruit Young Women for Research: PREFER (Contraceptive Preferences Study) Experience." Journal of Medical Internet Research 21, no. 11 (November 29, 2019): e15869. http://dx.doi.org/10.2196/15869.
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Background Social media is a popular and convenient method for communicating on the Web. The most commonly used social networking website, Facebook, is increasingly being used as a tool for recruiting research participants because of its large user base and its ability to target advertisements on the basis of Facebook users’ information. Objective We evaluated the cost and effectiveness of using Facebook to recruit young women into a Web-based intervention study (PREFER). The PREFER study aimed to determine whether an educational video could increase preference for and uptake of long-acting reversible contraception (LARC). Methods We placed an advertisement on Facebook over a 19-day period from December 2017 to January 2018, inviting 16- to 25-year-old women from Australia to participate in a Web-based study about contraception. Those who clicked on the advertisement were directed to project information, and their eligibility was determined by using a screening survey. Results Our Facebook advertisement delivered 130,129 impressions, resulting in over 2000 clicks at an overall cost of Aus $918 (Aus $0.44 per click). Web-based project information was accessed by 493 women. Of these, 462 women completed the screening survey, and 437 (437/463, 95%) women were eligible. A total of 322 young women participated in Surveys 1 and 2 (74% response rate), and 284 women participated in Survey 3 (88% retention rate), with an advertising cost of Aus $2.85 per consenting participant. Conclusions Facebook proved to be a quick, effective, and cost-efficient tool for recruiting young Australian women into a study that was investigating contraceptive preferences. However, Web-based recruitment may result in sociodemographic biases. Further research is required to evaluate whether Facebook is suitable for recruiting older study populations.
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Lewandowska, Milena, Richard De Abreu Lourenco, Marion Haas, Cathy J. Watson, Kirsten I. Black, Angela Taft, Jayne Lucke, et al. "Cost-effectiveness of a complex intervention in general practice to increase uptake of long-acting reversible contraceptives in Australia." Australian Health Review 45, no. 6 (2021): 728. http://dx.doi.org/10.1071/ah20282.
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ObjectiveThe aim of this study was to evaluate the cost-effectiveness of the Australian Contraceptive ChOice pRoject (ACCORd) intervention. MethodsAn economic evaluation compared the costs and outcomes of the ACCORd intervention with usual care (UC). Data from the ACCORd trial were used to estimate costs and efficacy in terms of contraceptive uptake and quality of life. Rates of contraceptive failure and pregnancy were sourced from the literature. Using a Markov model, within-trial results were extrapolated over 10 years and subjected to univariate sensitivity analyses. Model outputs were expressed as the cost per quality-adjusted life years (QALY) gained and cost per unintended pregnancy resulting in birth (UPB) avoided. ResultsOver 10 years, compared with UC, initiating contraception through the ACCORd intervention resulted in 0.02 fewer UPB and higher total costs (A$2505 vs A$1179) per woman. The incremental cost-effectiveness of the ACCORd intervention versus UC was A$1172 per QALY gained and A$7385 per UPB averted. If the start-up cost of the ACCORd intervention was removed, the incremental cost-effectiveness ratio was A$81 per QALY gained and A$511 per UPB averted. The results were most sensitive to the probability of contraceptive failure, the probability of pregnancy-related healthcare service utilisation or the inclusion of the costs of implementing the ACCORd intervention. ConclusionsFrom a health system perspective, if implemented appropriately in terms of uptake and reach, and assuming an implicit willingness to pay threshold of A$50 000 the ACCORd intervention is cost-effective. What is known about the topic?The uptake of long-active reversible contraceptives (LARC) in Australia is low. The ACCORd trial assessed the efficacy of providing structured training to general practitioners (GPs) on LARC counselling, together with access to rapid referral to insertion clinics. What does this paper add?This study is the first to assess the cost-effectiveness of a complex intervention in the general practice setting aimed at increasing the uptake of LARC in Australia. What are the implications for practitioners?The results show that implementing a complex intervention in general practice involving GP education and the availability of rapid referral to LARC insertion clinics is a cost-effective approach to increase LARC use and its attending efficacy. If the majority of Australian GPs were able to deliver effectiveness-based contraceptive counselling and either insert LARC or use a rapid referral process to a LARC insertion clinic, the additional cost associated with the purchase of LARC products and their insertion would be offset by reductions to health system costs as a result of fewer UPB and abortions. Moreover, the benefits to women’s physical and psychological health of avoiding such events is substantial.
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Turner, Rachel, Amanda Tapley, Sally Sweeney, Andrew Davey, Elizabeth Holliday, Mieke van Driel, Kim Henderson, et al. "Prevalence and associations of prescribing of long-acting reversible contraception by general practitioner registrars: a secondary analysis of ReCEnT data." BMJ Sexual & Reproductive Health 46, no. 3 (January 21, 2020): 218–25. http://dx.doi.org/10.1136/bmjsrh-2019-200309.
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ObjectiveLong-acting reversible contraception (LARC) is the most effective form of contraception but use in Australia is low. Uptake of LARC prescribing by early-career general practitioners (GPs) has important implications for community reproductive health. We aimed to investigate the prevalence and associations of Australian GP registrars’ LARC prescribing.MethodsA cross-sectional analysis of the Registrar Clinical Encounters in Training (ReCEnT) cohort study 2010–2017. GP registrars collected data on 60 consecutive consultations on three occasions during their training. The outcome factor was prescription of LARC (compared with non-LARC). A secondary analysis was performed with problems involving prescription of LARC (compared with other problems). Associations with patient, practice, registrar and consultation independent variables were assessed by univariate and multivariable logistic regression.Results1737 registrars recorded 5382 problems/diagnoses involving women aged 12–55 years in which contraception was prescribed. 1356 (25%) involved LARC. Significant multivariable associations of prescribing LARC included patient age (OR 2.85, 95% CI 3.17 to 3.74, for age 36–45 years compared with age 12–18 years), practice rurality - inner-regional (OR 1.47, 95% CI 1.22 to 1.79) and outer-regional/remote/very remote (OR 1.47 95% CI 1.15 to 1.87) compared with major cities, practices in areas of lower socioeconomic status (SES) (OR 0.93, 95% CI 0.91 to 0.96 for SES by decile), generating learning goals (OR 1.37, 95% CI 1.04 to 1.79), in-consultation assistance-seeking (OR 1.58, 95% CI 1.24 to 2.01), and the registrar having reproductive health-related postgraduate qualifications (OR 1.33, 95% CI 1.01 to 1.76).ConclusionsThe prevalence of LARC prescribing by Australian GP registrars is higher than has been previously estimated in established GPs. Postgraduate qualifications in reproductive health are associated with prescribing LARC. Prescribing practice differs according to rurality and relative socioeconomic disadvantage.
