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Nutaitis AC, Ferrando CA, Propst K. Patient Perspectives Following Obstetric Anal Sphincter Injury. UROGYNECOLOGY (PHILADELPHIA, PA.) 2024:02273501-990000000-00208. [PMID: 38621419 DOI: 10.1097/spv.0000000000001506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
IMPORTANCE An obstetric anal sphincter injury can significantly affect patients. Support for these patients is both limited and not well understood. OBJECTIVE The aim of this study was to describe patient experiences after an obstetric anal sphincter injury. STUDY DESIGN This is a prospective cross-sectional qualitative study of patients who experienced an obstetric anal sphincter injury within a tertiary care network between May and June of 2022. Demographic data, clinical data regarding the delivery, and the Edinburgh Postnatal Depression Scale were collected. Prospective semistructured interviews were conducted approximately 5-12 weeks postpartum to address opportunities to improve obstetric anal sphincter injury care. Qualitative analysis was performed using a grounded theory approach. RESULTS Fifteen women with a mean age of 31 (±3.93) years participated. The majority identified as White (93.3%) and non-Hispanic (100%). All participants identified as being married to men and completing undergraduate education; 9 (60%) also received postgraduate education. Five participants (33.3%) screened positive (score of 10 or greater) for postnatal depression on the Edinburgh Postnatal Depression Scale. Thematic saturation was reached with 3 major themes identified: (1) pain control, (2) desire for multifactorial support, and (3) obstetric anal sphincter injury knowledge and awareness. CONCLUSIONS Experiencing an obstetric anal sphincter injury represents a great unknown to most women. This study identifies opportunities for improved postpartum care through education, pain control, and patient support. Interventions are needed to improve the postpartum experience for women who experience an obstetric anal sphincter injury with childbirth.
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Affiliation(s)
- Alexandra C Nutaitis
- From the Department of Obstetrics and Gynecology, Cleveland Clinic Akron General, Akron, OH
| | - Cecile A Ferrando
- Center for Urogynecology and Pelvic Reconstructive Surgery, Women's Health Institute, Cleveland Clinic, Cleveland, OH
| | - Katie Propst
- Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, University of South Florida, Tampa, FL
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Manzer JL, Berndt VK, Bell AV. Intersections between culture, contraception, knowledge and the body in the USA. CULTURE, HEALTH & SEXUALITY 2023; 25:1164-1179. [PMID: 36327491 DOI: 10.1080/13691058.2022.2141330] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
Women's contraceptive use is a central feature of US culture around reproduction as evinced by high usage rates and nationwide public health efforts to further increase its use. Paradoxically, women know little about contraception within its biomedical framing, and successive public health-related educational campaigns have produced only moderate knowledge gains. Drawing on 86 in-depth interviews with a diverse sample of reproductive-age women, we set out to understand this persistent learning lag. In doing so, we found that women's limited contraceptive knowledge extended beyond simply being uneducated about various methods. Rather, these learning lags can be attributed to many women's lack of knowledge or misunderstandings about their anatomical bodies and reproductive processes. Employing feminist perspectives, we argue that these misunderstandings derive from factors beyond individual women's control. Indeed, they are rooted in cultural norms that stifle and stigmatise women's reproductive learning. Traditional public health efforts may inevitably fail to overcome these cultural barriers, perpetuating women's gaps in knowledge. Recognising the cultural dimensions of contraceptive knowledge and education reveals how critical action is needed around sexuality education in the USA as well as the limitations of on-going educational efforts.
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Bahamondes L, María Y Makuch. Awareness of the non-contraceptive benefits of reversible contraceptive methods in a cohort of Brazilian women: an exploratory study. EUR J CONTRACEP REPR 2022; 27:294-299. [PMID: 35377262 DOI: 10.1080/13625187.2022.2054983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE We assess the awareness of Brazilian women about non-contraceptive benefits of contraceptives and compare non-health with health care providers. MATERIAL AND METHODS We conducted a survey in Brazil using a questionnaire administered via Google Forms asking women to respond about the awareness of non-contraceptive benefits of combined oral contraceptives (COCs), depot-medroxyprogesterone acetate (DMPA), 52 mg levonorgestrel-releasing intrauterine system (LNG-IUS), etonogestrel (ENG)-implant, copper intrauterine device (Cu-IUD), and male condom. RESULTS We received 2,068 completed questionnaires, 720 women (34.8%) aged ≤ 29 years and 236 (11.4%) were physicians or nurses. Only one third of the respondents were aware that COC use is associated with decreased risks of ovarian and endometrial cancers; 296 (16.1%) about that the use of DMPA is associated with a decreased risk of endometrial cancer, and 253 (13.8%) were aware about that the users of the Cu-IUD present lower risk of cervical cancer. We identified significant differences between non-health care providers when compared to physicians or nurses. CONCLUSIONS We found low awareness regarding the associated lower risk of ovarian, endometrial and cervical cancer associated with the use of some contraceptives, evidencing the need to provide more information about the non-contraceptive benefits during training for health care providers.
