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Fulltext Factors associated with postpartum family planning in a cohort of Kelantanese women with previous caesarean delivery in Malaysia

Hafizah I, Tengku Alina TI, Suhaily MH, Zaharah S

IIUM Medical Journal Malaysia, 2020;19(1):85-97.
MyJurnal

This community-based, cross-sectional study aimed to identify the factors associated with
postpartum family planning use among a cohort of women with recent caesarean delivery in a state with the
lowest contraceptive use in Malaysia. Materials and Methods: A total of 281 women aged between 18-49
years old who had caesarean delivery in government tertiary centres in Kelantan from January until April
2017 were enrolled in this study. The study was conducted from January until April 2018. Women were
selected through stratified random sampling with probability proportional to size. Data were collected
through a validated structured questionnaire. The main outcome was binary (postpartum family planning use
or non-use). The factors included socio-demographic details, reproductive history, previous contraceptive
use, contraceptive health education received, knowledge, and social support. Simple and multiple logistic
regression were conducted to identify significant determinants of postpartum family planning use. Results:
The factors associated with postpartum family planning use included a secondary and below education level
of women (AOR= 2.37, 95% CI (1.05, 5.34)), previous contraceptive use (AOR= 9.82, 95% CI (4.81, 20.06)),
individual health education (AOR= 4.19, 95% CI (1.23, 14.30)), higher knowledge score (AOR= 1.12, 95% CI
(1.03, 1.23)), and higher social support score (AOR= 1.09, 95% CI (1.03, 1.16)). Conclusions: here remains a
need to enhance personalised contraceptive counselling in the primary care setting as well as to promote
longer acting reversible contraceptive methods.

Matched MeSH terms: Contraception Behavior
Fulltext Factors associated with crisis pregnancies in Ireland: findings from three nationally representative sexual health surveys

Bourke A, Kelleher C, Boduszek D, Morgan K

Reprod Health, 2015;12:14.
PMID: 25884222 DOI: 10.1186/s12978-015-0005-z

Findings on the demographic and sexual health characteristics associated with the experience of a crisis pregnancy are important to inform the public health policy of a country, including Ireland. Studies from other jurisdictions have suggested that certain demographic groups are at risk for unintended pregnancies and the disparity between the groups has been growing in recent years. Ireland is a country which experienced much economic and societal change in the first decade of the 21(st) century; changes which are likely to have affected demographic variables pertaining to sexual health. The current study had two aims: to investigate changes in the socioeconomic characteristics associated with crisis pregnancies over a seven year period [2003 to 2010], and to investigate the recent [2010] socioeconomic risk factors associated with crisis pregnancies in Ireland.

Matched MeSH terms: Contraception Behavior/statistics & numerical data*
Evidence from peninsular Malaysia of breastfeeding as a contraceptive method

Rao SR

Stud Fam Plann, 1992 Nov-Dec;23(6 Pt 1):376-85.
PMID: 1293861 DOI: 10.2307/1966895

This report examines Malaysian women's perceptions of the contraceptive effect of breastfeeding, the determinants of their perceptions, and any effect these perceptions might have on nursing duration and contraceptive use. The report also considers whether women are consciously replacing breastfeeding with modern contraceptive methods. Data from the 1976 Malaysian Family Life Survey are analyzed, and the author concludes that Malaysian women do perceive that breastfeeding has a contraceptive effect, but that this perception is not universal. Ethnicity and desire for a particular family size are the most significant determinants of this perception. Finally, Malaysian women's recognition of the contraceptive effect of nursing does not influence either the duration of their breastfeeding or their adoption of contraception. Malaysian women may not be abandoning breastfeeding to adopt contraception. More probably, breastfeeding declines and contraceptive prevalence increases with modernization.