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Fraser, IS. "A review of the use of progestogen-only minipills for contraception during lactation." Reproduction, Fertility and Development 3, no. 3 (1991): 245. http://dx.doi.org/10.1071/rd9910245.
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Progestogen-only minipills and other systems for releasing low doses of progestogens alone are widely used for contraception in breast-feeding women around the world. There is good evidence to confirm their acceptability and their lack of effect on milk production, neonatal growth and early development. In contrast, combined oral contraceptives frequently decrease milk production, and may produce minor changes in milk composition. However, even combined oral contraceptives do not appear to produce adverse effects on neonatal well-being and development, although minor reductions in initial growth rate may sometimes occur. Progestogen-only methods may also produce subtle changes in milk composition, although less than combined oral contraceptives. Steroids are transferred from plasma into milk in small quantities, but the amounts are usually very low or insufficient to allow detection in the infants using present-day assays. There has been theoretical concern that these tiny amounts of steroids might affect neonatal reproductive development, but this appears to be unwarranted. Progestogen-only methods are being widely used for post-partum contraception, and they appear to have particular advantages in this situation. They also have few disadvantages; a theoretical concern about a possible effect on later reproductive or sexual development has no evidence to support it. The present licensing situation in Australia, which lists lactation as a relative contraindication to progestogen-only contraceptive use, causes real concern to potential users and appears to lead to frequent errors in compliance.
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Bateman, H. L., and W. F. Swanson. "163 RE-ESTABLISHING REPRODUCTIVE CYCLICITY IN A FEMALE ASIAN SMALL-CLAWED OTTER FOLLOWING SUPRELORIN-INDUCED CONTRACEPTION: A CASE STUDY." Reproduction, Fertility and Development 27, no. 1 (2015): 172. http://dx.doi.org/10.1071/rdv27n1ab163.
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Asian small-clawed otters (ASCO) are a popular species to exhibit in zoological institutions globally, and are found in managed populations in the United States, Europe, Asia, and Australia. Captive breeding of these otters is integral to population sustainability, with management programs using pedigree analyses to make specific breeding recommendations to ensure long-term genetic viability. Because of the familial social structure of ASCO and limited space within zoos, physical separation of animals is not always possible for temporary breeding prevention, and short-term contraception may be preferred. In US zoos, Suprelorin (deslorelin; Virbac Australia, Milperra, Australia), a GnRH agonist, has been recommended for contraception of female carnivores, due to its small implant size and lack of side effects often associated with hormone-based contraceptives. However, the duration of reproductive suppression with Suprelorin may be excessive and reversibility (i.e. resumption of cyclicity, ovulation, and pregnancies) in implanted females across a range of species has been variable, unpredictable, and prolonged. Since 2006, 49 female ASCO have been implanted with Suprelorin at least once, and, of these, only two females have shown confirmed reversibility with pregnancies. No ASCO females implanted more than once have thus far exhibited reversibility (personal communication, AZA Wildlife Contraceptive Center, St. Louis, MO, USA). In this case study, fecal hormone monitoring of one female ASCO implanted with Suprelorin three times (Dec 2007, Jan 2009, Mar 2010), showed a lack of ovarian cyclicity and ovulation during the three years since her last implant. In an attempt to induce ovarian follicular growth and ovulation, this female was injected (IM) with exogenous gonadotropins (100 IU of equine chorionic gonadotropin followed 80 h later with 3000 IU of porcine luteinizing hormone). Fecal progesterone monitoring confirmed ovulation followed by a 76 day pseudopregnancy, with temporal characteristics similar to those previously reported in naturally cycling ASCO (Bateman et al. 2009 Zoo Biol. 28, 107–126). Following the induced pseudopregnancy and ~55 days of basal progestin levels, this female was observed breeding with a cohabitating ASCO male. Fecal hormone monitoring revealed subsequent ovulation and the occurrence of another pseudopregnancy of normal duration. These preliminary findings suggest that exogenous gonadotropin treatment may be useful for promoting resumption of normal ovarian cyclicity and ovulatory responses in ASCO following prolonged reproductive suppression with Suprelorin.
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Garsia, Kathryn, Freya MacMillan, Tinashe Dune, and David Simmons. "The role of the pharmacist in contraception and pre-pregnancy management for women with diabetes: a study of patient and pharmacist perspectives." Journal of Pharmaceutical Health Services Research 12, no. 3 (April 20, 2021): 377–89. http://dx.doi.org/10.1093/jphsr/rmab019.