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Affiliation(s)
- Luis Bahamondes
- Department of Obstetrics and Gynaecology, University of Campinas Faculty of Medical Sciences, Campinas, Brazil
| | - María Y Makuch
- Department of Obstetrics and Gynaecology, University of Campinas Faculty of Medical Sciences, Campinas, Brazil
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Caruso S, Palermo G, Caruso G, Rapisarda AMC. How Does Contraceptive Use Affect Women's Sexuality? A Novel Look at Sexual Acceptability. J Clin Med 2022; 11:810. [PMID: 35160261 PMCID: PMC8836660 DOI: 10.3390/jcm11030810] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 02/05/2023] Open
Abstract
Among the components of a healthy life, sexuality is essential, contributing to both the psychophysical and social well-being of women and, consequently, to their quality of life. A poorly investigated standpoint is the acceptability of contraceptive methods, both in terms of their tolerability and metabolic neutrality and in terms of their impact on sexual life. In this context, we will provide an overview of the different methods of contraception and their effects on female sexuality, from biological changes to organic, social, and psychological factors, which can all shape sexuality. A MEDLINE/PubMed review of the literature between 2010 and 2021 was conducted using the following key words and phrases: hormonal contraception, contraceptives, female sexual function, libido, sexual arousal and desire, and sexual pain. Recent studies have supported the effects of contraceptives on women's sexuality, describing a variety of positive and negative events in several domains of sexual function (desire, arousal, orgasm, pain, enjoyment). However, satisfaction with sexual activity depends on factors that extend beyond sexual functioning alone. A more holistic approach is needed to better understand the multitude of factors linked to women's sexuality and contraception. Contraceptive counseling must consider these important elements since they are closely related to good compliance and maximize non-contraceptive health benefits.
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Affiliation(s)
- Salvatore Caruso
- Research Group for Sexology, Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic, University of Catania, Via Santa Sofia, 78, 95125 Catania, Italy; (G.P.); (G.C.); (A.M.C.R.)
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Carbone SL, Guillen M, Ramirez JJ, Vargas SE, Lu CF, Getz ML, Frimpong Y, Smith KA, Stout C, Tong I, Hill M, Berry RE, Harrison A, Guthrie KM. 'I feel like a person has a right to use a product to protect themselves…': a qualitative study of the risk-benefit calculus on women's contraceptive use and choice. Sex Health 2020; 17:262-269. [PMID: 32586415 DOI: 10.1071/sh19197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 03/12/2020] [Indexed: 01/13/2023]
Abstract
Background Reducing pregnancy risk requires a multidimensional approach to sexual and reproductive health product development. The purpose of this analysis is to identify, compare, and contrast women's pre-use beliefs and attitudes about three different forms of contraceptives: intravaginal rings; spermicide in conjunction with condoms; and oral contraceptive pills - and explore how those attitudes and beliefs, along with actual method-use experience, may affect potential choices in contraceptive method moving forward. The relationship of beliefs and attitudes to their risk-benefit calculations when using these methods was also considered.? METHODS Women used one or more contraceptive methods, each for 3-6 months. Qualitative data from individual in-depth interviews completed after each 3-month use period were analysed using a summary matrix framework. Data were extracted and summarised into themes. Each woman's experiences were compared among the methods she used; comparisons were also made across participants. RESULTS The data consist of 33 90-120 min in-depth qualitative interviews from 16 women aged 20-34 years, in which they discussed various elements of their method use experience. One prominent theme was identified: the influence of attitudes and beliefs on the risk-benefit calculus. There were six key elements within the theme: pregnancy prevention; dosing and the potential for user error; side-effects; familiarity; disclosure; and sexual partnerships. CONCLUSIONS Women weighed perceived risks and benefits in their decision-making and, ultimately, their contraception choices. Understanding women's beliefs and attitudes that contribute to a calculation of risk-benefit can inform the development of sexual and reproductive health products.
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Affiliation(s)
- Sofía L Carbone
- Brown University School of Public Health, 121 South Main Street, Providence, RI 02903, USA
| | - Melissa Guillen
- Center for Behavioral and Preventive Medicine, Miriam Hospital, Coro West, Suite 309, 164 Summit Avenue, Providence, RI 02906, USA
| | - Jaime J Ramirez
- Center for Behavioral and Preventive Medicine, Miriam Hospital, Coro West, Suite 309, 164 Summit Avenue, Providence, RI 02906, USA
| | - Sara E Vargas
- Center for Behavioral and Preventive Medicine, Miriam Hospital, Coro West, Suite 309, 164 Summit Avenue, Providence, RI 02906, USA; and The Warren Alpert Medical School at Brown University, 222 Richmond Street, Providence, RI 02903, USA
| | - Connie Fei Lu
- The Warren Alpert Medical School at Brown University, 222 Richmond Street, Providence, RI 02903, USA
| | - Melissa L Getz
- Center for Behavioral and Preventive Medicine, Miriam Hospital, Coro West, Suite 309, 164 Summit Avenue, Providence, RI 02906, USA
| | - Yaa Frimpong
- The Warren Alpert Medical School at Brown University, 222 Richmond Street, Providence, RI 02903, USA
| | - Kelley A Smith
- Center for Behavioral and Preventive Medicine, Miriam Hospital, Coro West, Suite 309, 164 Summit Avenue, Providence, RI 02906, USA
| | - Claire Stout
- Center for Behavioral and Preventive Medicine, Miriam Hospital, Coro West, Suite 309, 164 Summit Avenue, Providence, RI 02906, USA
| | - Iris Tong
- The Warren Alpert Medical School at Brown University, 222 Richmond Street, Providence, RI 02903, USA; and Women's Medicine Collaborative, Lifespan, 146 West River Street, Providence, RI 02904, USA
| | - Melanie Hill
- Women's Medicine Collaborative, Lifespan, 146 West River Street, Providence, RI 02904, USA
| | - Robert E Berry
- Cambridge Health Alliance, 1493 Cambridge Street, Cambridge, MA 02139, USA
| | - Abigail Harrison
- Brown University School of Public Health, 121 South Main Street, Providence, RI 02903, USA
| | - Kate M Guthrie
- Brown University School of Public Health, 121 South Main Street, Providence, RI 02903, USA; and Center for Behavioral and Preventive Medicine, Miriam Hospital, Coro West, Suite 309, 164 Summit Avenue, Providence, RI 02906, USA; and The Warren Alpert Medical School at Brown University, 222 Richmond Street, Providence, RI 02903, USA; and Corresponding author.
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