Planificación familiar postparto: revisión de la evidencia / Post-partum Family Planning: A Review of Evidence

OBJETIVO: conocer los métodos anticonceptivos adecuados para su uso en el periodo postparto según la evidencia científica, así como el momento idóneo para informar sobre la anticoncepción postparto. MÉTODO: se realizó una revisión narrativa, mediante localización y búsqueda bibliográfica de los artículos publicados en las siguientes bases de datos: PubMed, Cochrane Plus y Cuiden. También se consultó la base de datos Uptodate, Biblioteca de Salud Reproductiva de la Organización Mundial de la Salud (OMS) y las Guías de Práctica Clínica (GPC) del Sistema Nacional de Salud, así como los protocolos publicados en la Sociedad Española de Contracepción (SEC). La búsqueda se estableció entre los años 2010-2020, incluyéndose solo artículos en español e inglés. Los documentos encontrados fueron revisados y seleccionados en función de varios criterios de inclusión. RESULTADOS: de los 579 documentos identificados, cuatro fueron eliminados por ser duplicados, por lo que fueron revisados un total de 575 artículos. De los mismos, 524 artículos fueron eliminados por incumplir los criterios de inclusión y solo 51 fueron seleccionados para valorar la calidad de los mismos, de los cuales se incluyeron 27 en la revisión. Los resultados se organizaron según los siguientes contenidos: cuándo y cómo informar sobre los métodos anticonceptivos postparto y los métodos anticonceptivos adecuados para ese periodo. CONCLUSIONES: a pesar de la demanda poblacional existe un déficit de información y consejo sobre la planificación familiar postparto. Los profesionales de la salud han de aprovechar cada oportunidad durante el embarazo, el parto y el puerperio para proporcionar información y asesoramiento. Los métodos anticonceptivos adecuados para el postparto son variados. Sigue existiendo controversia en relación al momento de inicio de los anticonceptivos con gestágenos y sobre el momento más idóneo para la inserción del DIU

OBJECTIVE: to identify the contraceptive methods adequate for use in the post-partum period according to scientific evidence, as well as the adequate time to inform about post-partum contraception. METHOD: a narrative review was conducted, through bibliographic location and search of the articles published in the following databases: PubMed, Cochrane Plus and Cuiden. The Uptodate database was also consulted, as well as the Library of Reproductive Health by the World Health Organization (WHO) and the Clinical Practice Guidelines (CPG) by the National Health System, and the protocols published at the Spanish Society of Contraception (SEC). The search was established during the years 2010-2020, and only articles in Spanish and English were included. The documents found were reviewed and selected according to various inclusion criteria. RESULTS: of the 579 documents identified, four were eliminated because they were duplicates; therefore, 575 articles were reviewed in total. Out of these, 524 articles were eliminated because the inclusion criteria were not met, and only 51 were selected in order to assess their quality, and 27 of these were included in the review. Results were classified according to the following contents: when and how to inform about post-partum contraception methods, and the contraceptive methods adequate for said period. CONCLUSIONS: regardless of demands by the population, there is deficit of information and advice regarding post-partum family planning. Health professionals must take every opportunity during pregnancy, delivery and puerperium, in order to provide information and guidance. There is a variety of contraceptive methods adequate for the post-partum period. There is still some controversy regarding the time to initiate contraception with gestagens, and the most adequate time to insert an IUD

CE: An Evidence-Based Update on Contraception.

Contraception is widely used in the United States, and nurses in all settings may encounter patients who are using or want to use contraceptives. Nurses may be called on to anticipate how family planning intersects with other health care services and provide patients with information based on the most current evidence. This article describes key characteristics of nonpermanent contraceptive methods, including mechanism of action, correct use, failure rates with perfect and typical use, contraindications, benefits, side effects, discontinuation procedures, and innovations in the field. We also discuss how contraceptive care is related to nursing ethics and health inequities.

The impact of using nurses to perform postpartum intrauterine device insertions in Kalyani Hospital, India.