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Abstract Objectives Women with diabetes are at increased risk of adverse pregnancy outcomes compared to women with gestational diabetes (GDM) or no diabetes. Pregnancy outcomes are improved by specialist pre-pregnancy care. We aimed to explore pharmacists’ and women with diabetes’ perceptions of the roles and barriers to pharmacist participation in a diabetes contraception and pre-pregnancy program in South-Western Sydney (SWS). Methods The Diabetes Contraception and Pre-pregnancy Program (DCAPP) aims to reduce adverse pregnancy outcomes among women with diabetes. This includes awareness raising among, and through, pharmacists. Surveys to explore pharmacists’ roles in contraception and pre-pregnancy management (CPPM) were completed by SWS pharmacists and women with diabetes from diabetes clinics aged 18–50 years. Survey themes were then discussed in interviews and focus groups with pharmacists across Australia. Thematic analysis of transcripts was undertaken. Key findings Pharmacists were seen to have a role in diabetes health promotion, information distribution and referral to pre-pregnancy clinics. Pharmacists and women recognised the need for increased knowledge and educational materials about CPPM and effective awareness and coordination of CPPM services. Some pharmacists recognised deficits in their knowledge regarding diabetes in pregnancy, including CPPM and differences to GDM. Barriers to pharmacists’ involvement in CPPM included difficulty identifying applicable women and reluctance to initiate pregnancy planning and contraception conversations, often due to language and cultural barriers. Conclusions Pharmacists and women with diabetes see an important role for pharmacists in CPPM. Co-designed diabetes training for pharmacists and increased communication about DCAPP were seen important for ongoing implementation.
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Bell, Stephen, James Ward, Peter Aggleton, Walbira Murray, Bronwyn Silver, Andrew Lockyer, Tellisa Ferguson, et al. "Young Aboriginal people's sexual health risk reduction strategies: a qualitative study in remote Australia." Sexual Health 17, no. 4 (2020): 303. http://dx.doi.org/10.1071/sh19204.
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Background Surveillance data indicate that Aboriginal and Torres Strait Islander young people are more likely than their non-Indigenous counterparts to experience sexually transmissible infections (STIs) and teenage pregnancy. Despite increasing emphasis on the need for strengths-based approaches to Aboriginal sexual health, limited published data document how young Aboriginal people reduce sexual health risks encountered in their everyday lives. Methods: In-depth interviews with 35 young Aboriginal women and men aged 16–21 years in two remote Australian settings were conducted; inductive thematic analysis examining sexual health risk reduction practices was also conducted. Results: Participants reported individual and collective STI and pregnancy risk reduction strategies. Individual practices included accessing and carrying condoms; having a regular casual sexual partner; being in a long-term trusting relationship; using long-acting reversible contraception; having fewer sexual partners; abstaining from sex; accessing STI testing. More collective strategies included: refusing sex without a condom; accompanied health clinic visits with a trusted individual; encouraging friends to use condoms and go for STI testing; providing friends with condoms. Conclusion: Findings broaden understanding of young Aboriginal people’s sexual health risk reduction strategies in remote Aboriginal communities. Findings signal the need for multisectoral STI prevention and sexual health programs driven by young people’s existing harm minimisation strategies and cultural models of collective support. Specific strategies to enhance young people’s sexual health include: peer condom distribution; accompanied health service visits; peer-led health promotion; continued community-based condom distribution; enhanced access to a fuller range of available contraception in primary care settings; engaging health service-experienced young people as ‘youth health workers’.
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Lukies, Matthew William, and Ferheen Abbasi. "Difference in post-termination of pregnancy contraception practice among Australia, New Zealand and Japan." Journal of Obstetrics and Gynaecology Research 42, no. 8 (May 26, 2016): 1063. http://dx.doi.org/10.1111/jog.13044.
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Mazza, Danielle, Sharon James, Kirsten Black, Angela Taft, Deborah Bateson, Kevin McGeechan, and Wendy V. Norman. "Increasing the availability of long-acting reversible contraception and medical abortion in primary care: the Australian Contraception and Abortion Primary Care Practitioner Support Network (AusCAPPS) cohort study protocol." BMJ Open 12, no. 12 (December 2022): e065583. http://dx.doi.org/10.1136/bmjopen-2022-065583.
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IntroductionAlthough primary care practitioners are the main providers of long-acting reversible contraception (LARC) and early medical abortion (EMA) in Australia, few provide these services. A professional community of practice (CoP) has the potential to improve LARC and EMA provision through evidence-based guidance, expert support and peer-to-peer engagement.The primary objective is to establish, implement and evaluate an innovative, multidisciplinary online CoP (AusCAPPS Network) to increase LARC and EMA services in Australian primary care. Secondary objectives are to (1) increase the number of general practitioners (GPs) and pharmacists certified to provide or dispense EMA, respectively, (2) increase LARC and EMA prescription rates and, (3) improve primary care practitioners’ knowledge, attitudes and provision of LARC and EMA.Methods and analysisA stakeholder knowledge exchange workshop (KEW) will be conducted to inform the AusCAPPS Network design. Once live, we aim to reach 3000 GPs, practice nurses and community pharmacists members. Changes in the number of GPs and pharmacists certified to provide or dispense EMA, respectively, and changes in the number of LARCs and EMAs prescribed will be gleaned through health service data. Changes in the knowledge attitudes and practices will be gleaned through an online survey with 500 individuals from each professional group at baseline and 12 months after members have joined AusCAPPs; and experiences of the AusCAPPS Network will be evaluated using interviews with the project team plus a convenience sample of 20 intervention participants from each professional group. The project is underpinned by the Reach, Effectiveness, Adoption, Implementation and Maintenance framework, and a realist framework will inform analysis.Ethics and disseminationEthical approval was received from the Monash University Human Research Ethics Committee (No. 28002). Dissemination will occur through KEWs, presentations, publications and domestic and international networks.Trial registration numberACTRN12622000655741.
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Hendriks, Jacqueline, Sue Fyfe, Dorota A. Doherty, Angela Jacques, Irene Styles, Martha Hickey, and S. Rachel Skinner. "Attitudes towards abortion in male and female adolescents with diverse sexual and pregnancy experiences: a cross-sectional study." Sexual Health 17, no. 1 (2020): 77. http://dx.doi.org/10.1071/sh19084.
