Knowledge and attitudes of Latin American gynecologists regarding unplanned pregnancy and use of combined oral contraceptives

Abstract

BackgroundUnintended pregnancy is a public health problem and unmet medical need worldwide. It is estimated that in the year 2012, almost 213 million pregnancies occurred, and the global pregnancy rate decreased only slightly from 2008 to 2012. It was also estimated that 85 million pregnancies (40% of all pregnancies) were unintended and that 38% ended in an unintended birth.ObjectivesTo assess knowledge and attitudes of Latin American (LA) obstetricians and gynecologists (OBGYNs) regarding unintended pregnancies and aspects of combined oral contraceptive (COC) use.MethodsA survey was conducted during a scientific meeting about contraception in 2014, in which OBGYNs from 12 LA countries who provide attention in contraception were invited to respond to a multiple-choice questionnaire to assess their knowledge and attitudes regarding unplanned pregnancy and some aspects regarding COC use.ResultsA total of 210 OBGYNs participated in the study. Their knowledge regarding COC failure was low. The participants reported they believed that their patients habitually forgot to take a pill and that their patients did not know what to do in these situations. They were aware of the benefits of COC use; however, they were less prone to prescribe COCs for the purpose of protecting against ovarian and endometrial cancer, and one-quarter of them had doubts about the association between COC use and cancer risk.ConclusionThe interviewed LA OBGYNs showed some flaws in terms of knowledge of COC failure rates and the non-contraceptive benefits and risks of COCs. To adequately counsel their patients regarding COC intake, OBGYNs must be updated regarding all aspects of COC use.

Sociodemographic Factors Associated with the Knowledge and Use of Birth Control Methods in Adolescents before and after Pregnancy

“…In our study, only 5% of participants received information about birth control methods from a doctor, who usually informed the adolescent only about condoms. The rationale for this approach is that all other methods of contraception supposedly cause damage to the adolescent, which was demonstrated by Bahamondes et al [48], who identified some deficiencies and contradictions in knowledge and attitudes based on responses from Latin American obstetricians and gynecologists who participated in the survey. In Mexico, de Castro et al [24], conducted a study where some adolescents pretended to be clients visiting pharmacies and healthcare facilities, asking for contraceptives.…”

Targeting factors for change: contraceptive counselling and care of female adolescents

“…[89] Health care providers not only need to be able to proactively address common myths and misconceptions around the suitability and potential side effects of different contraceptive methods but also correct inaccurate perception of the frequency with which side effects occur. [86][87][88]90] Accurate information regarding the relationship with hormonal contraception and certain cancers, including the well documented decrease in the risk of ovarian and endometrial cancers, should be provided. [90] In all countries, HCPs may need guidance in identifying situations where it is appropriate to explore the non-contraceptive benefits of hormonal methods, such as management of heavy menstrual bleeding, painful periods, polycystic ovary syndrome (PCOS), or acne.…”

“…[86][87][88]90] Accurate information regarding the relationship with hormonal contraception and certain cancers, including the well documented decrease in the risk of ovarian and endometrial cancers, should be provided. [90] In all countries, HCPs may need guidance in identifying situations where it is appropriate to explore the non-contraceptive benefits of hormonal methods, such as management of heavy menstrual bleeding, painful periods, polycystic ovary syndrome (PCOS), or acne. [78,90] Effective counselling techniques Concepts such as the GATHER approach (see Figure 4) [91] may be helpful in structuring the counselling of adolescent women.…”

“…[90] In all countries, HCPs may need guidance in identifying situations where it is appropriate to explore the non-contraceptive benefits of hormonal methods, such as management of heavy menstrual bleeding, painful periods, polycystic ovary syndrome (PCOS), or acne. [78,90] Effective counselling techniques Concepts such as the GATHER approach (see Figure 4) [91] may be helpful in structuring the counselling of adolescent women. Motivational interviewing techniques can also be useful to explore and manage ambivalence towards pregnancy and contraception, identify inconsistencies between life goals and sexual behaviour, anticipate potential compliance or adherence issues and assist in the selection of the most appropriate method.…”

Knowledge of Latin American Obstetricians and Gynecologists regarding Heavy Menstrual Bleeding

“…This is the third publication of the data obtained through a multiple-choice questionnaire completed by LA OBGYNs using an Interactive Audience Systems Response on occasion of a scientific meeting in Chile organized by Bayer HealthCare in the last quarter of 2014 [ 11 , 12 ]. The OBGYNs came from 12 countries (Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Ecuador, Guatemala, Mexico, Paraguay, Peru, and Venezuela).…”