In the postpartum period women are vulnerable to unintended pregnancy, which may lead to legal or illegal abortion and impact on maternal and neonatal morbidity and mortality. Although several postpartum family planning options are available, lack of access to and availability of family planning services and trained staff pose serious challenges. Peripheral centers may not have a doctor; however, they will have nursing staff that can be trained to offer family planning counselling and services. The present study demonstrates how task sharing with nurses to provide postpartum intrauterine device (PPIUD) services worked to give women a convenient and safe contraceptive method. PPIUD insertion provides women the additional advantage of leaving hospital with appropriate long-term contraception after institutional delivery, and also decreases the costs borne by patients and the government. This approach also impacts maternal and newborn health by avoiding unwanted pregnancy.

"Contraceptive Care for Adolescents in School-Based Health Centers Is Essential!": The Lived Experience of Nurse Practitioners.

Adolescents often face hurdles that may interfere with accessing contraceptive services. School-based health centers (SBHCs) are available to many teens in the United States; however, only half of SBHCs that serve adolescents are permitted to provide contraception. The aim of this descriptive phenomenological study was to describe the lived experience of nurse practitioners (NPs) providing contraceptive care to teens in SBHCs. Twelve NPs were interviewed and Colaizzi's method of descriptive phenomenological analysis was used to describe the lived experience of NPs providing contraceptive care to adolescents in SBHCs. Three themes emerged: Contraception is an Essential Part of Care for Teens Using SBHCs; Frustration! There are so Many Hurdles to Negotiate; and Walking a Fine Line. Despite the restrictions on SBHC services and the hurdles the NPs encountered, they remained committed to providing contraceptive services and seized available opportunities to provide health education and support for the adolescents accessing the SBHCs.

Midwife and Public Health Nurse Tatsuyo Amari and a State-Endorsed Birth Control Campaign in 1950s Japan.

Mrs. Tatsuyo Amari, a qualified midwife and nurse, served Japan's state-endorsed birth control campaign as a "birth control field instructor" in rural Minamoto Village of Yamanashi Prefecture just west of Tokyo. Her work sheds light on the role of female health-care workers in health and population governance in 1950s Japan. Amari not only facilitated the "top-down" transfer of the state-sanctioned idea of birth control and contraceptives, as did other birth control field instructors, but also enabled the "bottom-up" flow of knowledge about people's reproductive lives through her participation in the policy-oriented birth control research called the "three model-village study." Contextualizing Amari's engagement with the study elucidates how the state relied on the established role of female health-care workers as intermediaries between the state and the people. Finally, Amari's contribution to the scientific aspect of the campaign may motivate historians to recognize the politics around the participation of female health-care workers in the science of birth control.

Atención prenatal: acciones esenciales desempeñadas por los enfermeros / Assistência pré-natal: ações essenciais desenvolvidas pelos enfermeiros / Prenatal care: essential actions developed by nurses

Objetivo: Investigar el perfil, el conocimiento y la práctica de las enfermeras que trabajan la atención prenatal de bajo riesgo. Métodos: Estudio cuantitativo, descriptivo, transversal realizado en las Unidades Básicas de Salud Familiar Campina Grande / Paraíba, Brasil. Se incluyeron quince UBSF’s del distrito sanitario I de Campina Grande, totalizando 15 enfermeros que respondieron a un cuestionario. La colecta de datos se llevó a cabo entre marzo y junio de 2013. El análisis de datos se realizó de forma manual, en mapa resumen, según la población estudiada y posteriormente se analizaron mediante estadística descriptiva y organizados en gráficosy tablas de frecuencias absoluta y relativa. Resultados: Se puede considerar satisfactoria la atención prenatal realizada por los enfermeros, ya que además de los procedimientos y las pruebas de rutina, se observó que también llevan a cabo los procedimientos y pruebas consideradas como complementaria, de acuerdo con el Ministerio de Salud Conclusión: Es necesario proporcionar un mayor número de orientación con respecto al uso de métodos anticonceptivos tras el periodo gestacional. Se revela también la necesidad de estudios de evaluación de la calidad y el impacto de la atención prenatal realizados por enfermeros especializados en la reducción de la morbilidad y mortalidad materna y neonatal en el municipio, este enfoque sería de gran importancia para la consolidación de una práctica exitosa en Campina Grande (AU)

