Objectives: To study indicators specifically reflecting the reproductive health of Ukrainian women and to analyse factors behind the indicators. Methods: Induced abortion and maternal mortality were studied in some countries/regions of the former Soviet Union, using official statistics. Abortion rates, contraceptive practices and intentions in Ukrainian women were analysed by a large self-completion survey in 1996, and by a classroom questionnaire to first year medical students in 1999 in Donetsk, Ukraine. Totally, 1694 women and 689 students participated. Perinatal mortality was studied, applying the Nordic-Baltic perinatal death classification to all cases in the Donetsk region in 1997-98 (n=1126) and in Denmark in 1996 (n=540). Clinical guidelines, use of technology and rates of interventions in the two regions were analysed. Results: Abortion remains a major method of fertility control and abortion-related mortality contributes to maternal deaths. Perinatal mortality rate is twice as high in the Donetsk region as in Denmark. A substantial proportion of sexually active women do not practice contraception. Modern methods of contraception are not widely used. There is a lack of knowledge in reproductive health issues and negative attitude to OCs. There is a positive attitude towards abortion as an acceptable fertility control method and of having abortion instead of using OCs or IUD. Poor economy is an obstacle to the use of contraceptive methods associated with a cost. Lack of experience with contraception reduces the intention to use any method in the future. Being single, younger than 19 years, living with parents, having a positive attitude towards abortion as fertility control method, having a history of previous childbirth and/or abortion are important factors associated with pregnancy termination. Antepartum deaths of growth-retarded fetuses, intrapartum and neonatal deaths associated with asphyxia are more common in Ukraine than in Denmark, particularly among premature infants. Lack of evidence-based clinical guidelines and adequate resources for fetal monitoring during pregnancy and labour, together with negative attitudes towards, and limited resources for, instrumental delivery, contribute to high perinatal mortality. Conclusion: Better reproductive education/information of all strata of society is needed. Implementation of evidence-based guidelines in perinatal medicine, where international collaboration can be of great value, should be a matter of high priority.

The overall aim of this thesis was to investigate the knowledge of, attitudes toward, and experiences of the emergency contraceptive pill (ECP), sexual behaviour, and pornography consumption among high school students and young people. Data were obtained by questionnaires (studies I, II, and III), and by qualitative in-depth interviews (study IV). A majority of 16-year old high-school students were aware that ECP existed, and knew where to obtain it. Attitudes toward using ECP were generally positive, but more girls than boys were hesitant as to whether ECP should be available without a prescription. Of those having experienced sexual intercourse, more than one fourth stated that they themselves or their partner had ever used ECP (I). Almost half of the 16-year old high-school students surveyed (46%) had had sexual intercourse, a number similar in studies conducted 10 and 20 years earlier. Use of contraceptives at first intercourse had increased (to 76%) and use of alcohol had decreased (to 23%). More students in practical rather than theoretical programs smoked, had sexual intercourse at an earlier age, had more partners, and used contraceptives at first intercourse less often (II). Three out of four 18-year old students had had sexual intercourse, of which almost three quarters reported contraceptive use at first intercourse. Anal intercourse was reported by one sixth, with infrequent condom use. Males who consumed more pornography were more likely than males who consumed less pornography to engage in a variety of sexual activities, as were males with an early age at first sexual intercourse (III). The core category that emerged in the interviews was “Living with the current sexual norm”, pornography created sexual expectations and demands. The interviewees expressed contradictory feelings towards pornography and felt that sexuality was separated from intimacy. In order to deal with the current sexual norm, participants had different individual handling strategies, including liberal-, normalization-, distance-, feminist- and conservative strategies (IV). Overall, the studies highlight several differences between genders and between students attending practical- and theoretical study programs in questions concerning ECP, sexual behaviour and pornography. These differences should be addressed while planning for counselling and sex education. We suggest that health- and school personnel discuss how sexuality is portrayed in pornographic material with young people.