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Background Research focused on adolescents’ attitudes towards abortion is limited, and validated scales are not routinely used. A greater understanding of adolescents’ attitudes towards abortion could better inform the sexuality education strategies targeted at this age group. Methods: A cross-sectional survey was completed by 1470 adolescents (437 males, 1033 females) aged 12–19 years and living in Perth, Australia. Participants were recruited from secondary schools, antenatal clinics and termination clinics to capture varying experiences of sexual activity and pregnancy. Survey items investigated abortion attitudes, sexual behaviour and pregnancy history alongside other demographic and psychosocial factors. Analyses included comparative means and adjusted linear regressions. Results: Sexually active participants (n = 554) and females reporting a previous abortion (n = 196) held more supportive attitudes towards abortion (P < 0.001 for both). Among sexually active females, more supportive attitudes were held by those reporting a previous abortion (β = 2.60, 95% confidence interval 0.93–4.27, P = 0.002), later age (≥16 years) at first vaginal intercourse (P < 0.001), use of oral contraception at last sex (P = 0.029), previous condom use (P < 0.001) and/or three or more oral sex partners in the previous 12 months (P = 0.005). For sexually active males, more supportive attitudes were reported by those whose female partners had used oral contraception at last sex (P = 0.013) or ever (P = 0.017). Multivariable analyses indicated that other correlates, including risky sexual behaviour, had minimal or no effect on attitudes. Conclusions: Adolescents’ attitudes towards abortion appear to be influenced by their ability to personalise and contextualise the effect of a pregnancy. Associations between less-effective contraceptive use and reduced support for abortion may be explained by a diminished perceived risk of parenthood. Educational strategies should acknowledge and respond to differences in abortion attitudes as adolescents commence and navigate sexual relationships.
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Lohr, Cheryl A., Harriet Mills, Helen Robertson, and Roberta Bencini. "Deslorelin implants control fertility in urban brushtail possums (Trichosurus vulpecula) without negatively influencing their body-condition index." Wildlife Research 36, no. 4 (2009): 324. http://dx.doi.org/10.1071/wr08050.
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Wild brushtail possums (Trichosurus vulpecula) occur in large numbers in the grounds of Perth Zoo, Western Australia. These possums are a problem because they consume feed the zoo buys for its captive animals, damage seedlings and trees and many need to be treated for injuries sustained during fights with conspecifics. A contraceptive implant, which contains the gonadotrophin releasing hormone (GnRH) agonist deslorelin, could be a potential method of managing this population. We tested the efficacy of the implant and its impact on the body-condition index of treated possums with Kaplan–Meier analysis and a mixed model with residual maximum likelihood. We implanted 60 female possums with deslorelin and monitored reproductive success of treated and untreated possums for the following 18 months. At the conclusion of the study, 80% of 20 treated females recaptured had shown no evidence of breeding activity, giving an average minimum duration of effective contraception of 381 days. The implant did not have a negative impact on the body-condition index of treated possums during the course of the study. Our results suggest that deslorelin implants could be an effective management tool for brushtail possums at Perth Zoo and in other urban environments.
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Coulson, Graeme, Christopher D. Nave, Geoff Shaw, and Marilyn B. Renfree. "Long-term efficacy of levonorgestrel implants for fertility control of eastern grey kangaroos (Macropus giganteus)." Wildlife Research 35, no. 6 (2008): 520. http://dx.doi.org/10.1071/wr07133.
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Overabundant populations of kangaroos pose substantial management problems in small parks on the fringe of urban areas in Australia. Translocation is impractical and culling is often not publicly acceptable, but fertility control offers an acceptable alternative. One potential contraceptive is levonorgestrel, which provides effective long-term contraception in women, and prevents births in some marsupials for up to five years. We evaluated the long-term efficacy of levonorgestrel in free-ranging eastern grey kangaroos (M. giganteus) at two sites in Victoria, Australia. We trapped 25 adult females at one site (Portland Aluminium), treating 18 with two subcutaneous 70-mg levonorgestrel implants and seven with control (inert) implants. We darted 25 adult females at the other site (Woodlands Historic Park), treating all with two 70-mg levonorgestrel implants. We monitored the reproductive status of the kangaroos, as indicated by the obvious presence of a pouch young, in spring each year for up to seven years. In the first three years at Portland, 81–86% of levonorgestrel-treated females were infertile, compared with 12–29% in the control group, but the effectiveness of fertility control declined over time. At this site, the proportions of treated females breeding in the fourth, fifth, sixth and seventh years of the trial were 36%, 50%, 67% and 100% respectively. Fecundity at Woodlands was similar. Although this protocol achieved fertility control for several years, it was likely that more than one treatment or a higher dose rate would be required for effective fertility control in this long-lived species.
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Hussainy, Safeera Y., Kay Stewart, and My-Phuong Pham. "A mystery caller evaluation of emergency contraception supply practices in community pharmacies in Victoria, Australia." Australian Journal of Primary Health 21, no. 3 (2015): 310. http://dx.doi.org/10.1071/py14006.
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The aim of this study was to determine supply practices of Victorian community pharmacies in relation to the emergency contraceptive pill (ECP), following release of an updated guideline by the Pharmaceutical Society of Australia. Telephone call scripts were developed for three scenarios in which the ECP was requested: outside the licensed 72-h time frame (Scenario 1); by a woman under 16 years (Scenario 2); and for future use (Scenario 3). From 1222 pharmacies, 515 were randomly selected and allocated into three groups: 177 to Scenario 1 and 169 to each of Scenarios 2 and 3. Pharmacists’ responses were categorised as ‘yes’, ‘no’ or ‘ambiguous’ and descriptive statistics were calculated. The results are as follows. Scenario 1: over half (55.4%; 92/166) declined supply and most referred to the doctor, citing the time frame or the ECP as no longer being effective reasons. Decreased effectiveness was readily discussed among those willing to supply. Scenario 2: more than half (53.9%, 89/165) agreed to supply, assessing the request against eligibility criteria outlined in the guideline; however, 5.6% (5/89) were only willing if the woman obtained a doctor’s prescription or recommendation. Scenario 3: less than half (40.5%; 66/163) declined supply, mainly due to no therapeutic need. Only four respondents willing to give the ECP knew that supply was bona fide. In conclusion, pharmacists’ practices are variable and not always in line with the recommendations of the Pharmaceutical Society of Australia guideline. Pharmacists’ awareness of the guideline needs to be raised so women can unobtrusively access the ECP.