Matched MeSH terms: Contraception Behavior*
Estimation of fecundability from survey data

Goldman N, Westoff CF, Paul LE

Stud Fam Plann, 1985 Sep-Oct;16(5):252-9.
PMID: 4060210 DOI: 10.2307/1966998

The estimation of fecundability from survey data is plagued by methodological problems such as misreporting of dates of birth and marriage and the occurrence of premarital exposure to the risk of conception. Nevertheless, estimates of fecundability from World Fertility Survey data for women married in recent years appear to be plausible for most of the surveys analyzed here and are quite consistent with estimates reported in earlier studies. The estimates presented in this article are all derived from the first interval, the interval between marriage or consensual union and the first live birth conception.
PIP: The estimation of fecundability from survey data is plagued by methodological problems such as misreporting of dates of birth and marriage and the occurrence of premarital exposure to the risk of conception. The availability of data collected with a standard interview schedule from over 40 countries in the World Fertility Survey (WFS) is an invaluable resource for assessing the potential utility of measures of fecundability derived from single-round surveys as well as for comparing estimates across countries and regions of the world. In this article, data are used from 5 WFSs in Latin America (Colombia, Costa Rica, Panama, Mexico and Paraguay) and 3 in Asia (Korea, Malaysia and Sri Lanka) to determine the general usefulness of single-round survey data for the estimation of fecundability from survey data, given the limited information on contraceptive use available from many surveys and the data quality problems associated with reports of dates of marriage and dates of birth. Explored in the process are several different procedures for estimation and variations in estimates of fecundability by country, time period, and women's age. For most of this analysis, the median waiting time to conception in the absence of contraception is used as a measure of fecundability. All of the estimates presented are derived from the 1st birth interval. The estimates are based on data collected in both the birth and the marriage histories in the WFS individual interviews. The 8 surveys chosen for this analysis are characterized by relatively complete reporting of dates of birth and marriage. The primary conclusion of this exercise is that reasonable estimates of fecundability can be derived from WFS data only if one is careful to avoid numerous methodological pitfalls. The most plausible estimates appear to be for women married in the period from about 2 to 10 years before the survey. The average waiting times to 1st conception range from about 4 to 7 months; the corresponding monthly probabilities of conception lie between 0.17 and 0.26. The effect of age at marriage on fecundability is most apparent for ages below 16; differences between women married at ages 16-17 and at ages 18 and above are more modest. Suggestions for improvement of the estimation of fecundability by including a number of questions in survey questionnaires are presented.

Matched MeSH terms: Contraception Behavior
Efficacy of Contrasperm as a male contraceptive: clinical trials in Malaysian men

Hamid A, Jaffar A

Malays J Reprod Health, 1983 Jan;1(1):75-82.
PMID: 12279893

PIP:
The efficacy of a recently marketed posttesticular male oral contraceptive, Contrasperm, was assessed in a clinical trial involving 32 Malaysian volunteers ages 21-39 years. Contrasperm is claimed to be a pure botanical extract free of toxic chemicals, steroids, and hormones. The drug is believed to cause cells surrounding the sperm in the seminiferous tubules to secrete carbon dioxide, producing a weakly acidic environment that greatly increases the sperms' metabolism and reduces the pH of semen from its normal level of 7.5 to 1.5. The manufacturer claims that this drop in pH decreases motility from 95% to 0%. Semen samples were collected by masturbation from subjects to provide baseline data. 3 days after the initial sperm analysis, subjects were given 1 capsule of Contrasperm containing 10 mcg of the active ingredient. Additional semen analyses were conducted 30 minutes, 6 hours, and 24 hours after ingestion. Sperm count and sperm motility were greatly reduced in most subjects 30 minutes after ingestion. However, 6 subjects had increased sperm counts and 4 subjects demonstrated increased sperm motility, indicating an enhancing effect. At 6 hours after ingestion, 20 subjects had lowered sperm motility and 12 subjects showed normal sperm motility, contradicting the manufacturer's claim that motility is reduced to 0%. Although Contrasperm is claimed to be effective for 6-8 hours after ingestion, its effect wore off in less than 6 hours in 37% of subjects. Both sperm count and sperm motility returned to normal levels 24 hours after ingestion, confirming the reversibility of this drug. Most subjects reported mild side effects such as muscle weakness, blurred vision, dizziness, perspiration, urgency, abnormal muscle tension, and dry throat which persisted longer than 24 hours. Further studies, with proper controls, are needed to assess the reliability and toxicity of this preparation.