Objetivo: investigar o perfil, o conhecimento e prática dos enfermeiros que atuam na atenção pré-natal de baixo risco. Método: pesquisa quantitativa, descritiva, transversal, realizada nas Unidades Básicas de Saúde da Família do município de Campina Grande/Paraíba, Brasil. Foram incluídas quinze UBSF's do distrito sanitário I de Campina Grande, totalizando 15 enfermeiros que responderam a um questionário. A coleta dos dados ocorreu entre os meses de março a junho de 2013. A análise dos dados foi realizada manualmente, em mapa resumo, de acordo com a população estudada e posteriormente foram analisados através da estatística descritiva e organizados em gráficos e tabelas de frequência absoluta e relativa. Resultados: pode-se considerar satisfatória a assistência pré-natal realizada pelos enfermeiros, uma vez que além dos procedimentos e exames de rotina, observou-se que estes realizam os procedimentos e exames considerados como complementares, de acordo com o Ministério da Saúde. Conclusão: faz-se necessário o fornecimento de um maior número de orientação no que tange ao uso de métodos contraceptivos após o período gestacional. Revela-se ainda a necessidade da realização de estudos sobre avaliação de qualidade e impacto do atendimento pré-natal realizado por enfermeiros na redução de morbimortalidade materna e neonatal no município, abordagem esta que seria de grande relevância para a consolidação de uma prática bem-sucedida em Campina Grande

Objective: Investigating the profile, knowledge and practice of nurses who work in low-risk prenatal. Methods: This is a quantitative, descriptive, cross-sectional study conducted at the Family Health Basic Units of the city of Campina Grande/Paraiba, Brazil. The study included fifteen Basic Health Units of the Family of the sanitary district I of Campina Grande, totaling 15 nurses who responded to a questionnaire. Data were collected between March and June 2013. Data analysis was performed manually in map summary, according to the population studied and later the results were analyzed through descriptive statistics and organized into charts and tables of absolute and relative frequency. Results: the data analysis revealed satisfactory the prenatal care performed by nurses, since in addition to procedures and routine tests it was observed that they also carry out the procedures and tests considered as complementary, according to the Ministry of Health. Conclusion: it becomes necessary to give a larger guidance regarding the use of contraceptives after pregnancy. Also the study revealed the need for studies about evaluation of quality and impact of prenatal care conducted by nurses in decreasing maternal and neonatal morbidity and mortality in the municipality. This approach would be of great relevance for the consolidation of a successful practice in Campina Grande (AU)

Una manera diferente de abordar la sexualidad, la contracepción y la prevención de infecciones de transmisión sexual desde la escuela en la Costa da Morte / A different approach to sexuality, contraception and prevention of sexually transmitted infections from school on Costa da Morte

Introducción: La actividad sexual en edad precoz se relaciona con conductas de riesgo que pueden dar lugar a embarazos no deseados (END) o infecciones de trasmisión sexual (ITS). Los centros de enseñanza son los espacios idóneos para realizar actividades educativas en materia de sexualidad. Nuestro estudio tiene como objetivos: averiguar los conocimientos sobre sexualidad, anticoncepción e ITS de los alumnos de 2º,3º y 4º de la ESO, generar conocimientos y actitudes adecuadas en torno a la sexualidad y valorar los resultados de nuestra intervención educativa. Material y Métodos: Estudio descriptivo de corte transversal que cuenta con la participación de 686 alumnos con edades comprendidas entre los 13 y 16 años pertenecientes a centros educativos de A Costa da Morte. Realizamos sesiones educativas sobre sexualidad, anticoncepción e ITS con exposiciones teórico-prácticas. Elaboramos dos tipos de cuestionarios: uno de conocimientos, pre y post-intervención, y otro de satisfacción. Resultados: Los adolescentes conocen la mayoría de los métodos anticonceptivos, aunque la información que manejan es dispar. Existe un déficit de conocimientos respecto a las ITS importante; los jóvenes no conocen sus signos/síntomas, las medidas de prevención, los mecanismos de transmisión, ni las actitudes a seguir con la población portadora. Conclusión: La enfermería tiene un papel clave como impulsora de actitudes positivas en la salud sexual de los jóvenes. Es fundamental, para favorecer la adquisición de conocimientos en torno a la sexualidad, transformar a los adolescentes en los protagonistas de su historia a través de intervenciones innovadoras y participativas (AU)