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Mazza, Danielle, Christopher M. Harrison, Angela J. Taft, Helena C. Britt, Melissa Hobbs, Kay Stewart, Safeera Hussainy, and Bianca R. Brijnath. "Emergency contraception in Australia: the desired source of information versus the actual source of information." Medical Journal of Australia 200, no. 7 (April 2014): 414–15. http://dx.doi.org/10.5694/mja13.10983.
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Ding, Jacqueline, Henrietta Williams, Jane S. Hocking, and Jacqueline Coombe. "Requesting early removal of long-acting reversible contraception: a qualitative study exploring the experiences of doctors working in primary care." Australian Journal of Primary Health 27, no. 6 (2021): 467. http://dx.doi.org/10.1071/py21054.
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Long-acting reversible contraceptives (LARC) are the most effective contraceptive methods available in Australia and are effective for between 3 and 8 years. Early LARC removal (<12 months of use) can lead to gaps in contraceptive cover, exposing women to the risk of unplanned pregnancy. This study explored the experiences of doctors working in primary care (GPs and sexual health physicians) when asked to remove LARC earlier than expected. From May to July 2020, 13 doctors in Melbourne, Australia, were interviewed. Overall, participants felt conflicted about early LARC removal requests; participants highlighted the importance of respecting patient autonomy, but many felt that patients should ideally persist with LARC longer. Participants found balancing a desire to respect patients’ autonomy with their clinical responsibility challenging. Doctors used reassurance, delaying tactics and treatment of side effects to try and prolong LARC use. However, this balancing act led many doctors to perceive a tension between themselves and their patients when early LARC removal was requested. Incorporating professional education addressing these issues may help primary care providers better anticipate and navigate the tension surrounding early LARC removal consultations and maintain effective doctor–patient relationships.
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Douglass, Caitlin H., Can Qin, Fran Martin, Yinzong Xiao, Carol El-Hayek, and Megan SC Lim. "Comparing sexual behaviours and knowledge between domestic students and Chinese international students in Australia: findings from two cross-sectional studies." International Journal of STD & AIDS 31, no. 8 (June 3, 2020): 781–90. http://dx.doi.org/10.1177/0956462420921726.
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Few studies investigate sexual health among Chinese international students in Australia. We recruited domestic (n = 623) and Chinese international (n = 500) students for separate online surveys on sexual behaviours and knowledge. Samples were compared using Chi square, Fisher’s exact and equality of medians tests. Domestic students were more likely than international students to have ever touched a partner’s genitals (81% vs. 53%, p < 0.01), had oral sex (76% vs. 44%, p < 0.01), vaginal intercourse (67% vs. 41%, p < 0.01) and anal intercourse (31% vs. 6%, p < 0.01). Domestic students were younger when they first touched a partner’s genitals (16 vs. 18 years, p < 0.01), had oral sex (17 vs. 18 years, p < 0.01) and vaginal intercourse (17 vs. 18 years, p < 0.01). Domestic students were less likely than Chinese international students to report only one lifetime partner for touching genitals (22% vs. 50%, p < 0.01), oral sex (25% vs. 55%, p < 0.01), vaginal intercourse (30% vs. 58%, p < 0.01) and anal intercourse (54% vs. 88%, p < 0.01). Domestic students were more likely than Chinese international students to use the oral contraceptive pill (48% vs. 16%, p < 0.01) and long-acting reversible contraceptives (19% vs. 1%, p < 0.01). Domestic students scored higher than international students on a contraception and chlamydia quiz (4/5 vs. 2/5, p < 0.01). Domestic and Chinese international students differed in sexual behaviours and knowledge highlighting the need for relevant sexual health promotion for both groups.
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Rogers, Claire, and Jaya Earnest. "A Cross-Generational Study of Contraception and Reproductive Health Among Sudanese and Eritrean Women in Brisbane, Australia." Health Care for Women International 35, no. 3 (December 18, 2013): 334–56. http://dx.doi.org/10.1080/07399332.2013.857322.
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Dorney, E., J. R. Botfield, S. Robertson, K. McGeechan, and D. Bateson. "Acceptability of the copper intrauterine device as a form of emergency contraception in New South Wales, Australia." European Journal of Contraception & Reproductive Health Care 25, no. 2 (February 19, 2020): 114–19. http://dx.doi.org/10.1080/13625187.2020.1726888.
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Junaidi, A., P. E. Williamson, J. M. Cummins, G. B. Martin, M. A. Blackberry, and T. E. Trigg. "Use of a new drug delivery formulation of the gonadotrophin-releasing hormone analogue Deslorelin for reversible long-term contraception in male dogs." Reproduction, Fertility and Development 15, no. 6 (2003): 317. http://dx.doi.org/10.1071/rd03039.
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In the present study, we tested the effect of treatment with a slow-release implant containing the gonadotrophin-releasing hormone agonist DeslorelinTM (Peptech Animal Health Australia, North Ryde, NSW, Australia) on pituitary and testicular function in mature male dogs. Four dogs were treated with Deslorelin (6-mg implant) and four were used as controls (blank implant). In control dogs, there were no significant changes over the 12 months of the study in plasma concentrations of luteinising hormone (LH) or testosterone, or in testicular volume, semen output or semen quality. In Deslorelin-treated dogs, plasma concentrations of LH and testosterone were undetectable after 21 and 27 days, testicular volume fell to 35% of pretreatment values after 14 weeks and no ejaculates could be obtained after 6 weeks. Concentrations returned to the detectable range for testosterone after 44 weeks and for LH after 51 weeks and both were within the normal range after 52 weeks. Semen characteristics had recovered completely by 60 weeks after implantation. At this time, the testes and prostate glands were similar histologically to those of control dogs. We conclude that a single slow-release implant containing 6 mg Deslorelin has potential as a long-term, reversible antifertility agent for male dogs.