Matched MeSH terms: Contraception Behavior
Effectiveness of publications in family planning program

Noor Laily Abu Bakar, Tan BA, Tey NP, Yusuf Y

Malays J Reprod Health, 1983 Dec;1(2):109-19.
PMID: 12313333
Matched MeSH terms: Contraception Behavior*
Effective family planning programs

Rosenfield AG

Med Today, 1973;7(3-4):80-94.
PMID: 12309877

PIP: Organizational and content features of various national family planning programs are reviewed. The Thai program is cited as an example of a family planning program organized on a massive unipurpose compaign basis. The Korean and Taiwan programs have utilized special field workers while upgrading the general health care network. 3 major problems with family planning programs are: 1) the lack of experience with such programs; 2) lack of commitment at the highest political levels; and 3) medical conservatism. Utilization of all available contraceptive methods instead of reliance on 1 method would improve most programs. Nursing and auxiliary personnel could be trained to take over the work of physicians in family planning programs. This is already being done with IUD insertion and pill prescription in several programs. The postpartum tubal ligation approach has proven effective and should be extended. There is a place in all national programs for both the private and the commercial sectors. Incentives for clinics, personnel, and acceptors might spread family planning more rapidly.

Matched MeSH terms: Contraception Behavior*
Ectopic pregnancies following mini-laparotomy Pomeroy female sterilization

Puraviappan A, Arshat H

Malays J Reprod Health, 1984 Jun;2(1):20-4.
PMID: 12267517
Matched MeSH terms: Contraception Behavior
Do fertility intentions predict subsequent behavior? Evidence from Peninsular Malaysia

Tan PC, Tey NP

Stud Fam Plann, 1994 Jul-Aug;25(4):222-31.
PMID: 7985216 DOI: 10.2307/2137905

Data from the 1984 Malaysian Population and Family Survey were matched with birth registration records for 1985-87 to determine the accuracy of statements regarding desired family size that were reported in a household survey in predicting subsequent reproductive behavior. The findings of this study were that stated fertility intention provides fairly accurate forecasts of fertility behavior in the subsequent period. In other words, whether a woman has another child is predicted closely by whether she wanted an additional child. Informational, educational, and motivational activities of family planning programs would, therefore, have greater success in reducing family size if fertility intentions were taken into account.

Matched MeSH terms: Contraception Behavior
Fulltext Disturbing trends in abortions in Singapore--analysis in a private clinic

Chew SC

Singapore Med J, 1988 Feb;29(1):28-9.
PMID: 3406761

The figures for abortions performed under The Abortion Act, 1974 of Singapore in a private clinic over a period of 20 months were studied. Overall, an alarming proportion of repeat abortions were found, and this was true for all age groups suggesting that abortions are being used as a regular method of family planning in Singapore.

Matched MeSH terms: Contraception Behavior
Determinants of waiting time to third pregnancy using censored linear regression

Awang H

J Biosoc Sci, 2003 Jan;35(1):59-70.
PMID: 12537156

The intervals between pregnancies have important effects on fertility and maternal and infant health outcomes. This study uses linear regression with censored observation to assess the determinants of the waiting time to third pregnancy. The analysis is applied to data from the Second Malaysian Family Life Survey consisting of 1172 women who had their second delivery ending in a live birth. Contraceptive use, age of the woman, duration of breast-feeding, length of previous pregnancy interval and education of the woman all affect the waiting time to third pregnancy significantly.

Matched MeSH terms: Contraception Behavior
Determinants of birth-interval length in the Philippines, Malaysia, and Indonesia: a hazard-model analysis

Trussell J, Martin LG, Feldman R, Palmore JA, Concepcion M, Abu Bakar D

Demography, 1985 May;22(2):145-68.
PMID: 3996687
Matched MeSH terms: Contraception Behavior
Demographic and fertility characteristics of 4 squatter settlements

Yusof K, Zulkifli SN

Malays J Reprod Health, 1985;3(1):31-45.
PMID: 12268887
Matched MeSH terms: Contraception Behavior
Correlates of short interbirth intervals in Peninsular Malaysia: their pathways of influence through breastfeeding and contraceptive use