Background: To date, little information exists about contraception counselling, unplanned pregnancy counselling, and abortion services curricula in Ontario medical schools. Identifying existing curricula, including influences on whether and how curricula are delivered, is an essential starting point for evaluative processes. Purpose and Objectives: The purpose of this study was to explore contraception counselling, unplanned pregnancy counselling, and abortion services curricula in Ontario medical schools. The objectives were to 1) identify the existence of such curricula in undergraduate (preclinical, obstetrics and gynecology clerkship, and family medicine clerkship) and post-graduate (obstetrics and gynecology and family medicine) programs; and 2) explore factors influencing the existence and form of these curricula from the perspective of program directors. Design: An exploratory qualitative approach was used for this study whereby, Ontario program directors responsible for contraception counselling, unplanned pregnancy counselling, and abortion services curricula were interviewed. Results: Overall, the inclusion of routine curricula in contraception counselling, unplanned pregnancy counselling, and abortion services was limited and variable between schools, as well as within clerkship and post-graduate programs. Program directors were often uncertain about iii whether such routine curricula were present in their programs. Four factors were found to influence whether these curricula were included in a program: 1) program structure, 2) program resources, 3) the interests of residents/students, and 4) personal philosophy of the program director. A typology was developed to understand how program directors resolved uncertainty when asked about the existence of these curricula in their programs. The emergent sensemaking typology revealed strategies used by directors to either justify the current system of medical teaching (i.e., defending the status quo) or support change (i.e., responsive). Program directors were consistent across programs in terms of the factors they identified as influencing the curriculum offered. The perceived impact of these factors varied according to the sensemaking processes employed by each director. Conclusions: This study provides an outline of curriculum variability within and between medical school programs. Further, if offers a typology of the ways program directors explain their uncertainty regarding the inclusion of these curricula in their programs. In so doing, program director sensemaking as a key influence on the curriculum is revealed.

Background: To date, little information exists about contraception counselling, unplanned pregnancy counselling, and abortion services curricula in Ontario medical schools. Identifying existing curricula, including influences on whether and how curricula are delivered, is an essential starting point for evaluative processes. Purpose and Objectives: The purpose of this study was to explore contraception counselling, unplanned pregnancy counselling, and abortion services curricula in Ontario medical schools. The objectives were to 1) identify the existence of such curricula in undergraduate (preclinical, obstetrics and gynecology clerkship, and family medicine clerkship) and post-graduate (obstetrics and gynecology and family medicine) programs; and 2) explore factors influencing the existence and form of these curricula from the perspective of program directors. Design: An exploratory qualitative approach was used for this study whereby, Ontario program directors responsible for contraception counselling, unplanned pregnancy counselling, and abortion services curricula were interviewed. Results: Overall, the inclusion of routine curricula in contraception counselling, unplanned pregnancy counselling, and abortion services was limited and variable between schools, as well as within clerkship and post-graduate programs. Program directors were often uncertain about iii whether such routine curricula were present in their programs. Four factors were found to influence whether these curricula were included in a program: 1) program structure, 2) program resources, 3) the interests of residents/students, and 4) personal philosophy of the program director. A typology was developed to understand how program directors resolved uncertainty when asked about the existence of these curricula in their programs. The emergent sensemaking typology revealed strategies used by directors to either justify the current system of medical teaching (i.e., defending the status quo) or support change (i.e., responsive). Program directors were consistent across programs in terms of the factors they identified as influencing the curriculum offered. The perceived impact of these factors varied according to the sensemaking processes employed by each director. Conclusions: This study provides an outline of curriculum variability within and between medical school programs. Further, if offers a typology of the ways program directors explain their uncertainty regarding the inclusion of these curricula in their programs. In so doing, program director sensemaking as a key influence on the curriculum is revealed.

