Associations between perceived discrimination and contraceptive method use: why we need better measures of discrimination in reproductive healthcare

Loder, Charisse; Hall, Kelli Stidham; Kusunoki, Yasamin; Harris, Lisa H.; Dalton, Vanessa K.

doi:10.1080/03630242.2021.1919816

Cited by 2 publications

(1 citation statement)

References 25 publications

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“…A paternalistic attitude in contraceptive counseling would lead to preferentially recommending the use of the implant to women with low economic resources or to non-compliant women ( 17 , 19 ). The study by Loder ( 20 ) found that women with a higher perception of discrimination were more likely to use a highly effective, reversible method. It is possible that in our country’s health care model we have not managed to fully integrate person-centered care and that joint decision-making is not yet the norm when we talk about sexual and reproductive health.…”

Section: Discussionmentioning

confidence: 99%

Early removal of the etonogestrel contraceptive implant in Spanish women: a prospective cohort study

Ruiz de Viñaspre-Hernández,

Garrido-Santamaria,

Urra-Martínez

et al. 2024

Front. Med.

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PurposeTo know the discontinuation rate and characterize predictors and reasons of contraceptive implant removal within 12 months of insertion in our community setting.MethodsThis prospective cohort study included women receiving the etonogestrel contraceptive implant at sexual and reproductive health centers between September 2019 and September 2020. The variables collected were implanted insertion timing, reproductive and demographic characteristics, medical conditions, sexual activity and counseling. Our primary outcome was implant discontinuation. Kaplan–Meier survival curves were used to show the cumulative discontinuation rate of implants contraceptive within the first year of insertion. We also identified factors that increased the risk of implant removal using the log-rank test and the Cox regression model. Reasons for discontinuation were documented.Results199 women were followed up. Implant discontinuation was documented in 17.1% of implant users prior to 12 months. Factors that increase the risk of implant removal are living with a partner, being aged 25–34 years and not receiving comprehensive and structured counseling from the midwife. The main reason for removal was unsatisfactory bleeding (97.1%), but this was combined with other reasons such as cessation of sexual intercourse (58.8%), worsening mood (58.8%), weight gain (55.9%) or decreased libido (50.0%).ConclusionThe rate of discontinuous implant uses in the first year is relevant in relation to cost-effectiveness, there is room for improvement that should not be overlooked. Comprehensive and structured midwife-led counseling can reduce early implant abandonment removal. The development in different countries of the role of midwives in the management of contraceptives can contribute to the economic benefit of health services and the satisfaction of women.

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Section: Discussionmentioning

confidence: 99%