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Taylor, Rebecca Alexandra Margaret, Jenny M. Yang, Kate Cheney, and Kirsten Black. "Short interpregnancy interval: circumstance or choice?" BMJ Sexual & Reproductive Health 48, no. 2 (October 14, 2021): 110–16. http://dx.doi.org/10.1136/bmjsrh-2021-201269.
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IntroductionDespite the knowledge of pregnancy risks attributable to inadequate birth spacing, over one-third of pregnancies occur within 18 months of a preceding birth. In this qualitative study we sought to interview women with a short interpregnancy interval (sIPI) to explore their knowledge of contraception and birth spacing and their experience of counselling on these themes.MethodsWe conducted in-depth interviews with women with a sIPI (live-birth less than 18 months prior to conception of current pregnancy) at Royal Prince Alfred Hospital and Canterbury Hospital in Sydney, Australia. Women were recruited at the second antenatal visit or day 3 postpartum. Interviews were recorded and transcribed. The six-phase thematic analysis framework described by Braun and Clarke was used to perform qualitative data analysis.ResultsTwenty women were interviewed (IPI range: 3–18 months). The three central themes that arose were that perceptions of IPIs are shaped by individual circumstances, a lack of information from healthcare providers (HCPs) on IPI and contraception limited women’s ability to make informed decisions, and that reproductive life planning is an important element of pregnancy care.ConclusionsIn this study, women with a sIPI did not feel informed about birth spacing, had poor knowledge of reliable contraceptives, and remained at risk of further closely spaced pregnancies. There was a desire among women with a sIPI to receive clear and consistent education on these topics. HCPs need to do more to educate women in the antenatal and postnatal period to help them space their pregnancies appropriately.
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Botfield, Jessica, Melanie Tulloch, Hannah Contziu, Deborah Bateson, Hala Phipps, Sarah Wright, Kevin McGeechan, and Kirsten Black. "Who is responsible for postpartum contraception advice and provision? The perspective of hospital-based maternity clinicians in NSW, Australia." Women and Birth 35 (September 2022): 3. http://dx.doi.org/10.1016/j.wombi.2022.07.009.
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Callegari, Emma T., Suzanne M. Garland, Alexandra Gorelik, Cherie Y. Chiang, and John D. Wark. "Bone turnover marker determinants in young women: results from the Safe-D study." Annals of Clinical Biochemistry: International Journal of Laboratory Medicine 55, no. 3 (December 21, 2017): 328–40. http://dx.doi.org/10.1177/0004563217719734.
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Background Bone turnover markers (BTMs) may provide insight into bone health in young women, but have been little studied in this demographic. We aimed to explore the association between body composition, hormonal contraception, bone mineral density and biochemical parameters and BTMs in young women. Methods Participants were community-dwelling females aged 16–25 years, living in Victoria, Australia. Carboxy-terminal cross-linking telopeptide of type 1 collagen (CTX) and total procollagen type 1 N-propeptide (P1NP) were analysed on the Roche Elecsys automated analyzer. A total of 305 were evaluated, after excluding participants with medical conditions or medications (except hormonal contraceptives), which may affect bone metabolism. Results Median (Q1, Q3) BTM values were 540 (410, 690) ng/L for CTX and 61.7 (46.2, 83.7) µg/L for P1NP. Serum CTX and P1NP were inversely associated with chronological age ( P < 0.001), transferrin ( P < 0.020) and serum dehydroepiandrosterone sulphate concentration ( P < 0.001). BTM values were up to 22% lower in combined oral contraceptive (COC) pill users ( P < 0.001). Serum CTX was inversely associated with per cent body fat ( P = 0.009) and tibial cortical volumetric bone mineral density (vBMD; P = 0.003). Serum P1NP concentrations were 23 µg/L higher in participants who reported using an osteopath in the previous year ( P = 0.007). Conclusions These data suggest that BTMs are influenced by age, COC use, body composition, iron status and hormonal profiles. Higher CTX values were associated with lower tibial cortical vBMD. Examining BTMs in relation to interventions aimed at improving bone health in young women is warranted.
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Short, R. V. "Opinion: The future fertility of mankind: effects on world population growth and migration." Reproduction, Fertility and Development 13, no. 6 (2001): 405. http://dx.doi.org/10.1071/rd01107.
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The world’s population, currently just over 6 billion, is projected to increase to 9–10 billion by the year 2050. Most of this growth will occur in the developing countries of Asia, where there is an enormous unmet demand for contraception, while an increasing number of developed countries will have declining populations. The human immunodeficiency virus (HIV) pandemic will target developing countries, with India destined to become its new epicenter. By 2050, there may be 1 billion HIV-infected people in the world. The significant protective effect of male circumcision may spare Islamic countries, such as Pakistan, Bangladesh, Iran and Indonesia, from the worst effects of the pandemic. Australia will be increasingly threatened by the high rates of population growth of her Asian neighbours. This, coupled with political instability and sea-level rises as a consequence of global warming, will turn the present trickle of refugees from a variety of Asian countries seeking safe haven on our sparsely populated northern coastline into a veritable flood. There will come a time when we have neither the manpower, nor the means, nor even the moral right to intercept, detain or repatriate the thousands who will come in peace, in search of a better life. However, if Australia is to stabilize its future population at around 23 million, which seems highly desirable on ecological grounds, then the net immigration rate must be limited to approximately 50000 people per year. Because the final point of departure for all these refugees is Indonesia, it is essential that Australia maintains good relations with Indonesia, so that together we can attempt to manage the refugee problem. However, Indonesia’s own population is destined to increase by 100 million in the next 50 years, which will only exacerbate the situation. Australia would be well advised to make a major increase in its paltry financial assistance to Indonesia’s excellent family planning programmes, which are currently starved of funds. Helping Indonesia to contain its population growth is Australia’s best long-term investment for its own future.
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Cooper, DW. "Should immunocontraception be used for wildlife population management?" Australian Mammalogy 26, no. 1 (2004): 61. http://dx.doi.org/10.1071/am04061.
