contraceptives--postcoital and Abortion--Spontaneous

Topics: Abortion, Spontaneous; Antigens; Chorionic Gonadotropin; Contraception; Contraceptive Agents; Contraceptives, Postcoital; Cyproterone; Endometrium; Female; Foreign Bodies; Humans; Intrauterine Devices; Male; Medroxyprogesterone; Menstruation; Methods; Norethindrone; Ovulation; Pregnancy; Progestins; Prostaglandins; Skin Absorption; Spermatozoa; Sterilization, Reproductive; Suppositories; Vas Deferens

Topics: Abortion, Induced; Abortion, Spontaneous; Amniotic Fluid; Contraceptives, Postcoital; Ethanol; Female; Humans; Labor, Induced; Labor, Obstetric; Menstruation; Molecular Conformation; Pregnancy; Prostaglandin Antagonists; Prostaglandins; Uterus

Emergency contraceptives (EC) are used to avoid unintended pregnancy, hence avoiding its incidence and its effects. In Ethiopia, emergency contraception is commonly accessible, especially in the big cities. However, there is virtually little understanding of or awareness of EC and Ethiopia has a high abortion rate. Therefore this study was aimed to assess the magnitude and associated factors for emergency contraceptive knowledge in Ethiopia.. The study was based on secondary data analysis of the Ethiopian Demographic and Health Survey 2016 data. A total weighted sample of 1236 reproductive age women was included. A multilevel mixed-effect binary logistic regression model was fitted to identify the significant associated factors of emergency contraceptive knowledge. Statistical significance was determined using Adjusted Odds Ratio (AOR) with 95% confidence interval.. Overall magnitude of emergency contraceptive knowledge was observed to be 17.19% (95% CI: 15.18, 19.40) with intra-class correlation (ICC) 57% and median odds ratio (MOR) 6.4 in the null model. Women's age 25-34 (AOR = 2.6; 95% CI: 1.2, 5.5), and 35-49 (AOR = 1.5; 95% CI: 1.06, 3.3), secondary and above educational level (AOR = 3.41; 95% CI: 2.19, 4.88), media exposure (AOR = 2.97; 95% CI: 1.56, 5.64), Being in metropolitan region (AOR = 2.68; 95% CI: 1.46, 4.74), and women being in urban area (AOR = 3.19; 95% CI: 1.20, 5.23) were associated with emergency contraceptive knowledge.. Emergency contraceptive knowledge in this study was low. Women age, educational level, media exposure, residency, and region were significantly associated with emergency contraceptive knowledge. Therefore, to enhance understanding and use of ECs in the current Ethiopian setting, it is imperative to ensure exposure to EC information, particularly in rural regions.

Topics: Abortion, Induced; Abortion, Spontaneous; Adult; Contraception Behavior; Contraceptives, Postcoital; Ethiopia; Female; Humans; Multilevel Analysis; Pregnancy

Topics: Abortion, Induced; Abortion, Spontaneous; Contraceptives, Postcoital; Female; Humans; Pregnancy

The mechanism of action (MOA) of emergency contraceptive pills (ECPs) is frequently mischaracterized. Our objective was to identify how members of the general public understand the mechanisms of ECPs.. We recruited a convenience sample from social media for a survey about reproductive health attitudes and analyzed spontaneous descriptions of how ECPs work. We inductively coded responses to create themes and subthemes, and collapsed subthemes into three MOA categories based on previous research.. Among 1443 respondents, 533 mentioned an MOA in their description of ECPs. While nearly half of these responses (49.5%) stated that ECPs prevent pregnancy before fertilization occurs (in accordance with most biomedical ECP research), over 60% described a mechanism related to preventing implantation of a fertilized egg. Nine percent of responses described a postimplantation mechanism that would be considered abortion by mainstream medical standards. Some respondents conveyed significant confusion about the biological processes involved with pregnancy and pregnancy prevention.. Confusion about how ECPs work was common among our sample. The largest group of responses described a mechanism-preventing implantation of a fertilized egg-listed on the Food and Drug Administration (FDA)-approved ECP labels that does not reflect most relevant biomedical research. Mischaracterizations of ECPs' mechanisms have been used to limit access to EC. These misunderstandings were common in our sample and may reflect poor quality sex education and public information, and confusion introduced by the FDA-approved labels. Additional research should identify whether public perception of ECPs' mechanisms influences policy, health care provision, and use of ECPs.

