ABSTRACT
The coronavirus 19 (COVID-19) pandemic has negatively impacted family planning services worldwide. There are no published reports from Jordan on the impact of COVID-19 pandemic on family planning methods. This was a web-based cross-sectional study between September and December 2020 with 519 participants; of these 43.5% did not use any method. The most used methods were intrauterine devices, coitus interruptus and male condoms. Furthermore, 38.2% of women changed methods due to limited access to services and non-availability of methods. While 82.1% of women preferred modern methods before the pandemic, 79.7% became more acceptant of traditional methods. Moreover, 35.3% of women got pregnant during the curfew, and 90% were unplanned with a statistically significant higher rate in women who changed their routine method, accepted traditional methods, have been married for less than 10 years and multiparous women. National health policy makers should consider the impact of large-scale pandemics on family planning services.IMPACT STATEMENTWhat is already known on this subject? Family planning services in Jordan have improved significantly over the last decade because of accessibility and availability of a wide range of contraceptive methods. Available methods are either traditional or modern. Because of the high failure rates of traditional methods, public health family planning programmes promote modern methods.What do the results of this study add? There are no published reports from Jordan on the impact of COVID-19 pandemic and curfew on family planning methods. This study aims to report on what family planning methods women used during the pandemic, reporting if women changed their preferred methods and the reasons, assess women's knowledge about the natural methods of family planning which is probably an alternative method in situations where services and accessibility to more effective methods are limited and estimate unplanned pregnancies.What are the implications of these findings for clinical practice and/or further research? National health policy makers should consider the impact of large-scale pandemics on family planning services. Additionally, the implementation of telehealth and home delivery of self-administered methods should be considered. Natural methods of contraception may be an option when access and availability to modern methods is limited.
Subject(s)
COVID-19 , Pandemics , COVID-19/epidemiology , COVID-19/prevention & control , Contraception/methods , Contraception Behavior , Cross-Sectional Studies , Family Planning Services , Female , Humans , Jordan/epidemiology , Male , Pandemics/prevention & control , PregnancyABSTRACT
PURPOSE: Our study aimed to evaluate the acceptability, adverse effects and continuation rates among adolescents who accepted the etonogestrel (ENG) subdermal implant and compared to adolescents who chose other methods during the immediate postpartum period before hospital discharge, with one year follow-up up. MATERIALS AND METHODS: We conducted a cohort non-randomised study at the Women's Hospital, University of Campinas. All women up to 19 years of age, who gave birth at the hospital between July 2019 and April 2020, were invited to participate and were offered the ENG-implant or the routine contraceptive methods. They were followed for one year postpartum. RESULTS: We included 100 teenagers and 72 accepted the ENG-implant. Students are more likely to accept the ENG-implant than non-students (PR: 1.25 [95%CI 0.99-1.59]). Up to one year of follow-up, survival analysis showed that the time of adherence to the method was longer for the ENG-implant users (p = 0.0049). More than 90% of the adolescents were satisfied with the implant; however, five requested early removal due to menstrual irregularity and local discomfort. CONCLUSION: Provision ENG-implant for adolescents in the immediate postpartum demonstrated high acceptance and ensured effective contraception. After one year, most of them were satisfied, with a high continuation rate and without unplanned pregnancies.
ABSTRACT
This study was conducted to determine the incidence of unplanned pregnancies and the factors affecting it during the COVID-19 pandemic. An analytical-cross-sectional study was carried out at a public hospital in Aydin, Turkey between January and October 2021. The sample of the study comprised 220 pregnant women. The data was collected with a Pregnant Information Form, and the Pearson Chi-square test and Binary Logistic Regression analysis were employed in the analysis. It was determined that the incidence of unplanned pregnancy during the COVID-19 pandemic was 33.6% and that number of living children [AOR:0.73, 95% CI:(0.23-0.99)], thought of having another child [AOR:1.21, 95% CI:(1.43-7.89)], the family planning method used [AOR:1.31, 95% CI:(1.05-5.22)], and having problems in reaching a family planning method [AOR:1.97, 95% CI:(0.04-0.50)] affected the occurrence of unplanned pregnancies (p < .05). IMPACT STATEMENTWhat is already known on this subject? Unplanned pregnancies adversely affect maternal and newborn health.What do the results of this study add? It was found that approximately one out of three pregnancies during the COVID-19 pandemic process was unplanned and that the number of living children, the thought of having another child, the family planning method used, and having problems in obtaining a family planning method affected the occurrence of unplanned pregnancies.What are the implications of these findings for clinical practice and/or further research? It can guide politicians in the arrangements regarding sexual and reproductive health services during the COVID-19 pandemic.
