The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception最新文献

{"title":"Global web trends for contraceptive methods: understanding dynamics in reproductive health.","authors":"Gökhan Çeker, Hakan Anıl","doi":"10.1080/13625187.2025.2531020","DOIUrl":"10.1080/13625187.2025.2531020","url":null,"abstract":"<p><strong>Objective: </strong>To analyse global web search trends for contraceptive methods, identify regional differences, and explore implications for reproductive health.</p><p><strong>Materials and methods: </strong>Google Trends data (2004-2024) were analysed for condoms, intrauterine devices (IUDs), vasectomy, birth control pills, and tubal ligation. Relative search volume (RSV) trends were assessed using polynomial regression, with beta coefficients indicating trend directions and R² values measuring correlation strength. Regional preferences were identified by ranking the top five countries with the highest RSV for each method.</p><p><strong>Results: </strong>IUDs (β = 1.457, R² = 0.910, <i>p</i> < 0.001) and vasectomy (β = 0.166, R² = 0.261, <i>p</i> = 0.018) showed significant upward trends, while condoms declined sharply in the last decade (β = -0.169, R² = 0.691, <i>p</i> = 0.003). Birth control pills (β = -0.411, R² = 0.835, <i>p</i> < 0.001) and tubal ligation (β = -0.096, R² = 0.734, <i>p</i> = 0.042) showed steady declines. Uganda ranked highest for IUD interest, and the U.S. for vasectomy.</p><p><strong>Conclusions: </strong>Rising interest in IUDs and vasectomy suggests a shift towards long-term, effective contraceptives with minimal procedural complexity and high patient satisfaction. Declining searches for condoms and birth control pills may indicate a preference for methods requiring less user compliance. The downward trend in tubal ligation suggests a growing preference for less invasive, reversible options. Public health strategies should align with these trends to enhance reproductive health outcomes.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"247-253"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrauterine devices and gynaecological malignancies - an umbrella review of systematic reviews and meta-analyses.","authors":"Alice Lessa, Anna Podlasek","doi":"10.1080/13625187.2025.2499686","DOIUrl":"10.1080/13625187.2025.2499686","url":null,"abstract":"<p><strong>Background and aims: </strong>The intrauterine device (IUD) is globally recognised as a safe, cost-effective, and reliable contraceptive. This umbrella review and meta-analysis synthesises current evidence regarding the association between IUD usage and incidence of gynaecological and breast malignancies.</p><p><strong>Materials and methods: </strong>A comprehensive search of PubMed, Cochrane Library, and Ovid databases was conducted for systematic reviews and meta-analyses examining any type of IUD in relation to gynaecological and breast cancers. The screening and data extraction processes adhered to PRISMA guidelines, and random-effects meta-analysis was employed for data synthesis.</p><p><strong>Results: </strong>323 titles and abstracts were screened, leading to the review of 41 full texts and the inclusion of 17 articles. Analyses of these articles and of their 32 primary sources indicated a decreased risk of cervical, endometrial and ovarian cancer for ever-users of IUD (respective OR: 0.63 [95% CI 0.48-0.82], 0.41 [0.31-0.54], and 0.71 [0.59-0.86]; all <i>p</i> < 0.001). Our analysis did not yield any statistically significant association between IUD use and breast cancer risk (OR 1.00 [0.70-1.41], <i>p</i> = 0.99).</p><p><strong>Conclusion: </strong>IUD use is associated with a reduced risk of ovarian, endometrial, and cervical cancers, while no link was found with breast cancer. These findings can inform patient counselling on the benefits and risks of IUD use.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"177-189"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ulipristal acetate for medical abortion: did we really need to create a 'monster'?","authors":"Christian Battipaglia, Alessandro D Genazzani, Giovanni Grandi","doi":"10.1080/13625187.2025.2521294","DOIUrl":"10.1080/13625187.2025.2521294","url":null,"abstract":"","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"167-169"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The CPLAN study: Clotting Parameters after medicaL AbortioN.","authors":"John J Reynolds-Wright, Alastair F Nimmo, Julia A M Anderson, Sharon T Cameron","doi":"10.1080/13625187.2025.2499005","DOIUrl":"10.1080/13625187.2025.2499005","url":null,"abstract":"<p><strong>Background: </strong>There is paucity of information on coagulation parameters throughout pregnancy, the puerperium, and post-abortion - and how these relate to venous thromboembolism (VTE) risk. Guidance for thromboprophylaxis post-abortion is guided by expert opinion and extrapolated from post-birth, with recommendations varying from 0 to 6 weeks duration.