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Immunocontraception involves eliciting an immune response against eggs, sperm or hormones so that successful reproduction is prevented. Work in Australasia is aimed at European rabbits (Oryctolagus cuniculus), red foxes (Vulpes vulpes), house mice (Mus musculus), common brushtail possums (Trichosurus vulpecula), koalas (Phascolartcos cinereus) and kangaroos (Macropus spp.), with the vaccines involved all containing self antigens or their relatives. Two fundamental problems have been inadequately addressed in this research. The first problem is that it is difficult to obtain strong immune responses against self antigens and so the vaccines may be ineffective. Most published data on the effect of immunocontraceptives on reproduction involve the use of an adjuvant of which there are many kinds. The materials enhance the immune response greatly. The most frequently used is Freund?s adjuvant which can cause chronic suffering. Its use on wildlife will lead to very negative public perceptions. There has been no convincing demonstration that successful immunocontraception is possible with any method of vaccination likely to be used in the field, if success is defined as contraception of a proportion of the population high enough for management requirements. If it is assumed that success can be achieved, the second fundamental problem arises with two potential consequences. Even with adjuvant, a substantial minority of the vaccinated animals remains fertile. The first consequence is that since failure to be contracepted is likely to be in part genetic, there is likely to be rapid selection for these non-responders. The method will become ineffective in a few generations. The second problem is that the offspring of the animals which breed will have altered immune responses. Their capacities to respond to their own pathogens or to harbor pathogens of other species in the same ecosystem are likely to be changed. The presence of chlamydia in P. cinereus and bovine tuberculosis in New Zealand T. vulpecula means that responses to these pathogens would have to be studied in offspring of immunocontracepted parents to ensure that the offspring were not more susceptible to them. New Zealand intentions to put an immunocontraceptive into a T. vulpecula gut worm must be viewed with caution by Australia. The eggs of transgenic worms will be easily transplanted either accidentally or deliberately back into Australia, and so infect T. vulpecula in Australia.
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Harris, Melissa L., Nicholas Egan, Peta M. Forder, Jacqueline Coombe, and Deborah Loxton. "Contraceptive use among women through their later reproductive years: Findings from an Australian prospective cohort study." PLOS ONE 16, no. 8 (August 11, 2021): e0255913. http://dx.doi.org/10.1371/journal.pone.0255913.
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Objective Examine patterns of contraceptive use and contraceptive transitions over time among an Australian cohort of women through their later reproductive years. Study design Latent Transition Analysis was performed using data on 8,197 women from the Australian Longitudinal Study on Women’s Health’s 1973–78 cohort to identify distinct patterns of contraceptive use across 2006, 2012 and 2018. Women were excluded from the analysis at time points where they were not at risk of an unintended pregnancy. Latent status membership probabilities, item-response probabilities, transitions probabilities and the effect of predictors on latent status membership were estimated and reported. Results Patterns of contraceptive use were relatively consistent over time, particularly for high efficacy contraceptive methods with 71% of women using long-acting reversible contraceptives in 2012 also using long-acting reversible contraceptives in 2018. Multiple contraceptive use was highest in 2006 when women were aged 28–33 years (19.3%) but declined over time to 14.3% in 2018 when women were aged 40–45 years. Overall, contraceptive patterns stabilised as the women moved into their late 30s and early 40s. Conclusions Although fertility declines with age, the stability of contraceptive choice and continued use of short-acting contraception among some women suggests that a contraceptive review may be helpful for women during perimenopause so that they are provided with contraceptive options most appropriate to their specific circumstances.
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Suha, Mariyam, Linda Murray, Deborah Warr, Jasmin Chen, Karen Block, Adele Murdolo, Regina Quiazon, Erin Davis, and Cathy Vaughan. "Reproductive coercion as a form of family violence against immigrant and refugee women in Australia." PLOS ONE 17, no. 11 (November 3, 2022): e0275809. http://dx.doi.org/10.1371/journal.pone.0275809.
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Reproductive coercion (RC), generally considered a form of intimate partner violence (IPV), refers to perpetrator behaviours and actions that are intended to interfere with and control the autonomous decision-making of a person regarding their reproductive health. To date there are few studies that document RC as experienced by immigrant and refugee women. In this article, we explore cases of RC as described by women who were part of a larger qualitative study investigating violence against immigrant and refugee women in southern Australia. The study aimed to identify the types of RC detailed in immigrant and refugee women’s narratives, and to illustrate the contexts in which these experiences occurred. Analysis followed Baxter and Jack’s (2008) case study methodology; whereby particular “cases” are used to describe a phenomenon in context. Thirteen women from seven countries described experiences that fit definitions of RC. The cases describe various types of RC including violence during pregnancy with the intent of causing miscarriage, forced abortion, contraception sabotage and forced pregnancy. As well as intimate partners, some women described multiple perpetrators being complicit in their experience of RC, especially in regard to controlling women’s access to, and interactions with health services. More information is needed about immigrant and refugee women’s experiences of RC, and how vulnerability to multi-perpetrator violence affects health service access. In particular knowledge about how multi-perpetrator RC can affect consent processes for women who already face barriers to health care requires attention. Further research is required to address knowledge gaps about appropriate prevention and advocacy work about RC in refugee and migrant communities, and what training is needed for professionals in the family violence sector, women’s health services, women’s organisations, multicultural and ethno-specific services.
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Wigginton, Britta, Melissa L. Harris, Deborah Loxton, Danielle Herbert, and Jayne Lucke. "The feminisation of contraceptive use: Australian women’s accounts of accessing contraception." Feminism & Psychology 25, no. 2 (December 18, 2014): 178–98. http://dx.doi.org/10.1177/0959353514562802.
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McKelvey, Robert S., John A. Webb, Loretta V. Baldassar, Suzanne M. Robinson, and Geoff Riley. "Sex Knowledge and Sexual Attitudes Among Medical and Nursing Students." Australian & New Zealand Journal of Psychiatry 33, no. 2 (April 1999): 260–66. http://dx.doi.org/10.1046/j.1440-1614.1999.00549.x.