Topics: Abortion, Induced; Abortion, Spontaneous; Contraceptives, Postcoital; Female; Humans; Pregnancy; Reproduction; Zygote

Emergency contraceptives may sometimes prevent implantation, thereby causing the death of the embryo. According to some positions contrary to abortion, because the embryo is a human animal, there are usually decisive moral reasons not to use them. In this article, I will show that objecting to the use of emergency contraceptives on those grounds is unjustified. If organisms are real existents, then according to the most plausible conception of what is required for a group of cells to compose one, the embryo cannot qualify as a single organism. On the other hand, if organisms are virtual objects, then whether or not the embryo qualifies as one is morally irrelevant. I conclude that even if those positions are right about the morality of abortion, they are not entitled to oppose the use of emergency contraceptives.

Topics: Abortion, Induced; Abortion, Spontaneous; Animals; Beginning of Human Life; Contraceptives, Postcoital; Embryo Implantation; Embryo, Mammalian; Female; Humans; Moral Obligations; Personhood; Pregnancy; Value of Life

Levonorgestrel (LNG), as a dedicated emergency contraception (EC) product, has been available over-the-counter in China for 10 years. Until now, only a small number of deliveries after LNG-EC failure have been documented.. This study was a prospective comparative cohort study. A group of 332 pregnant women who had used LNG-EC during the conception cycle was recruited, and matched to a group of 332 pregnant women without the exposure to LNG. Congenital malformations, perinatal complications and delivery circumstances were investigated in this study.. There were 31 pregnant women in the study group and 28 in the comparison group miscarried within 14 weeks of gestation. In the study and comparison groups, four malformations were found in each group. In the study group, both birthweight (3416 versus 3345 g, P = 0.040) and the sex ratio of birth (boys/girls, 1.14 versus 0.90, P = 0.153) were higher than in the comparison group. There were no statistically significant differences in the incidence of miscarriage or malformation or in the neonatal outcome between the two groups.. There was no association between the use of LNG-EC pills and the risk of major congenital malformations, pregnancy complications or any other adverse pregnancy outcomes in our study.

Topics: Abortion, Spontaneous; Adult; Cohort Studies; Congenital Abnormalities; Contraception, Postcoital; Contraceptive Agents, Female; Contraceptives, Postcoital; Female; Humans; Levonorgestrel; Male; Pregnancy; Pregnancy Outcome; Prospective Studies

Court Decision: [2002] Family Law Reports 146; 2002 May 10 (date of decision). The Queen's Bench Division held that a criminal statute proscribing the supply, administration, or use of any substance to procure a miscarriage did not prohibit the sale of emergency contraception (the "morning-after pill"). The Society for the Protection of Unborn Children, a privately funded lobbying organization, had brought suit to enjoin pharmacists from selling emergency contraception to women over the age of sixteen without a prescription. The organization argued that the morning-after pill is an abortifacient agent and that Parliament had intended, in the 1861 Offences Against the Person Act, to prevent interference with implantation by criminalizing miscarriage. The court held that the 1861 Act left the word 'miscarriage' undefined, and that the word is to be interpreted using modern parlance. In contemporary understanding, 'miscarriage' refers only to the disruption of pregnancies after implantation. Furthermore, pre-implantation methods of contraception have been available to, and used by, the general public for decades. Therefore, emergency contraception which merely prevents implantation or fertilization is not prohibited as supplying, administering, or using a substance to procure a miscarriage.

Topics: Abortifacient Agents; Abortion, Spontaneous; Contraceptives, Postcoital; Female; Humans; Legislation as Topic; Nonprescription Drugs; Pharmacists; Terminology as Topic; United Kingdom

RU 486 is the first antiprogesterone to be used clinically. It inhibits the action of the hormone at the receptor level in target tissues. Its action is particularly significant in the endometrium where it prevents the initiation and progression of pregnancy in the first weeks (contragestive effects). The data indicate that the compound can be used for: voluntary interruption of pregnancy between 6 and 10 weeks, induction of menstruation during the fifth week of amenorrhea, and post-coital contraception. Current trials include its use as a once-a-month menses inducer. It can also be utilized for therapeutic interruption at a late stage of pregnancy, and tried as adjuvant treatment in some case of breast cases. The data on RU 486 have been obtained through studies in physio-pharmacological endocrinology and biochemistry. The development of this antihormone represents a concerted research effort between biology and medicine.. RU 486 steroid, the 1st antiprogesterone which may be used in human therapy, prevents the hormone action by taking its place at the receptor level in target cells. It is a norethindrone derivative of the historical progestagen of oral contraception. Its affinity for the progesterone receptor is high, it is orally active, and toxicology studies fail to show any other effects than the endocrine consequences which may be expected from an antihormone. Consequently, it can be tested as a "contragestive" agent, putting emphasis on the fact that a few hours interruption of the progesterone action prevents pregnancy. At the Department of Obstetrics and Gynecology at the Geneva Hospital Cantonal, women who had asked to terminate 6-10 week pregnancies were administered 200 mg RU 486 to be taken orally for 4 days. The present results concern several hundred pregnancy terminations. With RU 486 alone, a unique dose of less than 400-600 mg, given in the evening, was more efficient than 50-200 mg/day for 3-7 days as in the initial trials. The results were particularly satisfactory when the compound was administered within the days following the assumed date of menstruation (5th week of amenorrhea). Several cases of normal pregnancies have been reported after using RU 486, including 1 as early as the following month. The analysis of the RU 486 mechanism of action showed that the blockage of the progesterone activity on decidualized endometrium causes the detachment of the embryo, resulting in a drop in hCG and secondary luteolysis. Then, prostaglandins are produced, as in laboratory animals, thus increasing contractility of the uterine muscles, such property already being used in pregnancy interruption. Thus, the fact of adding on the 4th day of the RU 486 treatment a weak dosage of synthetic prostaglandin equal to 1/6 of that used alone when inducing abortions made a clear improvement in the results possible. Trials have shown the feasibility of using RU 486 as a means of postcoital contraception. The monthly use of RU 486, at each cycle, of RU 486 as a menses-inducer for women who have regular coitus, is still under study. A study as to how much and for how long RU 486 is to be prescribed should make it possible to define conditions for maintaining a regular menstrual cycle. Conversely, other trials may lead to the use of RU 486 to monitor or suppress ovulation. RU 486 also makes it possible to provoke the therapeutic abortion of dead or abnormal fetuse

