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Contraceptive Technology Update

Diaphragm: Update on This Barrier Contraceptive
Diaphragm: Update on this barrier contraceptive Executive Summary The female diaphragm offers hormone-free contraception that is female-initiated and female-controlled. Currently available diaphragms require a pelvic examination and fitting to ensure proper size and placement of the device. * Two ... (Publication: Contraceptive Technology Update)

CNE/CME Objectives & Questions
CNE/CME Objectives After reading Contraceptive Technology Update, the participant will be able to: * identify clinical, legal, or scientific issues related to development and provisions of contraceptive technology or other reproductive services; * describe how those issues affect services and ... (Publication: Contraceptive Technology Update)

Perspectives in Sexual and Reproductive Health

Who Is Using Long‐Acting Reversible Contraceptive Methods? Findings from Nine Low‐Fertility Countries
CONTEXT Long‐acting reversible contraceptive (LARC) methods—IUDs and implants—are more effective than other reversible methods, yet are little used in the United States. Examining which U.S. women use LARC methods and how they differ from users in other low‐fertility countries may help point the way toward increasing use. METHODS Data from married or cohabiting women participating in the National Survey of Family Growth (2008–2010) and in eight countries’ Generations and Gender Programme surveys (2004–2010) were used in bivariate and multinomial logistic regression analyses examining LARC use within each setting. RESULTS The proportion of contraceptive use accounted for by LARC methods was generally greater in Europe (10–32%) than in the United States (10%) and Australia (7%). Compared with LARC use among comparable groups in other countries, use was particularly low among U.S. women who were married, were aged 40–44 or had had three or more children, yet was comparatively high among 18–24‐year‐olds. Among U.S. women, those aged 35–39 or 40–44 were more likely than 18–29‐year‐olds to rely on sterilization rather than on LARC methods (odds ratios, 3.0 and 10.7, respectively), those who had had three or more children were more likely to do so than were those who had had none or one (4.9), and women who had completed college were less likely than those who had not finished high school to do so (0.4). CONCLUSIONS Certain subgroups of U.S. women may benefit from the reversibility and effectiveness of LARC methods.

A Qualitative Analysis of Approaches To Contraceptive Counseling
CONTEXT Underuse and inconsistent use of contraceptives contribute to the continued high rate of unintended pregnancy in the United States. High‐quality interaction between patient and provider about contraception is associated with improved contraceptive use, yet little is known about how providers support patients in the decision‐making process. METHODS A random sample of 50 family planning visits by patients in the San Francisco Bay Area was selected from a larger sample of 342 audio‐recorded visits to six clinics between 2009 and 2012. In qualitative analysis guided by grounded theory techniques, transcripts were assessed to determine counseling approaches and patterns in the use of these approaches. RESULTS Providers employed three counseling approaches: foreclosed (in 48% of visits), characterized by discussion of few contraceptive methods and method selection by the patient with no involvement from the provider; informed choice (30%), characterized by detailed description of multiple methods, but little or no interaction between the patient and the provider; and shared decision making (22%), characterized by the provider's interactive and responsive participation with the patient in method selection. Use of these approaches varied by patient's age: Women 25 or younger experienced the foreclosed approach more often than older women, and patients older than 35 were far more likely than their younger counterparts to experience the shared decision‐making approach. CONCLUSIONS Most visits did not include interactive engagement between the patient and the provider. Contraceptive counseling interventions should encourage providers to responsively engage with patients of all ages to better meet their contraceptive needs.

Guttmacher Policy Report

Guttmacher Institute Monthly State Policy Update
This update provides information on legislation, as well as relevant executive branch actions and judicial decisions in states across the country

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