To investigate the contraception and sexual health-related awareness, attitudes, and practices of a representative sample of Canadian women of childbearing age.
A self-report survey was mailed to a national sample of 3345 women, aged 15 to 44 years, who were members of a pre-recruited market research panel. Survey questions and methodology were similar to 3 previous Canadian Contraception Studies, allowing for description of current patterns of behaviours and beliefs and comparison of trends over time.
Of 3345 women contacted, 1582 returned completed surveys, for a response rate of 47.3%. Responses were weighted to represent Canadian women by region, age, and marital status on the basis of current census data. Eighty-six percent of women sampled had ever had sexual intercourse and 78% were currently sexually active. Women's familiarity with oral contraceptives and condoms as methods of contraception was high (96% and 93%, respectively), but familiarity with other methods was much lower (sterilization, 62%; withdrawal, 59%; the morning-after pill, 57%; intrauterine devices, 50%; depot [injectable] medroxyprogesterone acetate, 38%). A very favourable opinion was held by 63% of respondents concerning oral contraceptives, by 38% concerning condoms, and by 39% and 28% concerning male and female sterilization, respectively. Among respondents who have ever had sexual intercourse, the most frequently used current methods were oral contraceptives (32%), condoms (21%), male sterilization (15%), female sterilization (8%), and withdrawal (6%). Nine percent of these respondents reported using no method of contraception at all. The currently reported rate of female sterilization is the lowest ever recorded in Canada. Survey results show that adherence to contraceptive methods is a challenge for many women and their partners, and that risk of sexually transmitted disease is an ongoing concern.
This study provides a wide-ranging examination of contraception awareness, beliefs, and use among Canadian women that may provide guidance for clinical and public health practice. Part 1 of this report describes the methodology of the 2002 Canadian Contraception Study and the overall results of this study; Part 2 considers results pertaining specifically to adolescent women and women in their later reproductive years, reports on indicators of women's sexual function and reproductive health history, describes approaches to addressing challenges in contraception counselling, and presents data concerning trends in Canadian women's awareness and use of contraception over the past 2 decades.
The various countries of Europe have similar conditions of access to contraceptive methods. In eastern Europe, however, the supply of contraceptive pills, coils, spermicidal products, and condoms is less than the demand (except for Hungary and the Czech and Slovak republics), particularly in Poland, in the former Soviet Union, and in Romania. Sweden and Turkey have authorized midwives to prescribe contraceptive pills or to insert coils. In Turkey, Bulgaria, Romania, and in the former Soviet Union, the dispensing of pills without prescription is tolerated. Spermicidal products can generally be dispensed in pharmacies without a prescription. Condoms are sold even in Ireland. France dose not allow the advertising of contraceptives in nonmedical journals, while Denmark encourages such advertising. Today a number of European countries regulate contraceptive surgery. In Finland, a minimum of 3 children is the prerequisite and age conditions are set (over 18 years in Turkey, over 25 years in Austria, Denmark, Iceland, Norway, Portugal, and Sweden, over 30 years in Finland, and over 35 years in Croatia and Slovenia). Sterilization for contraceptive purposes constitutes a statutory offense of mutilation in France, Ireland, Austria, Greece, Malta, and Poland. Sterilization is carried out in Spain and Italy, less so in Ireland and Malta, and there is slow progress in this regard in Belgium and France. Voluntary sterilization is legally allowed in Hungary and Romania, practiced on a small scale in Albania, and prohibited in Bulgaria. The Netherlands has the highest number of couples protected by sterilization. Most often the public family planning services are integrated in other services, such as community clinics, hospitals, and pre- and postnatal clinics. In Europe as compared with the developing countries, a very large number of private practitioners have the responsibility of informing and prescribing.
The Patient Insurance (PI) scheme in Sweden was instituted on 1 January 1975. From the PI it is possible for a patient to obtain acknowledgement of an injury sustained in connection with medical treatment or operation--and receive financial compensation therefore--without having to prove that the injury was the result of fault or neglect. Special conditions of undertaking are laid down for the guidance of PI assessors which, if fulfilled, will entitle the patient to indemnity from the respective county council (via the PI) for injury sustained in connection with medical care received from county institutions or staff. As the Swedish PI scheme was the first of its kind in the world, an evaluation of its application during the first 5 years seemed justified. The present work constitutes the obstetrical-gynaecological part of that project. The objectives of the study were: to analyse and group according to injury all claims concerning obstetrical or gynaecological intervention submitted to the PI during 1975-79; to evaluate available literature on such injuries in relation to the present findings; to make recommendations for changes in the treatment routines of frequently occurring or serious injuries; and to study the working procedures of the PI, especially regarding its assessment of patient claims. Chapter I sets out the historical background of the PI. The extent of a patient's right to indemnity from the PI is discussed, covering the conditions of undertaking that must be fulfilled on the patient's part, and the PI's obligations. The Patient Injuries Committee is presented, to which injured parties can appeal against decisions of the PI. Chapters II--X. During the period studied, altogether 275 claims concerning obstetrical and gynaecological treatment were submitted to the PI, i.e. 2.5% of all claims received by the PI during that period. Most of the injuries resulted from surgical intervention. The claims have been grouped into six gynaecological and three obstetrical chapters. The reporting frequency to the PI was low during this period and therefore no statistical information can be derived from the analysis. A review of the current literature revealed a similar pattern of severe complications as that found among claims to the PI. In one respect, however, the present study is unique, since complications resulting from certain types of intervention, though performed under so varying circumstances, have never before been compiled and evaluated. The reported injuries were fairly evenly distributed among the 26 counties and the three different sizes of hospital.(ABSTRACT TRUNCATED AT 400 WORDS)
In Korea as in many other nations vasectomy as a male sterilization has become more popular as a method of planned parenthood. In this overview of male sterilization emphasis is on the mainly technical aspects of the ordinary vasectomy and vasovasostomy. Although the principle of vasectomy is the same, many different techniques have been reported and used. Specific differences are found in techniques for immobilizing the vas, for making the scrotal incision, for treating the cut ends of vasa, and for removing segments of vas. Attention is given to some important factors so as to provide complete protection against the passage of sperm without any failure and to improve the chances of later reversibility. The following aspects of ordinary vasectomy procedure are reviewed: ideal operative level, local anesthesia, immobilization of the vas, skin incision, isolation of the vas, treatment of the cut ends of vasa, prevention of hematoma formation, disappearance rate of residual sperm, immediate sterility technique, complications, psychological effects, and antibodies following vasectomy. In relation to vasovasostomy, numerous factors such as operative techniques, splint, various factors for the successful operation, overall success rates and low pregnancy rates are discussed and compared to this author's series.