Thesis (M.S.)--University of Wisconsin--Madison, 1982. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 93-102).

Thesis (M.S.)--University of Michigan, 1980.

Thesis (M.S.)--University of Michigan, 1990.

Thesis (S.T.L.)--Catholic University of America, 2004. / Includes bibliographical references (leaves 99-102).

Thesis (M.A.)--Oregon State University, 2006. / Printout. Includes bibliographical references (leaves 87-96). Also available on the World Wide Web.

Thèse (M.Ps.)--Université Laval, 2002. / Bibliogr.: f. [114]-122. Publié aussi en version électronique.

Adolescent (14-17 year-olds) and young adult (18-20 year-olds) women account for a disproportionate 20% of the total number of unintended pregnancies that occur among women of all reproductive ages (14-55 year-olds) each year in the US. Nearly half (41%) of all unintended pregnancies result from the 18% of women who report inconsistent, incorrect, or no use of their contraceptive method. Evidence shows that a large proportion of these young women, especially those who are sexually active, come to the emergency department for their core sexual and reproductive health care needs. By obtaining a better understanding of the sexual and reproductive health needs and preferences of an urban population that is disproportionately low income and ethnically and racially diverse, our hope is to maximize adolescent and young adult accessibility to contraceptive services most feasible in the PED environment such as Nexplanon, in addition to the provision of comprehensive contraceptive counseling and education. OBJECTIVES: The first objective of this subgroup analysis is to determine the percentage of adolescent and young adult females presenting to an urban PED who are familiar with Nexplanon and to describe the demographic, sexual health, and contraceptive use characteristics of these young women. The second main objective of our study is to evaluate the sources of Nexplanon-related information reported by respondents familiar with Nexplanon. In addition to the main objectives, we also determine participant willingness to initiate or switch to Nexplanon® and receptivity to learning about contraceptive methods during a related or nonrelated visit to the PED. METHODS: This is a cross-sectional descriptive study using a paper-based anonymous questionnaire distributed to female patients, ages 16-21 years, presenting to a Boston urban pediatric emergency department (PED). This is a sub-group analysis of a larger study aimed at describing the contraceptive use history of young women who present to the PED. To identify if any statistically significant categorical variables existed between the two assigned groups, univariate analysis was performed using Chi-squared tests. Odds ratios with 95% confidence intervals (CIs) were obtained for the relationship between participants who have heard of Nexplanon and the three statistically significant variables: history of STDs, gravidity, and prior sexual intercourse with a male. Mean and Standard Deviation were used to describe the one continuous variable, age, followed by univariate analysis using independent t-test. Statistical significance was indicated using p-values for the categorical variables and odds ratio with 95% CI for the continuous variable—age. RESULTS: Of the 366 adolescent and young adult females included in our subgroup analysis, 230 (62.8%) indicated they were familiar with Nexplanon. We found that female participants familiar with Nexplanon were 1.3 times more likely to have had a prior STI, twice as likely to have had one or more previous pregnancies, and 3.5 times more likely to have previously engaged in sexual intercourse with a male compared to those female participants unfamiliar with Nexplanon. We also found that most (42.2%) female participants familiar with Nexplanon obtained their contraceptive information from their family and friends only, while about a third obtained their contraceptive information from medical professionals only. Among our total population of respondents, 6% (22/366) of our sub-group participants identified the contraceptive implant as their current method of contraception. Lastly, approximately 21% of female participants familiar with Nexplanon indicated current use of a long-acting reversible contraceptive method at the time of the survey. CONCLUSION: Overall, our study findings are supportive of and consistent with the provision and education of Nexplanon in the PED. This would be a crucial opportunity to provide comprehensive contraceptive counseling and convenient access to the most effective method of contraception among a population that disproportionately affected by unintended pregnancy. This can be made possible by enabling PED health care providers with the proper access to and training in Nexplanon. By adapting these patient-centered practices and techniques, the PED setting can contribute to the notable reduction in teen pregnancy seen in a variety of similar clinic-based interventions. The PED atmosphere has enormous potential to serve young women as an additional venue for contraception education and access.