Da Vanzo J, Starbird EH

Stud Fam Plann, 1991 Jul-Aug;22(4):241-54.
PMID: 1949106 DOI: 10.2307/1966480

Recent research has shown that children born before and after short birth intervals run a considerably greater risk of dying in infancy or childhood than do others. This report investigates which women have short interbirth intervals, under what circumstances, and for what reasons. The analysis uses data from the Malaysian Family Life Survey to examine influences on the two main behaviors--breastfeeding and contraceptive use--that affect birth interval length, and assesses the the impact of these same variables on the probability of having a birth interval of less than 15 months. The analysis shows that many of the independent variables affect breastfeeding and contraceptive use in opposite directions, with no significant net effect on the likelihood of a short interval. For example, a woman's education is negatively related to the probability that she breastfeeds, positively related to the probability that she uses contraceptives, and has no significant effect on the likelihood that the interpregnancy interval is less than 15 months. Having a family planning clinic nearby is associated with less breastfeeding, offsetting whatever positive effects family planning clinics have on contraceptive use in terms of the percentage of birth intervals that are so short as to be detrimental to infant and child health. Hence, factors that increase contraceptive use do not necessarily reduce the incidence of short interbirth intervals, because they are also associated with reduced breastfeeding. We simulate the proportion of intervals that would be short for alternative combinations of breastfeeding and contraceptive use in the population and show that over the period covered by the data (1961-75), breastfeeding had a considerably greater effect on preventing short interbirth intervals than did contraceptive use.

Matched MeSH terms: Contraception Behavior*
Contraceptive use in Cambodia: does household decision-making power matter?

Lai SL, Tey NP

Cult Health Sex, 2020 07;22(7):778-793.
PMID: 32037969 DOI: 10.1080/13691058.2019.1685683

In Cambodia, the growth of family planning services and socio-economic development have resulted in a spectacular rise in contraceptive prevalence rate and an equally remarkable reduction in contraceptive use differentials. With rising educational levels and increased participation in the modern labour market, Cambodian women are playing an increasingly pivotal role in household decision-making. This study used data from three rounds of Cambodia Demographic and Health Surveys to elucidate trends and patterns of contraceptive use. It then examined the determinants of contraceptive use through the use of logistic regression. The central hypothesis to be tested was whether or not women's involvement in household decision-making affected contraceptive use. Multivariate analysis showed that apart from the number of living children, women's work status and education of both men and women had a more significant impact on contraceptive use, as compared to women's power in household decision-making. More effort is needed to empower women in all aspects in order to reduce the socio-economic differentials in contraceptive use and improve their reproductive health, in line with the goal of the global agenda of the sustainable development goals (SDGs) to leave no one behind.

Matched MeSH terms: Contraception Behavior
Fulltext Contraceptive use among women with chronic medical conditions and factors associated with its non-use in Malaysia

Manaf RA, Ismail IZ, Latiff LA

Glob J Health Sci, 2012 Sep;4(5):91-9.
PMID: 22980381 DOI: 10.5539/gjhs.v4n5p91

INTRODUCTION: Women with chronic medical conditions are at higher risk of adverse pregnancy outcomes, which may be minimized through optimal preconception care and appropriate contraceptive use. This study aimed to describe contraceptive use among women with chronic medical conditions and factors associated with its non-use.
METHODS: This study used cross-sectional data from a family planning survey among women with chronic medical conditions conducted in three health facilities in a southern state of Malaysia. A total of 450 married women in reproductive age (18-50 year) with intact uterus, and do not plan to conceive were analysed for contraceptive use. Both univariate and multivariate analysis was conducted to identify factors associated with contraceptive non-use among the study participants.
RESULTS: A total of 312 (69.3%) of the study participants did not use contraceptive. Contraceptive non-use was highest among the diabetics (71.2%), connective tissue disease patients (68.6%) and hypertensive patients (65.3%). Only 26.3% of women with heart disease did not use contraceptive. In the multivariate analysis, contraceptive non-use was significantly more common among women who received their medical treatment in the health clinics as compared to those who received treatment in the hospital (adjusted odds ratio [OR]=1.75, 95% confidence interval [CI]: 1.09, 2.79), being in older age group of 41-50 year (adjusted OR=2.31, 95% CI: 1.19, 4.48), having children (adjusted OR=4.57, 95% CI: 1.66, 12.57) and having lower education (adjusted OR=2.87, 95% CI: 1.43, 5.77).
CONCLUSION: About two-third of women with chronic medical conditions who needed contraceptive did not use them despite the higher risk of pregnancy related complications. The high unmet need warrant an effective health promotion programme to encourage the uptake of contraceptives especially targeting women of older age group, low education and those who received their medical treatment at health clinics.
Study site: Outpatient clinic, three hospitals; 8 health clinics, Malaysia

Matched MeSH terms: Contraception Behavior/statistics & numerical data*
Contraceptive method switching in Peninsular Malaysia: ethnic differences, 1940s-1970s