Topics: Abortifacient Agents; Abortifacient Agents, Steroidal; Abortion, Spontaneous; Amenorrhea; Contraceptives, Postcoital; Estrenes; Female; Humans; Mifepristone; Models, Biological; Pregnancy

The reasons that often render contraceptive measures in young girls are explained and the various contraceptive methods and their special indications and contraindications in the case of adolescents are discussed. The advantages and dangers of oral hormonal contraceptives in adolescents are discussed in greater detail, because of a possible harmful influence on the establishment of a normal functioning of the hypothalamus-hypophysis-ovary systerm, which often is very delicate at an early age. The usefulness of special gynecoligic examinations for adolescents is emphasized; such examinations would also be useful to provide education on contraceptive methods as part of a more general sex education program.

Topics: Abortion, Spontaneous; Adolescent; Contraception; Contraceptives, Oral, Hormonal; Contraceptives, Postcoital; Female; Humans; Legislation, Medical; Nausea; Pregnancy; Switzerland

Presently we are witnessing two unique occurrences in the field of public health: the first demonstration of transplacental carcinogenesis in humans and the first drug-induced cancer epidemic in women under age 30. This article examines the current status of the vaginal cancer epidemic and possible reasons for the failure of governmental health agencies to recall and test the generation of females who were exposed to diethylstilbestrol (DES) in utero. Epidemiologic evidence indicates that the large majority of "DES daughters" may develop adenosis. The carcinogenicity of other estrogens in wide use is examined. It is pointed out that, although vaginal cancer in daughters exposed to DES in utero provided the clinical evidence to secure a Food and Drug Administration ban on DES as an additive to cattle feed, the FDA approved a new use of DES as a "morning-after pill" contraceptive even though the contraceptive contains 833,000 times the amount of DES banned for human consumption in beef. The lack of standards of informed consent in the testing of the morning-after pill on university women and the additional risk this presents to DES daughters are discussed. The sociopolitical and economic contributing factors to the vaginal cancer epidemic and the extent to which the scientific direction of medical care is influenced by economic factors are examined. Public health measures which might prevent the occurrence of such man-made epidemics in the future are recommended.. The occurrence of transplacental carcinogenesis in humans and a drug-induced cancer epidemic in women under age 30 associated with dieth ylstilbestrol (DES) has led to various investigations. The neglect on the part of governmental health agencies to recall and test the generation of females who were exposed to DES in utero is examined in this article. Epidemiologic evidence indicates that a large majority of "DES daughters" may develop adenosis. Other estrogens in wide use are examined in light of their carcinogenicity. Evidence provided by daughters exposed to DES in utero with vaginal cancer contributed to the FDA ban on DES as an additive to cattle feed. However, the FDA approved use of DES as a "morning-after pill" which is 833,000 times the strength banned from use in cattle feed. Improvement of testing procedures for new drugs to insure safety and efficacy prior to marketing and more judicious use of drugs in medical practice may prevent the occurrences of man-made epidemics such as this one.

Topics: Abortion, Spontaneous; Adenocarcinoma; Adolescent; Adult; Animal Feed; Carcinogens; Child; Contraceptives, Postcoital; Diethylstilbestrol; Estradiol Congeners; Female; Humans; Informed Consent; Legislation, Drug; Maternal-Fetal Exchange; Pregnancy; Public Health Administration; United States; United States Food and Drug Administration; Vaginal Diseases; Vaginal Neoplasms