</p><p><strong>Methods: </strong>We conducted a study in a community abortion clinic in Edinburgh, UK March-August 2021. We recruited healthy pregnant women requesting medical abortion (<12 weeks gestation) and healthy, non-pregnant women (controls). Blood samples were taken prior to abortion and 10-14 days afterwards. Controls provided a single sample. We assessed laboratory markers of coagulation (Clauss-fibrinogen, prothrombin time, activated partial thromboplastin time, platelets) and viscoelastic measures using the ClotPro® system. We compared the control group with the pregnancy group pre- and post-abortion.</p><p><strong>Results: </strong>We recruited 45 women (24 pregnant, 21 non-pregnant). Clauss-fibrinogen was significantly elevated pre-abortion compared to controls (3.4 g/L vs 2.8 g/L, <i>p</i> = 0.04), although remained within normal range. Two viscoelastic measures showed pro-coagulant changes, one pre-abortion and one post-abortion compared to controls. The absolute differences were small and remained within normal ranges.</p><p><strong>Conclusion: </strong>There were minimal differences in measures of coagulation in first trimester pregnancy, that largely resolved 10-14 days after medical abortion. Shorter courses of thromboprophylaxis might be sufficient compared to post-birth for those at high risk of VTE.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"216-220"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What's illegal? To learn, to practice, or both? Recommendations for the midwifery field to respond to the post-<i>Dobbs</i> abortion crisis.","authors":"Nicole Quinones, Talita Wells Oseguera, Nikia Grayson","doi":"10.1080/13625187.2025.2502801","DOIUrl":"10.1080/13625187.2025.2502801","url":null,"abstract":"<p><strong>Purpose: </strong>Since before the ruling of the <i>Dobbs v. Jackson</i> Supreme Court decision there has been a shortage of abortion providers that has contributed to the lack of abortion access across the U.S. Midwives are uniquely positioned to provide abortion care due to their community-based training and practice, their professional scope of practice, and their reproductive health expertise. The purpose of this commentary is to analyse current advanced practice clinician (APC) abortion scope of practice policies and state level abortion restrictions to make recommendations to increase APC abortion training.</p><p><strong>Materials and methods: </strong>Online state policy data on abortion restrictions and APC abortion scope of practice were compiled to describe the current U.S. landscape. An online survey (<i>n</i> = 197) of U.S. midwives collected responses on whether abortion training was a part of their midwifery curriculum, and the type of training received.</p><p><strong>Results: </strong>Medication and procedural abortion care is included in the legal scope of practice of advanced practice clinicians, including midwives, in 22 states. Nine states where abortion is legal do not allow midwives to provide abortions. Although the American College of Nurse Midwives supports abortion and midwives providing abortion, the curricula at their accredited programs are limited. 65.5% of survey respondents indicated they didn't receive any abortion training in their midwifery program.</p><p><strong>Conclusions: </strong>Ensuring communities have their health care needs met is our collective responsibility. We believe that innovative solutions including implementing institutional policies that intentionally integrate clinical abortion training into the curriculum of accredited programs and midwifery practice is part of the solution.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"226-231"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telemedicine contraceptive counselling through WhatsApp in South African abortion care: a mixed-methods acceptability study.","authors":"Maja Weinryb, Lucia Knight, Elin C Larsson, Margit Endler","doi":"10.1080/13625187.2025.2500637","DOIUrl":"10.1080/13625187.2025.2500637","url":null,"abstract":"<p><strong>Introduction: </strong>While telemedicine contraceptive counselling may enhance access and uptake, particularly in low-resource settings, the evidence for its acceptability as an alternative to in-person counselling remains limited. We therefore assessed the acceptability of PlanUrFam, a comprehensive WhatsApp-based contraceptive counselling tool, among women seeking abortion care in South Africa.