ABSTRACT
Introduction The COVID-19 pandemic has shifted services offered in clinic online, with some local authorities starting to offer Emergency Hormonal Contraception (EHC) through a sexual health e-service. After completing an online, asynchronous consultation, EHC could be delivered or collected in pharmacy. Method Retrospective analysis of 12,016 EHC consultations completed between 1st January 2021 and 31st December 2021, from 11 local authority areas in London. Age, ethnicity, and deprivation deciles were used to identify demographic trends. Results The majority of EHC consultations were completed by 25-34 year olds (41.0%, n=4922). 53.4% (n=6422) of consultations were completed by users from the bottom 3 deciles of deprivation. 74.6% (n=8967) of consultation were from racially minoritised groups. Amongst 16-17 year olds and 35-44 year olds, the majority of consultations were completed by users in the bottom 3 deciles of deprivation (58.5% (n=197) and 58.6% (n=495) respectively). 66.2% (n=1289) of Black African women were from the bottom 3 deciles of deprivation, as were 58.6% (n=1498) of Black Caribbean women and 46.4% (n=1416) of White British women. 53.1% (n=1033) of Black African women, 54.3% (n1388) of Black Caribbean women, and 47.1% (n=1435) of White British women, were 16-24 years old. Discussion The majority of individuals accessing online EHC are young and racially minoritised, experiencing significant levels of deprivation. This approach to helping users access online EHC could help reduce unintended pregnancies and mitigate health inequalities. Local authorities could consider whether an online EHC service would help in their local area.
ABSTRACT
Introduction The COVID-19 pandemic has moved some health services, such as contraception, online. Eleven local authorities in London enrolled for a routine contraception (RC) e-service. After completing an online, asynchronous consultation, RC could be delivered or collected in pharmacy. Method Retrospective analysis of 10,525 RC consultations completed between 1st January 2021 and 31st December 2021, from 11 local authorities in London. Age, ethnicity and deprivation decile were used to identify demographic trends. Results The majority of RC consultations were completed by 25-34 year olds (47.9%, n=5042). The majority (61.2%, n=6442) of consultations were completed by users in the lower deciles 2-4. 66.7% (n=7021) of consultations were completed by users from ethnic minority groups. In 16-17 year olds and 35-44 year olds, the majority of RC consultations were completed by users in the bottom 3 deciles of deprivation (55.5% (n=146) and 55.8% (n=383) respectively). 68% (n=607) of Black African women were from the bottom 3 deciles of deprivation, as were 59.5% (n=606) of Black Caribbean women as compared to 40.6% (n1432) of White British women. 46.1% (n=412) of Black African women, 51.9% (n=576) of Black Caribbean women, and 45.5% (n=1595) of White British women, were 16-24 years old. Discussion The majority of individuals accessing RC online are young and racially minoritised, experiencing significant levels of deprivation. An online RC service can reach populations with the poorest sexual health outcomes, reduce unintended pregnancies and help reduce health inequalities. Local authorities could consider whether an online RC service would help in their area.
ABSTRACT
Introduction The COVID-19 pandemic presented challenges to delivery of reproductive health services. To explore effects, we examined patterns of contraceptive use, service access and pregnancy planning in the year following the first UK lockdown. Methods The Natsal-COVID Wave 2 survey was conducted in March-April 2021, one year after the first lockdown began in Britain. We analysed a subset of sexually-active participants aged 18-44 years and described as female at birth. We estimated differences in outcomes by age and markers of vulnerability. We examined changing contraception use, access to and unmet need for contraceptive services, and London Measure of Unplanned Pregnancy scores (LMUP;range 0-12). Results Of 1,488 eligible participants, 78.0% were considered at risk of unplanned pregnancies. Of 441 at-risk participants who tried to access contraceptive services, 16.4% faced barriers. Young participants (18-24 years) were most likely to report trying to access contraceptive services (38.4%;(32.2, 45.0);vs 28.4% overall) and to face barriers doing so (OR: 2.87 (1.36, 6.06)). Encountering barriers was more likely among participants reporting no educational qualifications and those reporting symptoms of anxiety or depression. 199 participants reported a pregnancy in the last year. Pregnancies to young participants were less likely to be 'planned' (difference in mean LMUP score: -2.95;(-3.91, -1.99)). Less 'planned' pregnancies were associated with lower social grades and becoming unemployed. Discussion Young and vulnerable participants were more likely to report difficulties accessing reproductive services and less planned pregnancies during the pandemic. In navigating pandemic recovery, sexual health services should consider the needs of these at-risk groups.
