Sexual and reproductive health knowledges: a study with Pacific young people enrolled in an Aotearoa New Zealand tertiary institution.

Pacific young people living in Aotearoa New Zealand experience disparities in their sexual and reproductive health outcomes, thought to stem from cultural differences and educational inequities. Although these barriers have been characterised in literature, their influence on Pacific youth's understandings of sexual and reproductive health have been relatively unexplored. This study investigated the sexual and reproductive health knowledge of Pacific students enrolled at a university in Aotearoa New Zealand in 2020 and where they gained this knowledge. The study used the theoretical framework of the (revitalised) Fonofale health model and was guided by the Kakala research methodology. Data were collected by means of an online survey comprised of open-ended questions and Likert scales, completed by eighty-one eligible students. Open-ended questions were analysed for general themes and responses to Likert scale items are reported using descriptive statistical analysis. The study found that Pacific youth have strong foundations of health knowledge that is heavily influenced by Polynesian cultural beliefs. Both formal and non-formal learning environments were important in developing participants' health knowledge of these topics and for encouraging independent help-seeking behaviours. This is the first reported study to investigate the sexual and reproductive health knowledges of a pan-Pacific tertiary cohort of young people.

The role of menstrual apps in healthcare: provider and patient perspectives.

AIM: This study aimed to understand the role that menstrual apps ("period tracking apps" or "fertility apps") could perform in healthcare. METHODS: Expert stakeholders including healthcare providers, app users, and patients offered perspectives on potential benefits, concerns, and role of apps in healthcare. Responses from an online qualitative survey (N=144) and three online focus groups (N=10) were analysed using reflexive thematic analysis. RESULTS: The role of menstrual apps in healthcare could include keeping a record of cycle dates and symptoms and assisting in the management of menstrual disorders, diseases and conditions linked to the menstrual cycle such as endometriosis, PCOS, infertility, and perimenopause. Respondents are using app calendars and symptom tracking to improve communication between healthcare providers and patients, while also expressing concerns about inaccuracies and other uses of data. Respondents wished for assistance in managing their health, while noting that apps currently are limited and suggesting that apps need to be better suited to Aotearoa New Zealand specific menstrual disorders, diseases and life stages. CONCLUSIONS: Menstrual apps may have a role in healthcare, but further research needs to develop and evaluate app functions and accuracy as well as providing education and guidelines for whether and when apps are appropriate for healthcare.

Impact of New Zealand teenagers' fertility intentions on childbearing.

Objective: To assess the impact of age 15 fertility intentions on childbearing outcomes three decades later. Background: Evidence is mixed about the implications of teenage fertility intentions on later childbearing. Taking a prospective life course approach to assessing intentions and outcomes may help clarify these mixed findings. Method: A general population birth cohort (born 1972/73) was asked about their fertility intentions at age 15 and 775 of this sample (384 women, 391 men) provided data on their childbearing between ages 15 and 45. Results: At age 15, almost all of the sample indicated they would like to have children in the future (93%). Most (79%) reported having had a biological child by they time they were 45; but those who professed to not wanting children as teenagers were significantly less likely to have had a child three decades later. Conclusion: Fertility intentions during adolescence are probably influenced by social, political and economic norms and may influence later childbearing decisions. This may be particularly true for those whose intentions counter established norms around childbearing. Implications: A life course framework is useful for examining the relationship between hypothetical fertility intentions and outcomes.

Unplanned pregnancies of women with chronic health conditions in New Zealand.

AIM: Chronic health conditions can pose risks for pregnancy and childbearing which may be mitigated by preconception care and pregnancy planning. The objective of this study is to identify the proportion of pregnancies reported as unplanned among women in New Zealand with chronic health conditions and the co-occurrence of these pregnancies with socioeconomc disadvantage. METHOD: This study included 6,822 pregnant women in the Growing Up in New Zealand study. Nearly 15% identified a chronic health condition, including diabetes, heart disease, asthma, depression and anxiety. RESULTS: Pregnancies were reported as unplanned by 45% of women with chronic health conditions, as compared to 39% of women without these conditions. Among women with chronic conditions, those who identified as Maori or Pacific Islander reported two-thirds of their pregnancies as unplanned, and those who were younger, had less education, were lower-income or did not have a co-resident partner reported between 50-80% of their pregnancies as unplanned. CONCLUSION: Obstetricians and midwives in New Zealand should be prepared to provide care for women with chronic conditions who may have surprise pregnancies. Comprehensive family planning services, preconception care and systemwide reduction in health inequities are needed to help women with chronic health conditions enter pregnancy as healthy as possible.

Unplanned pregnancies in New Zealand.

BACKGROUND: Unplanned pregnancies can bring risk. It is important to have an accurate count of unplanned pregnancies, but to date there is no precise number for New Zealand or Australia. AIMS: This analysis estimates the number and proportion of pregnancies in New Zealand that are unplanned. MATERIALS AND METHODS: Estimates were generated using information about unplanned births from the Growing Up in New Zealand study, combined with data on the number of births and abortions from Statistics New Zealand and estimates of miscarriages. These were further refined by age and ethnic group. RESULTS: Of an estimated 95 335 pregnancies in New Zealand in 2008, over half (53%) were unplanned. Unplanned pregnancies resulted in 24 131 births. As a percentage of all pregnancies, 25% were births from unplanned pregnancies, 19% were abortions and 8% were unplanned pregnancies that ended in miscarriage. There were a high number of unplanned pregnancies among younger women as well as among Maori and Pacific women, and a low number among women in their 30s and European women. CONCLUSIONS: Programs, policy and practice should be designed to accommodate women with unplanned pregnancies. Ensuring accessible pregnancy care such as antenatal care and abortion and making preconception care programs widely available, particularly for women with chronic health conditions, will reduce the health risk posed by unplanned pregnancies. Reducing the number of unplanned pregnancies through comprehensive sexuality education and contraception is important for those in their teens and early 20s, and continues to be important throughout the reproductive lifespan.