</p><p><strong>Methods: </strong>We conducted a mixed-methods pilot study at two public health clinics. Women seeking abortion care (<i>n</i> = 31) used PlanUrFam for contraceptive counselling and were followed-up at two weeks (<i>n</i> = 28). The primary outcome was a composite measure acceptability, informed by the Theoretical Framework of Acceptability (TFA). The secondary outcome was choice of long-acting reversible contraception (LARC) and preference for future counselling. In-depth interviews with a nested subgroup (<i>n</i> = 8) explored experiences of the tool using the TFA and content analysis.</p><p><strong>Results: </strong>There was high acceptability (89%, <i>n</i> = 25/28) across framework domains. Qualitative results confirmed that PlanUrFam was acceptable, easy to use, understand and reduced judgement experienced in in-person care. Comprehensive information increased perceived confidence and agency in contraceptive decision-making. After using PlanUrFam, most participants chose LARC methods (64%, <i>n</i> = 18/28), chose a different contraceptive than previously used (96%, <i>n</i> = 27/28), and preferred either PlanUrFam alone (54%) or in combination with in-person counselling (36%) for future contraceptive care.</p><p><strong>Discussion: </strong>This pilot demonstrates high acceptability of PlanUrFam in abortion care and supported informed decision-making and choice of LARC. The effectiveness of PlanUrFam or similar interventions compared to standard care should be explored in randomised controlled trials measuring method initiation, continuation, recurrent pregnancy and abortion.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"190-199"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction.","authors":"","doi":"10.1080/13625187.2025.2502248","DOIUrl":"https://doi.org/10.1080/13625187.2025.2502248","url":null,"abstract":"","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":"30 2","pages":"123-125"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144122003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Labour induction for termination of pregnancy with severe fetal anomalies after 24 weeks' gestation: a case series and systematic review of the literature.","authors":"Jessica Kiley,&nbsp;Ashley Turner,&nbsp;Catherine Nosal,&nbsp;Molly Beestrum,&nbsp;Jeffrey Dungan","doi":"10.1080/13625187.2022.2102604","DOIUrl":"https://doi.org/10.1080/13625187.2022.2102604","url":null,"abstract":"<p><strong>Purpose: </strong>Under some circumstances, individuals choose to undergo pregnancy termination for foetal anomalies in the second half of pregnancy. This report provides objective information on the clinical management of such cases and a systematic review of the literature on labour induction outcomes for third-trimester abortion using mifepristone-misoprostol.</p><p><strong>Materials and methods: </strong>The study is a case series describing outcomes for labour induction abortion for foetal anomalies, at gestational age 24 weeks and beyond. A systematic review was performed, searching PubMed, Embase, and Cochrane databases. Two independent authors reviewed and quality assessed the data from the articles.</p><p><strong>Results: </strong>During a two-year period, 15 patients met inclusion criteria. Fourteen patients received mifepristone and misoprostol, and one received oxytocin. All delivered vaginally. Thirteen patients delivered within 24 hours of the first misoprostol dose, and half delivered within 12 hours. The average interval from misoprostol initiation to foetal expulsion was 15.5 hours in our series. The systematic review identified nine articles for inclusion, all retrospective studies. Labour induction protocols for mifepristone-misoprostol, reporting of gestational age, and key comparisons varied greatly.</p><p><strong>Conclusions: </strong>The case series illustrates successful termination of pregnancy primarily using combined mifepristone-misoprostol. Certainty of current evidence is low, based on the GRADE framework. Future research is necessary on third-trimester outcomes with mifepristone-misoprostol.