For every method, there's a story - the IUD that almost killed her, the male birth control that almost happened, the weight gained and the moods changed. Whether a narrative of personal experience or one heard through the grapevine, stories about contraception illuminate critical issues in reproductive health today. Using ethnographic data deeply colored by ongoing partisan rhetoric around reproductive rights and the body, I discuss the dynamics of power at play in patient experience, the performance of social complaint and institutional critique, and vernacular conceptualizations of health and embodiment in the contraceptive regimen.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A tese versa sobre as grandes questões relativas à contracepção no Brasil. Integra um esforço por analisar condutas referentes à contracepção, segundo lógicas que priorizam a situacionalidade e a relacionalidade de tais fenômenos. As estratégias para gerir a fecundidade são constitutivas da sexualidade heterossexual. Mulheres e homens podem usar ou não contracepção; as razões dessa conduta extrapolam aspectos concernentes a informação e acesso. Busca-se compreender as práticas contraceptivas a partir do processo do aprendizado das lógicas relacionais e de gênero, em diferentes momentos dos percursos biográficos: o início da trajetória afetivo-sexual, os contextos de irrupção de uma gravidez e o encerramento da potencialidade reprodutiva, por meio da esterilização contraceptiva. Este compósito demandou a utilização de materiais empíricos distintos para a construção e análise das etapas eleitas dos percursos biográficos. Enfoca-se, primeiramente, o momento de passagem à sexualidade com parceiro. Problematiza-se a ideia de relaxamento das práticas contraceptivas, a partir da iniciação sexual, concepção corrente na literatura nacional em função do decréscimo de uso de preservativo em relações sexuais posteriores. Aborda-se, em seguida, as atitudes e as questões presentes no processo de construção da prática contraceptiva, no momento em que a vida sexual se torna regular. A proposição da perspectiva da gestão contraceptiva sublinha as posições dos protagonistas, marcadas pelo gênero. Por último, analisa-se as circunstâncias biográficas e os cenários relacionais da esterilização contraceptiva, a qual emerge como uma estratégia de estabilização ou de consolidação de um percurso contraceptivo/reprodutivo. O debate em torno da contracepção no Brasil apresenta a tendência a enfatizar a determinação social para explicar as gestações imprevistas. Contudo, salienta-se, com base em uma literatura crítica, as dimensões de agência individual, ainda que circunscritas por um campo delimitado de possibilidades. / The thesis deals with the major issues relating to contraception in Brazil. Integrates an effort to analyze behaviors related to contraception, according to logics that prioritize the situatedness and relationality of such phenomena. Strategies to manage fertility are constitutive of heterosexual sexuality. Women and men can use contraception or not; the reasons for that conduct extrapolate aspects concerning information and access. We seek to understand contraceptive practices from the process of learning of relational logic and gender, at different times of biographies: the beginning of the affective-sexual trajectory, the contexts of eruption of pregnancy and termination of reproductive potential by means contraceptive sterilization. This composite require use of different empirical materials for the construction and analysis of the stages of elected biographies. It focuses, first, the passing moment sexuality with a partner. Problematizes the idea of relaxation of contraceptive practices, from the sexual initiation, current design in the national literature due to the decrease in condom use in sex later. We discuss then the attitudes and issues present in the construction process of contraceptive practice, at the time the sexual life becomes regular. The proposition from the perspective of contraceptive management emphasizes the positions of the protagonists, marked by gender. Finally, we analyze the biographical circumstances and relational scenarios of contraceptive sterilization, which emerges as a strategy of stabilization or consolidation of a contraceptive / reproductive route. The debate around the contraception in Brazil has a tendency to emphasize the social determining to explain unexpected pregnancies. However, it is noted based on a critical literature, the dimensions of individual agency, although circumscribed by a delimited range of possibilities.

Objetivos: Objetivos: Avaliar o crescimento de crianças amamentadas cujas mães haviam inserido um implante de liberação de etonogestrel no pós-parto imediato. Métodos: Ensaio clínico aberto, randomizado, controlado e paralelo de mulheres pós-parto que foram randomizadas em blocos para inserção precoce (até 48 horas pós-parto antes da alta) ou convencional (6 semanas após o parto) de um implante etonogestrel. O desfecho primário foi o peso médio do bebê aos 12 meses (360 dias), e uma diferença de >=10% entre os grupos foi considerada clinicamente significativa. Os desfechos secundários foram a comprimento da criança, o perímetro cefálico e a circunferência braquial. Estas variáveis foram medidas no início e aos 14 e 40, 90, 180, 270 e 360 dias pós-parto. O modelo de regressão linear de efeitos mistos foi utilizado para avaliar os desfechos, com um poder de 80%, e um nível de significância de 1% para o desfecho primário e 0,3% para os desfechos secundários, devido à correção para múltiplas hipóteses. Resultados: De junho a agosto de 2015, um total de 100 mulheres foram randomizadas para inserção precoce ou convencional do implante de etonogestrel no pós-parto. As características sociodemográficas foram semelhantes entre os grupos, exceto no nível de escolaridade, que foi maior no grupo de inserção convencional (88% vs. 70% no grupo de inserção precoce, p = 0,02). Não houve diferença no peso do bebê em 360 dias entre os grupos [precoce: (média ± desvio padrão) 10060,3 ± 1156,0 g vs convencional: 9812,1 ± 1270,3g, estimativa da diferença de média 321,6g, intervalo de confiança 95% (IC): -183,5 A 495,7]. As curvas de crescimento do comprimento e as curvas dos perímetros cefálico e braquial também não diferiram entre os grupos. Conclusões: Não há diferença no crescimento das crianças amamentadas, em 12 meses, cujas mães receberam a inserção do implante liberador de etnogestrel precocemente comparado com a inserção pós-parto convencional. / Objective: To evaluate the growth of breastfed children whose mothers had inserted an etonogestrel-releasing implant in the immediate postpartum period. Methods: An open, randomized, controlled, and parallel trial of postpartum women who were block randomized to early (up to 48 hours postpartum before discharge) or conventional (at 6 weeks postpartum) insertion of a etonogestrel implant. The primary outcome was average infant weight at 12 months (360 days), and a difference of >=10% between groups was considered clinically significant. The secondary outcomes were infant\'s lenght, head and arm circumferences. These variables were measured at baseline and at 14 and 40, 90, 180, 270, and 360 days postpartum. The mixed-effects linear regression model was used to evaluate the outcomes, with a power of 80%, and a significance level of 1% for primary outcome and 0.3% for secondary outcomes, due to correction for multiple hypothesis testing. Results: From June to August of 2015, a total of 100 women were randomized to either early or conventional postpartum etonogestrel insertion. Sociodemographic characteristics were similar between the groups, except for educational attainment, which was higher in the conventional insertion group (88% vs. 70% in the early insertion group, p=.02). There was no difference in infant weight at 360 days between the groups [early: (mean ± standard deviation) 10060.3 ±1156.0 g vs conventional: 9812.1 ± 1270.3g, mean difference estimate 321.6g, 95% confidence interval (CI): - 183.5 to 495.7]. The growth curves of the lenght and the curves of the head and arm circumferences did not differ between the groups. Conclusion: There is no difference in growth at 12 months among breastfed infants whose mothers underwent early compared with conventional postpartum insertion of the etonogestrel implant.