In the United States, concerns about adolescent childbearing and its perceived corollaries – negative health outcomes for mother and child, the disintegration of the nuclear family, and “over-dependence” on public resources – began to circulate widely in policy spheres and popular media in the 1970’s, resulting in a proliferation of policies, programs, and services designed to address its prevention. Although national birth rates among adolescents are currently at their lowest since peaking in the early 1990’s, this decline masks persistent and significant disparities between groups of young people by race, ethnicity, geography, and poverty level. The concomitant existence of social and economic inequities that contribute to these differences is particularly striking in New York City; an urban center of vast extremes in health, wealth, and opportunity, but which boasts extensive reproductive health services for young people, including confidential care and availability of free or low-cost contraception. Within this setting, the promotion of hormonal and long-acting reversible contraceptive methods, specifically aimed at young women deemed at high risk of pregnancy and with less access to health care, has emerged as a key primary prevention strategy to reduce both overall adolescent pregnancy rates and disparities between adolescent groups. Using ethnographic methods, this research examined the promulgation and interpretation of this strategy by reproductive health leaders and healthcare workers as well as contextualized these perspectives with the reproductive decisions and fertility desires of female youth for whom this strategy is intended. As a result, this study elucidates broader political and socio-cultural contexts in which young women negotiate intimate relationships and contraceptive use. Recommendations are subsequently offered for clinical practices attuned to female youths’ lived experiences, educational programs for healthcare workers, and reproductive health policies reflective of the broader factors that influence contraceptive behaviors.

No description available.

Unintended pregnancy has been the subject of considerable research in Lesotho. Lack of priority placed on young people’s sexuality and reproductive health was found to be a major factor exacerbating the rate of unintended pregnancy in the country. The study draws on qualitative data collected from in-depth interviews with university students in Lesotho. In total, 15 in-depth interviews were conducted with 10 women and 5 men. The findings of the study show that unsafe sex coupled with low contraceptive use are the leading causes of unintended pregnancy among young women in Lesotho. Evidence suggests that even though contraceptive prevalence is noticeably low, modern contraceptive methods have a greater potential than other means for reducing the prevalence of unintended pregnancy. The findings of the study also suggest that there is a considerable gender differences in sexual behaviour; males are more likely than females to experience earlier sexual onset, have more sexual partners and to practise unsafe sex. This study recommends that increasing contraceptive prevalence among young people will lead to better reproductive health outcomes. The study also suggests that family planning services should be more male friendly because men play a major role in decision making, and have a great influence on their partners’ decisions to use contraceptives. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2011.

The primary aim of this investigation is to focus on the delivering of pre-abortion counselling from a social work perspective. The importance of delivery of pre abortion counselling with regard to the pregnant woman, who is considering the termination of a pregnancy, is accentuated on the one hand. On the other hand, the focus is on making social workers aware of becoming involved in abortion-related services. The thesis consists of five Sections: SECTION A This section indicates the actuality of the research, namely a study of pre-abortion counselling according to which four research questions are formulated. The overarching research aim and four research objectives are discussed in the section. This research takes on the intervention research model within the combined qualitative and quantitative research approach. The survey procedure was utilized in two different manners to wit the single-system design and mailed questionnaires. The data which was captured during thorough interviews was processed computer-wise as well as by hand. SECTION B This section was presented in the form of four articles in which the research finding were reported. AU four articles form part of the all-embracing research aims and objectives and of the entire research project. However, every article is a sub-project of the entire research project because it also acts independently - each with a distinctive problem statement, research aim and objectives, research methods and distinctive content. Section B consists of the following articles: Article 1 discusses abortion as a moral dilemma in South Africa and points out that there are still unanswered questions with regard to this acute subject that is as old as mankind. In Article 2 the living space of the pregnant woman who requests the termination of a pregnancy is discussed with the accent on the necessity for the understanding of such a woman who finds herself in a crisis situation, in order to deliver an effective social work service. The importance of pre-abortion counselling with crisis intervention as the proper model is discussed in Article 3. And as indicated that delivering pre-abortion counselling to the pregnant woman who requests the termination of a pregnancy is essential for the decision-making process but also with regard to her future. Article 4 discusses the opinion of social workers concerning the delivery of pre-abortion counselling. 'The social worker as a pre-abortion counsellor, and who forms part of the multi-professional team receives priority attention here. SECTION C In Section C, the conclusions and recommendations with regard to this research is explained. The limitations of this study are indicated, and recommendations are made with a view to its utilisation in theory and in practice as well as for training and research SECTION D AU addendum that are referred to in the thesis are contained in this section. SECTION E Although each article has its own source list, a combined source list of the entire research project is presented in this section. / Thesis (Ph.D. (Social Work))--North-West University, Potchefstroom Campus, 2005.