Aim: Sexual activity at an early age is associated with risk behaviors that can lead to unwanted pregnancies or sexually transmitted infections (STIs). Schools are the ideal for educational activities in relation to sexuality. Our study aims to find out knowledge about sexuality, contraception and STIs to the students of 2nd, 3rd and 4th of Secondary School, generate appropriate knowledge about sexuality and evaluate the results of our intervention attitudes. Methods: A descriptive cross-sectional study with the participation of 686 students aged between 13 and 16 years old, belonging to schools in Costa da Morte. We offered educational sessions on sexuality, contraception and STIs with theoretical and practical presentations. We developed two types of questionnaires: one of knowledge, pre-post intervention and other about satisfaction. Results: Teenagers know most contraceptive methods, although the information they handle is questionable. There is a deficiency of knowledge related to the important STI; young people do not know their signs/symptoms, prevention, transmission mechanisms, and attitudes to go with the carrier population. Conclusion: Nurses play an important role in promoting a change of attitude in youth´s sexual behavior. Encouraging teens and transforming them in the protagonists of his story through innovative and participatory activities, is essential to achieve the acquisition of knowledge about sexuality (AU)

History, policy and nursing practice implications of the plan b(®) emergency contraceptive.

Numerous policy changes have expanded access to emergency contraception, such as Plan B®, in recent years. Plan B® is a progesterone-based medication that prevents pregnancy from occurring up to 120 hours after unprotected intercourse by preventing ovulation and tubal transport. Increased access to Plan B® allows women to make independent decisions regarding reproductive health. Nurses play an important role in providing education as well as comprehensive, compassionate and holistic care.

Nurse-led management of contraceptive services.

This article discusses the role of the practice nurse (PN) in the provision of health assessment for contraceptive choices. PNs who have an extended role as an independent nurse prescriber must demonstrate the principles of safe prescribing practice, with appropriate and informed assessment of the patient's needs and risk within the limited time of a general practice appointment. With continued professional development, PNs are well placed to provide comprehensive, independent nurse-led contraceptive services.

Contraceptive use among low-income women living in medically underserved neighborhoods.

OBJECTIVE: To describe the rate of contraceptive use and types of contraception used by low-income women. DESIGN: A descriptive study was used to survey women about their contraceptive use and sexual behaviors 12 months prior to the time of the interview. PARTICIPANTS AND SETTING: A convenience sample of 110 low-income women living in three urban medically underserved neighborhoods who enrolled in a larger study was included. METHODS: Univariate and bivariate descriptive analyses were conducted using STATA 10. RESULTS: Forty-eight (43.6%) of the women were African American, 43 (39.1%) were Hispanic, and 17 (15.5%) were White. The women were age 18 to 55 years (Mean = 31 years). Forty percent of these women who were not pregnant or planning to get pregnant had sex without contraceptives in the past 12 months. The percentage of women who used contraception decreased from 77.3% users in the last 12 months to 63.6% current users. The most common methods used within the last 12 months were condom use by male partner (28.2%), birth control pills (14.6%), contraceptive injection (12.7%), intrauterine device (10.9%), and the patch (1.8%). CONCLUSIONS: Many of the low-income women from medically underserved neighborhoods did not use contraceptives and of those who used contraceptives, the majority used the least effective methods.

Hormonal contraception and headaches: what are the prescriber's options?

This article will review evidence-based hormonal contraception prescribing options in the primary care setting for reproductive age women who experience headaches. Safe prescribing of hormonal contraception requires the nurse practitioner to be able to differentiate between the common primary headache phenotypes, such as the migraine and the tension-type headache.

Contraception: a guide for midwives.

Women will generally spend more of their reproductive lifetime preventing pregnancy than experiencing it. The choice of contraceptive methods can be confusing for women, each one having its own set of advantages and disadvantages. For new mothers, a method of contraception is important if a reasonable gap between pregnancies is the desired outcome. Given that ovulation can resume four weeks following childbirth, midwives have a clear role in the provision of up to date contraceptive health advice to women, including the availability of emergency contraception. Midwives, especially those working in the community, also need to be familiar with the range of contraceptive health clinics in their locality, together with a working knowledge of the various services offered by them.