ABSTRACT
Introduction: The pandemic of Coronavirus Disease 2019 (COVID-19) had a significant impact on obstetric surgeries. Obstetric surgical procedures during the COVID-19 pandemic affect individuals who are suspected or proven to be high-risk endeavors. Aim: To evaluate the demographic characteristics, indications, intraoperative and postoperative complications, and foetomaternal outcomes in the women who had an Emergency Peripartum Hysterectomy (EPH) during the first and second waves of the COVID-19 at a tertiary care centre in North India. Materials and Methods: This was a retrospective cohort study, conducted in the Department of Obstetrics and Gynaecology at a tertiary care centre in Uttar Pradesh, India, including women who underwent EPH operated from March 2020 to May 2021 in terms of demographic characteristics, indications, intraoperative and postoperative complications, and foetomaternal outcomes. Information about their self-reported health issues due to traumatic birth (when they came for a follow-up visit at five weeks) were also obtained. Simple frequency, percentage, and proportion were calculated using descriptive statistics. Results: A total number of 1827 deliveries were conducted and out them 11 cases underwent emergency peripartum hysterectomy at our institute during the time frame of the COVID-19 pandemic. All of the patients were in their 20s or 30s, with ages ranging from 21 to 34. All of these were unplanned pregnancies and arrived at various gestational ages. Eight cases had the previous scarring on the uterus, with six women having morbidly adhered placenta. All of the women in the study cohort were unbooked, and 72.73 % (eight out of 11) of them were referred to our centre because they had high-risk factors. Due to substantial blood loss, five females required Critical Care Unit (CCU) support. The study sample had a poor newborn outcome, with three early neonatal deaths out of 11 deliveries. As a part of their 5th-week follow-up, after the women had been stabilized and discharged from the ICU, they were asked to share their major issues related to health, psychological status and social interaction. The main worries revolved around the newborn child's and COVID-19 positive husband's health. Pregnant women who delivered during the COVID-19 pandemic had a significant rate of postpartum depression and Post-traumatic Stress Disorder (PTSD). Conclusion: The predominant cause of EPH in the study population was a morbidly adherent placenta. It is critical to protect women's physical and psychological health during traumatic childbirth in order to mitigate the pandemic's already-existing harmful impacts.
ABSTRACT
OBJECTIVE: The aim of the study was to assess the impact of the COVID-19 pandemic on sales of modern contraceptive methods in Brazil. METHODS: Monthly sales data were analysed of short-acting reversible contraceptive methods and long-acting reversible contraceptive (LARC) methods (implants and intrauterine contraception) and COVID-19 related deaths. Contraceptive methods were grouped as follows: emergency contraception (EC); oral contraception, vaginal rings and transdermal patches; injectable contraception; LARC methods including the copper intrauterine device (Cu-IUD); and LARC methods excluding the Cu-IUD. RESULTS: Contraceptive sales showed a non-significant increase in 2020 compared with the previous year; average sales ranged from 12.8 to 13.0 million units per month. Sales of injectable contraceptives increased between March and June 2020 and EC pills between June and July 2020; the variation in sales of pills, patches and rings was not significant. Sales of the levonorgestrel-releasing intrauterine system (LNG-IUS) and the etonogestrel (ENG) implant showed three patterns: a decrease in sales between February and May 2020 (coinciding with the closure of family planning services), an increase in sales after May 2020 (coinciding with the first COVID-19-related deaths), and a further increase in sales after July 2020 (corresponding to the increasing number of deaths from COVID-19). CONCLUSION: The COVID-19 pandemic has disrupted the Brazilian health care system. Since many family planning clinics were closed, sales of most modern contraceptives fell during 2020; however, the increase in sales of the LNG-IUS and ENG implant in the private sector indicates inequitable access to modern contraceptive methods.