Trente ans après la légalisation de la contraception en France (Loi Neuwirth du 28 décembre 1967), la " pilule du lendemain " était autorisée à la vente (1998). La loi relative à l'interruption de grossesse et à la contraception promulguée en 2001 permet, notamment, que la contraception d'urgence soit vendue sans ordonnance, en pharmacie. Elle autorise en outre les mineures à accéder gratuitement et sans autorisation parentale à cette méthode. En tant que contraception post-coïtale, la " pilule du lendemain " permet aux femmes d'éviter la survenue d'une grossesse en cas de rapport non ou mal protégé. À partir du récit de 64 jeunes femmes âgées de 15 à 25 ans (entretiens compréhensifs), cette thèse de sociologie appréhende les enjeux sanitaires, relationnels et identitaires liés à l'utilisation des méthodes contraceptives. Elle questionne l'existence de domaines de compétences distincts en matière de gestion de la sexualité : la protection pour les hommes et la contraception pour les femmes. À travers les recours à la contraception d'urgence nous étudions les formes d'investissement du partenaire et saisissons combien son implication peut être révélatrice de l'intensité du lien amoureux. À partir des pratiques et des stratégies de protections (imaginaires et identitaires) mises en œuvre par les jeunes femmes, l'intention de cette recherche est de mettre en évidence l'imbrication des biographies affectives et sexuelles pour comprendre les pratiques contraceptives.

The primary aim of this investigation is to focus on the delivering of pre-abortion counselling from a social work perspective. The importance of delivery of pre abortion counselling with regard to the pregnant woman, who is considering the termination of a pregnancy, is accentuated on the one hand. On the other hand, the focus is on making social workers aware of becoming involved in abortion-related services. The thesis consists of five Sections: SECTION A This section indicates the actuality of the research, namely a study of pre-abortion counselling according to which four research questions are formulated. The overarching research aim and four research objectives are discussed in the section. This research takes on the intervention research model within the combined qualitative and quantitative research approach. The survey procedure was utilized in two different manners to wit the single-system design and mailed questionnaires. The data which was captured during thorough interviews was processed computer-wise as well as by hand. SECTION B This section was presented in the form of four articles in which the research finding were reported. AU four articles form part of the all-embracing research aims and objectives and of the entire research project. However, every article is a sub-project of the entire research project because it also acts independently - each with a distinctive problem statement, research aim and objectives, research methods and distinctive content. Section B consists of the following articles: Article 1 discusses abortion as a moral dilemma in South Africa and points out that there are still unanswered questions with regard to this acute subject that is as old as mankind. In Article 2 the living space of the pregnant woman who requests the termination of a pregnancy is discussed with the accent on the necessity for the understanding of such a woman who finds herself in a crisis situation, in order to deliver an effective social work service. The importance of pre-abortion counselling with crisis intervention as the proper model is discussed in Article 3. And as indicated that delivering pre-abortion counselling to the pregnant woman who requests the termination of a pregnancy is essential for the decision-making process but also with regard to her future. Article 4 discusses the opinion of social workers concerning the delivery of pre-abortion counselling. 'The social worker as a pre-abortion counsellor, and who forms part of the multi-professional team receives priority attention here. SECTION C In Section C, the conclusions and recommendations with regard to this research is explained. The limitations of this study are indicated, and recommendations are made with a view to its utilisation in theory and in practice as well as for training and research SECTION D AU addendum that are referred to in the thesis are contained in this section. SECTION E Although each article has its own source list, a combined source list of the entire research project is presented in this section. / Thesis (Ph.D. (Social Work))--North-West University, Potchefstroom Campus, 2005.