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Contraceptive use and reproductive intentions among women requesting contraceptive counseling
Örebro University, School of Health Sciences. Maternal Health Care Unit.ORCID iD: 0000-0003-2412-4676
Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden.
Örebro University, School of Medical Sciences. Örebro University Hospital. Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. (Clinical Epidemiology and Biostatistics)ORCID iD: 0000-0002-3552-9153
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Obstetrics and Gynecology.ORCID iD: 0000-0002-2691-7525
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2018 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 97, no 11, p. 1349-1357Article in journal (Refereed) Published
Abstract [en]

Introduction: Limited attention has been paid to the use of contraception in relation to women's family planning intentions. The aim of this study was to investigate the use of contraception during the most recent intercourse as well as the reproductive intentions of Swedish-speaking women requesting contraceptive counseling.

Material and methods: Across-sectional baseline survey in a randomized controlled trial regarding reproductive life planning (before randomization). Women requesting contraceptive counseling answered questions about contraception and whether they wanted to have children/more children in the future.

Results: In total, 1946 women participated: 33.7% (n = 656) parous and 65.7% (n = 1279) nulliparous. The majority, 87.1% (n = 1682), had used contraception during their latest intercourse; 64.6% (n = 1239) used short-acting reversible contraception, 22.8% (n = 443) used long-acting reversible contraception (LARC), and 12.9% (n = 251) had not used any contraception. A combined oral contraceptive was more common among nulliparous and LARC among parous. Among all women, 64.8% (n = 1253) intended to have children/more children in the future, among parous women 35.7% (n = 220) and among nulliparous 80.0% (n = 1033). Among women who did not intend to have children/more children, 22.6% (n = 60) of parous and 10% (n = 8) of nulliparous had not used contraceptives during their most recent intercourse.

Conclusions: Women did not always use contraceptives that were suitable for their reproductive intentions. Questioning women who request contraceptive counseling about their pregnancy intention can give healthcare providers better opportunities for individualized counseling.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018. Vol. 97, no 11, p. 1349-1357
Keywords [en]
Contraception, counseling, long-acting reversible contraception, preconception care, reproductive health, unintended pregnancy, unplanned pregnancy
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:oru:diva-69535DOI: 10.1111/aogs.13426ISI: 000446155300010PubMedID: 30007091Scopus ID: 2-s2.0-85052671672OAI: oai:DiVA.org:oru-69535DiVA, id: diva2:1256489
Note

Funding Agencies:

ALF founding Region Örebro län  

Research Council of Örebro Region County  

Bayer AB 

Available from: 2018-10-17 Created: 2018-10-17 Last updated: 2021-05-17Bibliographically approved
In thesis
1. Preconception health in Sweden: The impact of lifestyle factors and the role of midwife's counselling
Open this publication in new window or tab >>Preconception health in Sweden: The impact of lifestyle factors and the role of midwife's counselling
2021 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Preconception health is an important topic since women and men have a possibility to change lifestyle habits preceding pregnancies, to increase the chances of a healthy pregnancy and child. The aim of this thesis was to increase knowledge about fertility and awareness of preconception health. 

Studies I and II were based on a randomised controlled trial among women who visited midwives for contraceptives counselling. Questionnaires were used before and after an intervention with the Reproductive Life plan (RLP), which is a discussion tool for preconception health. Study I showed that women do not always use a contraceptive that is suitable for their reproductive intentions and Study II indicated that women´s knowledge about fertility and awareness of preconception health increased with RLP-counselling (RLPC). Study II also showed that women appreciated the RLPC by the midwives.

In studies III and IV, data from the Swedish Pregnancy Register were used. The main findings in Study III were that smoking, and use of snuff, in early pregnancy and risk consuming of alcohol the year preceding pregnancy were associated with spontaneous abortion (SA). Study IV showed that heavy alcohol consumption the year preceding pregnancy was associated with lower Apgar-score and might have been associated with lower birth weight. 

The studies contribute important new knowledge about lifestyle factors preceding pregnancy. It is important to highlight this new knowledge together with other factors about preconception health to midwives and other healthcare providers. Preconception counselling is also needed to increase women´s (and men´s) knowledge. There is still a lack of knowledge in the field, but it is a golden opportunity for midwives to start talking about reproductive health during contraception counselling.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2021. p. 81
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 235
Keywords
Preconception health, preconception counselling, preconception care, Reproductive life plan, pregnancy, alcohol, smoking, snuff, AUDIT
National Category
Other Health Sciences
Identifiers
urn:nbn:se:oru:diva-90319 (URN)978-91-7529-383-7 (ISBN)
Public defence
2021-05-21, Örebro universitet, Forumhuset, Hörsal F, Fakultetsgatan 1, Örebro, 09:00 (Swedish)
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Supervisors
Available from: 2021-03-09 Created: 2021-03-09 Last updated: 2024-01-02Bibliographically approved

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Skogsdal, Yvonne Rosalie ElisabethCao, YangFadl, Helena

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