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Objectives: The aim of this study was to assess the relationship between background and sociodemographic variables, attitudes toward controversial aspects of human sexuality and sex knowledge among medical and nursing students. Method: The study design was a questionnaire-based survey of medical and nursing students in Western Australia. Participants were first-through fifth-year medical students at the University of Western Australia and first-through third-year undergraduate nursing students at Edith Cowan University. Outcome measures were students' attitudes toward controversial aspects of human sexuality expressed on a five-point Likert scale and a modified version of the Kinsey Institute/Roper Organization National Sex Knowledge Test. Results: A significant relationship was found between certain background and sociodemographic variables, sexual attitudes and sex knowledge. The background variable most strongly related to both attitudes and knowledge was frequency of attendance at religious services of any religious denomination during the past month, with those attending three or more times more likely to express negative attitudes and have lower sex knowledge scores. Lower sex knowledge was related to negative attitudes toward gay/lesbian/bisexual behaviour, masturbation, premarital sex and contraception. Other important background and sociodemographic variables related to negative attitudes were: never having experienced sexual intercourse; right-wing political orientation; lower family income; gender and ethnicity. Conclusions: Negative attitudes toward controversial aspects of human sexuality and lower sex knowledge scores among medical and nursing students can be predicted on the basis of background and sociodemographic variables. Education aimed at increasing sex knowledge and modifying negative attitudes may increase students' ability to function more effectively as sexual history takers and sex counsellors.
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Fenwick, Sarah E., Jessica R. Botfield, Prudence Kidman, Kevin McGeechan, and Deborah Bateson. "Views and experiences of the female condom in Australia: An exploratory cross-sectional survey of cisgender women." PLOS ONE 16, no. 2 (February 19, 2021): e0246664. http://dx.doi.org/10.1371/journal.pone.0246664.
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Background The female condom is the only female-initiated form of protection against unintended pregnancy and sexually transmissible infections (STIs). However, use of this method in Australia is low. To better understand women’s views and experiences of the female condom, we conducted an interventional cross-sectional study. Methods Cisgender women ≥16 years, heterosexually active and living in New South Wales were recruited through social media advertisements and email invitations to clients of a family planning service. Eligible participants were provided with three female condoms and invited to complete a follow-up survey. Survey responses for women who attempted to use at least one female condom were summarised using counts and proportions. Results We recruited 556 women; few (30/556) had used the female condom before the study. There were 284 women who used, or attempted to use, a female condom during the study and completed the follow-up survey. Fifty-one percent (104/205) reported experiencing some difficulty in insertion, although only 46% (130/284) had seen an instructional demonstration. Approximately half (105/204) of women rated the sensation and comfort of the female condom as the same or better than the male condom, and 66% (137/204) reported that it provided the same or better lubrication. Approximately half of women said they would consider using the female condom again for STI prevention (51% (133/260)) or contraception (40% (103/260)), or would recommend to others (43% (112/260)). Conclusion Findings highlight the need for increased health promotion and education regarding use of the female condom. To increase access it will be important to address method cost and availability in Australia. Future research should explore other perspectives of this method, including among the LGBTIQ+ community.
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Bauleni, Esther M., Leesa Hooker, Hassan P. Vally, and Angela Taft. "Intimate-partner violence and reproductive decision-making by women attending Victorian Maternal- and Child-Health services: a cross-sectional study." Australian Journal of Primary Health 24, no. 5 (2018): 422. http://dx.doi.org/10.1071/py17183.
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The reproductive years are a critical period where women experience greater risk of intimate-partner violence (IPV). Most studies investigating the association between IPV and reproductive health have been completed in low- and middle-income countries. This study aimed to examine the relationship between IPV and women’s reproductive decision-making in Victoria, Australia. We analysed secondary data from a cluster-randomised trial of IPV screening that surveyed new mothers attending Maternal- and Child-Health centres in Melbourne. Survey measures included the experience of partner abuse in the past 12 months using the Composite Abuse Scale and four reproductive decision-making indicators. Results showed that IPV affects reproductive decision-making among postpartum women. Women who reported abuse were less likely to plan for a baby (adjusted Odds Ratio 0.48, 95% CI: 0.31–0.75) than were non-abused women, significantly more likely to have partners make decisions for them about contraception (Risk ratio (RR) 4.09, 95% CI: 1.31–12.75), and whether and when to have a baby (RR 12.35, 95% CI: 4.46–34.16), than they were to make decisions jointly. Pregnant and postpartum women need to be screened for partner violence that compromises women’s decision-making power regarding their reproductive rights.
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Jenkinson, Rebecca, Anna Bowring, Paul Dietze, Margaret Hellard, and Megan S. C. Lim. "Young Risk Takers: Alcohol, Illicit Drugs, and Sexual Practices among a Sample of Music Festival Attendees." Journal of Sexually Transmitted Diseases 2014 (December 14, 2014): 1–6. http://dx.doi.org/10.1155/2014/357239.
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Background. Alcohol and other drug use and sexual risk behaviour are increasing among young Australians, with associated preventable health outcomes such as sexually transmissible infections (STIs) on the rise. Methods. A cross-sectional study of young people’s health behaviours conducted at a music festival in Melbourne, Australia, in 2011. Results. 1365 young people aged 16–29 completed the survey; 62% were female with a mean age of 20 years. The majority (94%, n=1287) reported drinking alcohol during the previous 12 months; among those, 32% reported “binge” drinking (6+ drinks) at least weekly. Half (52%) reported ever using illicit drugs and 25% reported past month use. One-quarter (27%) were identified as being at risk of STIs through unprotected sex with new or casual partners during the previous 12 months. Multivariable analyses found that risky sexual behaviour was associated with younger age (≤19 years), younger age of sexual debut (≤15 years), having discussed sexual health/contraception with a doctor, regular binge drinking, and recent illicit drug use. Conclusion. Substance use correlated strongly with risky sexual behaviour. Further research should explore young people’s knowledge of alcohol/drug-related impairment and associated risk-taking behaviours, and campaigns should encourage appropriate STI testing among music festival attendees.