Unwanted pregnancy in Armenia--the larger context

Knowledge and Attitudes Regarding Family Planning Options in Armenia

Objective

In many Transcaucasian and Middle Eastern populations, research in women's sexual and reproductive health remains limited, especially in Armenia despite recent political and cultural changes. This study explores the current state of family planning in Armenia while both highlighting the recent progress and identifying current barriers to reproductive health.

Study Design

We conducted a mixed-methods study using both a quantitative survey and qualitative interviews with women and key informants in the field of women's sexual and reproductive health.

Results

Armenian women are familiar with many types of contraception. The use of modern methods has increased but remains low. Sexual education for women is uncommon and often sought through independent online searches or books. We found no significant access barriers, however, a prevailing distrust in hormonal contraceptive methods left many women to rely on condoms and withdrawal. Although the majority of surveyed women (72%) believed having access to safe abortions was an important right, only 42% would consider having an abortion in the case of an unintended pregnancy. Interviewees highlighted the lack of sexual education, discrepancies in sexual and reproductive services between rural provinces and the urban capital city of Yerevan, as well as the need for information and the government's responsibility in this field.

Conclusions

The lack of comprehensive sexual education in Armenia fuels misinformation regarding family planning options. One option we recommend is a government-funded sexual education program which begins as culturally sensitive, sex-positive education in schools and continues with counseling and support for women within the health care system.

Prevalence of unwanted pregnancy in Iranian women: a systematic review and meta-analysis

BACKGROUND

Unwanted pregnancies are considered as one of the most important public health risks. Regarding the importance of the unwanted pregnancy in the country and helping health policy-makers obtain more accurate information on this issue, this study aims to provide a systematic review and meta-analytical on the prevalence of unwanted pregnancies in Iran.

METHODS

The present study was carried out using meta-analysis. Articles related to the topic were obtained through SID, Magiran, Scopus, PubMed, and ScienceDirect and Google Scholar databases from 2001 to 2017, Articles written based on cross-sectional studies were included in the study and other overviews, case-control, cohort, and interventional studies were excluded from the list of articles. Heterogeneity of studies was investigated using I2 index and data analysis was performed in Comprehensive Meta-Analysis software (Version 3).

RESULTS

In 23 articles, the prevalence of unwanted pregnancy in Iranian women was 27.9% (95%CI: 24-32.1%). The meta-regression analysis was used in two sample sizes and years of study. It was reported that as the sample size and Years increases, the prevalence of the unwanted pregnancy decrease, this difference was also statistically significant (P = 0.000).

CONCLUSION

Considering that the prevalence of unwanted pregnancy is high in Iran, it is necessary that health policy makers take effective measures to enhance the awareness of couples and public information about the risks of the unwanted pregnancy.

Pregnancy-related maternal risk factors of attention-deficit hyperactivity disorder: a case-control study

Background. The etiology of attention-deficit hyperactivity disorder (ADHD) is complex.This study was conducted to evaluate the pregnancy-related maternal risk factors of ADHD. Methods. 164 ADHD children attending to Child and Adolescent Psychiatric Clinics compared with 166 normal children selected in a random-cluster method from primary schools. ADHD rating scale and clinical interview based on Schedule for Affective disorders and Schizophrenia for School-Aged Children (K-SADS) were used to diagnose ADHD cases and to select the control group. Results. The mean maternal age at pregnancy, duration of pregnancy, and the mean paternal age were alike in two groups. The ADHD children's mothers compared with those of control group had higher frequencies of somatic diseases, psychiatric disorders, and alcohol and cigarette exposure during the pregnancies (P < 0.01). Also birth by cesarean section was more common among mothers of ADHD children (P < 0.001). These factors plus trauma to the abdomen during pregnancy were significantly predictors of ADHD in children. Conclusions. Some pregnancy-related maternal factors may be considered as environmental risk factors for ADHD. Each of these factors considered in our study as a risk factor needs to be tested and confirmed through next methodologically appropriate researches in this field.

Postcommunist Deinstitutionalization of Children With Disabilities in Romania

The author examines the policies and treatment of children institutionalized during and after the communist regime, the adoption policies for these children, the human rights claimed in the name of these children, and the ecology of disabilities in Romania. Institutionalized children fell into three categories: children who had one or more minor to severe disabilities, children who had been abandoned, and children who were part of ethnic minorities, especially the Roma. The author reviews the literature on these topics and adds her own perspective, as a Romanian special education teacher and researcher. While during communism, institutionalized persons were invisible to the public and kept in inhuman conditions, after communism, increased awareness about the situation in state institutions and about disabilities and human rights in general led to the adoption and implementation of new disability-friendly policies. Currently, there is increased advocacy for the rights of the people with disabilities, although great challenges remain.