RESUMO
Initiation of long-acting reversible contraception (LARC) in the immediate postpartum period is becoming more common, resulting in increased requests for early removal, primarily because of unpredictable bleeding patterns. Competing interests of healthful spacing of pregnancies, impact on breastfeeding, risks associated with pregnancy versus contraceptive method, potential adverse effects of LARC, and timing of informed consent make immediate postpartum initiation of LARC an important issue. Nearly 40% of women do not attend a postpartum visit at all, resulting in decreased initiation of contraception and increased risk of unplanned pregnancy. Nurses caring for women during the peripartum period can help women make informed decisions and can provide anticipatory guidance regarding this method of contraception. Evidence-based postpartum education and support can result in women's increased continuation of and satisfaction with LARC.
Assuntos
Anticoncepção/métodos , Mães/psicologia , Cuidado Pós-Natal/métodos , Fatores de Tempo , Adulto , Aleitamento Materno , Anticoncepção/normas , Contraindicações , Desogestrel/farmacologia , Desogestrel/uso terapêutico , Feminino , Humanos , Dispositivos Intrauterinos de Cobre/normas , Educação de Pacientes como Assunto/normas , Segurança do Paciente/normas , Gravidez , Gravidez não Planejada/efeitos dos fármacos , Progestinas/farmacologia , Progestinas/uso terapêuticoRESUMO
PURPOSE: To describe lucky adolescents who unintentionally avoid pregnancy. DESIGN AND METHODS: The second phase of a descriptive qualitative study in which 17 low-income African-American females ages 19 to 26 participated in open-ended interviews on how they avoided pregnancy as adolescents. RESULTS: Constant comparative analysis revealed that five of the girls avoided pregnancy because they were "lucky" that others insisted they use contraceptives. These lucky girls were unaware of sexual risks, but used contraceptives because they complied with decisions made by their parents, grandparents, and partners. PRACTICE IMPLICATIONS: Lucky girls are at risk for adolescent pregnancy because they abdicate decision making to others and are likely to be overlooked in practice because they are using contraceptives. Promoting self-protection includes assessment, knowledge, skills-building strategies, and health-promoting contracts between the nurse and adolescent.