Davanzo J, Starbird E, Reboussin D, Tan Boon Ann, Abdullah SH

Malays J Reprod Health, 1988 Jun;6(1):1-21.
PMID: 12281591
Matched MeSH terms: Contraception Behavior*
Contraceptive choice and acceptability: the future for STI risk in Kelantan, Malaysia

Shiely F, Saifuddin MS

Int J STD AIDS, 2014 Mar;25(3):219-27.
PMID: 23970646 DOI: 10.1177/0956462413497699

More than 150 million women become pregnant in developing countries annually and an estimated 287,000 die from pregnancy-related causes. Contraception is vital to prevent unnecessary maternal deaths, as well as sexually transmitted infections. The objective of this study was to investigate preferred contraceptive methods and the factors that influence contraceptive choice among women in Kelantan, Malaysia. A cross-sectional study using interview-based questionnaires was conducted, during July and August 2009, in local family planning clinics in Kelantan. The questionnaire was administered to adult women (age 20-50). Prevalence of unplanned pregnancies was high (48%). Contraceptive preference was Depo contraceptive injection (32%), oral contraceptive pills (27%), intrauterine devices (15%) and contraceptive implants (12%); 9% used condoms. Only 2% used contraception to protect against sexually transmitted infections or HIV/AIDS. Younger women (OR 0.90; 95% CI 0.807-0.993) were more likely to use contraception. In conclusion, non-interrupted contraceptive methods were preferred. More than 60% would stop using contraception if it interrupted intercourse. From both a public health and infectious disease perspective, this is extremely worrying.

Matched MeSH terms: Contraception Behavior*
Fulltext Contraception: herbal and modern strategies

Nurul Ain, K.B., Mahanem, M.N., Irfan, Y.

Medicine & Health, 2018;13(2):20-35.
MyJurnal

Population explosion is one of the global issues of concern. The increasing number of individuals could result in negative impact on social and economy. To overcome this problem, convenient and safe modern contraception was introduced. However, recently many researchers have conducted studies on the effectiveness of medicinal plants as contraceptive agents on human and animal models. Therefore, the studies of herbal and modern contraceptives were summarized in this review article. A total of 66 relevant articles were documented having information regarding the modern and herbal contraceptives. All contraceptives are highly effective provided they are used consistently and in the proper way. Contraception is important as it could prevent diseases and infections caused by sexual intercourse and prevent unintended pregnancy. Therefore, this review is an attempt to summarize the potential of medicinal plants as contraceptive agents and the modern contraceptive methods used as birth control in males and females.

Matched MeSH terms: Contraception Behavior
Fulltext Consistent condom use and its predictors among female sexual Partners of People who Inject Drugs in Klang Valley, Malaysia

Abdul Manaf R, Dickson N, Lovell S, Ibrahim F

BMC Public Health, 2019 Nov 07;19(1):1473.
PMID: 31699061 DOI: 10.1186/s12889-019-7855-1

BACKGROUND: Men who inject drugs (MWIDs) comprise the highest percentage of diagnosed HIV cases in Malaysia. Their female partners risk being infected through unprotected sexual contact. This paper reports the prevalence of consistent condom use and its predictors among the wives and regular sexual partners of MWIDs in Klang Valley, Malaysia.
METHODS: A cross-sectional study using a self-administered questionnaire was conducted among the wives and regular sexual partners of MWIDs in the study location; 221 women were recruited through respondent-driven sampling. Data were analysed descriptively for the prevalence of consistent condom use, HIV status and HIV risk-related behaviour. Subsequently, simple and multiple logistic regressions were undertaken to identify the predictors of consistent condom use.
RESULTS: The prevalence of consistent condom use among respondents was 19.5%. Slightly more than half (52.5%) of respondents had never used condoms with their partner. Fourteen women (6.3%) reported being HIV positive. While 7.7% had HIV-positive partners, 45.7% were unaware of their partner's HIV status. Consistent condom use was significantly higher among single women (AOR = 4.95; 95% CI: 2.45, 9.99), women who lived in urban areas (AOR = 2.97; 95% CI: 1.30, 6.78), HIV-positive women (AOR = 3.45; 95% CI: 1.13, 10.5) and women involved in sex work (AOR = 3.55, 95% CI: 1.45, 8.67).
CONCLUSIONS: Inconsistent condom use among the majority of female sexual partners of MWIDs underscores the heightened risk faced by these women and calls for alternative prevention methods that women are able to control.

Matched MeSH terms: Contraception Behavior/statistics & numerical data*

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