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"486-493"},"PeriodicalIF":1.7,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40651636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The views of women and pharmacists on the desirability of a progestogen-only pill over the counter. Results of a survey in Germany, Italy and Spain.","authors":"Emilio Arisi,&nbsp;Cosima Bauer,&nbsp;Manuela Farris,&nbsp;Chiara Giulini-Limbach,&nbsp;Anna Glasier,&nbsp;Inaki Lete,&nbsp;Uwe May,&nbsp;Noushin Mirjalili,&nbsp;Rossella E Nappi,&nbsp;Rafael Sanchez-Borrego,&nbsp;Isabel Serrano","doi":"10.1080/13625187.2022.2128643","DOIUrl":"https://doi.org/10.1080/13625187.2022.2128643","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the perceived need and enthusiasm for over the counter (OTC) progestogen-only pills (POP).</p><p><strong>Materials and methods: </strong>A web-based survey of 1000 sexually active women (16-45) and 100 pharmacists in Germany, Italy and Spain.</p><p><strong>Results: </strong>Despite not wanting to conceive, 5-6% of women in each country were not using contraception and 8-20% were using methods less effective than condoms. At least 74% of respondents felt knowledgeable about the different contraceptives available but at least 1/3 had experienced difficulty accessing oral contraceptive (OCs) in the past two years. The cost of contraceptives, the need to see a doctor and long waits for appointments were cited as barriers for not using OCs. The majority agreed they would discuss with their doctor the decision to buy the POP, consult about side effects and other reproductive health issues. Over 2/3 of pharmacists in each country would be very, or fairly, likely to recommend the POP, agreeing that the benefits included improved access for women, and offered them more independence.</p><p><strong>Conclusions: </strong>Asked directly, women in Germany, Spain and Italy currently using contraception are positive about a POP OTC. Pharmacists are also positive, with the overwhelming majority in favour of providing POPs.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"494-503"},"PeriodicalIF":1.7,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40339444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The safety of misoprostol alone use for second-trimester termination of pregnancy in women with previous caesarean deliveries.","authors":"Anil Erturk,&nbsp;Bayram Tunahan Karapinar,&nbsp;Fatma Nurgul Tasgoz,&nbsp;Betul Dundar,&nbsp;Nergis Kender Erturk","doi":"10.1080/13625187.2022.2115836","DOIUrl":"https://doi.org/10.1080/13625187.2022.2115836","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the safety of misoprostol use in second-trimester pregnancy termination among women with previous caesarean sections.</p><p><strong>Materials and methods: </strong>This is a retrospective cohort study conducted in a tertiary centre, examining 359 patients whose pregnancy was terminated with misoprostol alone between 14 and 24 weeks with the indication of foetal anomalies. Two dose regimens were administered vaginally or sublingually: (1)400 mcg misoprostol every 3-6 h; (2) 200 mcg misoprostol every 3-6 h following a loading dose of 400 mcg. The patients were divided into three groups according to the number of previous caesarean sections (CSs) and compared in terms of demographic and clinical characteristics and complications. Termination-related complications were the primary outcomes considered.</p><p><strong>Results: </strong>Of the 217 patients, 80 (36.8%) had no previous uterine scar, 79 (36.4%) had one previous CS, and 58 (26.7%) had at least two prior CSs. The overall complication rate was 0.9%. There were no differences among groups in terms of complications (<i>p</i> > 0.05). There was no difference in complications in women with prior CS when they were compared according to the misoprostol regimens used (<i>p</i> > 0.05). The total dose of misoprostol used ranged from200 to 3,600 mcg. The treatment success of misoprostol during the second trimester was 92.1%. According to regression analysis, an increase in the week of gestation increased the failure rate of misoprostol for inducing second-trimester abortion by 2.7 times (95%CI (1.38-5.39)).</p><p><strong>Conclusion: </strong>Misoprostol alone is a safe and effective option for terminating second-trimester pregnancies with one or more previous CSs in settings where mifepristone is unavailable.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"473-477"},"PeriodicalIF":1.7,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40351716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}