Half of them were white and half were African-American. Young adult women belonged to this broad age-range group. The 146 reasons given were categorized into four, namely method-related, user-related, partner-related, and cost/access-related. This result suggested the need for multidimensional interventions in effectively reducing the rate of unintended pregnancy (Nettleman et al.).
Side effects and health-related concerns deterred contraceptive use in many respondents (Nettleman et al., 2007). They experienced these side effects themselves or related to them by friends or family. They avoided a particular method because it did not work for them or for someone they knew. Their erroneous perception needs to be corrected by accurate information not only on an individual level but also through social networks of friends and family. Other respondents refrained from contraceptive use because of less common side effects like cancer and stroke. The rest did not desire pregnancy but did not think it would be a problem if their partners or family would extend economic and emotional support. The variety of reasons showed that intending pregnancy is not an absolute condition (Nettleman et al.).
This collection of findings puts health providers in a special position to help women make informed choices in the use of contraception according to their needs (Nettleman et al., 2007). Health providers can provide accurate information and correct misconceptions about contraception methods. They need to be sensitive to women's concerns about contraception .They also need to consider that interpersonal and social relations and individual life experiences affect the incidence of unprotected sexual intercourse (Nettleman et al.).
Pregnant Women
The Centers for Disease Control and Prevention recently reported that approximately 1.5 million women become victims of intimate partner violence each year (Cox, 2008). The risk is greatest during women's reproductive years at 35.6% higher in pregnant women than in non-pregnant women. The prevalence of intimate partner violence or IPV is 4-8% greater during pregnancy. Pregnant women who are victimized by their intimate partners also tend to delay seeking out prenatal care. They, thus, confront increased risk of poor maternal and infant health, pregnancy complications and pre-term delivery or low birth weight of their child. Pregnancy complications include low maternal weight gain, infections, high blood pressure and vaginal bleeding, The Healthy People 2010 initiative linked IPV with 8 of 10 leading health indicators. Violence both affects and is affected by these leading health issues. In comparison with non-abused women, IPV women victims are less likely to practice responsible sexual behavior. They face increased risk for mental health disorder and substance abuse and have less access to care. These women come from all social strata, races and ethnic groups. They are also likely to be young, unmarried, with little education and have low household incomes (Cox).
The first realistic step towards IPV prevention or intervention is accurate screening, especially by the local health department or LHD (Cox, 2008). The American College of Obstetrics and Gynecology recommended that all healthcare providers should regularly screen patients for violence. Screening should be conducted during routine annual examinations, pre-conception visits, once per trimester of pregnancy and during postpartum examinations. However, there is as yet no universal screening for IPV. And according to a national survey, routine IPV is conducted by only 17% of prenatal providers and only 5% make follow-up visits. Yet LHDs play a crucial role in identifying, intervening into and preventing IPV. That role goes beyond setting up a crisis hotline or shelter for abused women and extends to identifying the risk and offering protection. Common barriers, however, stand on the way to fulfilling this role. These include incomplete data on IPV women victims, lack of enhanced training and education on IPV and related resources, promoting screening and assessment tools, and low-level communication with clients (Cox).
In tackling the problem of incomplete data, LHDs may secure these on a State level or enter into data-sharing agreements with local law enforcement or emergency medical services (Cox, 2008). LHDs need to connect with networks, keep updated information on community resources and maintain and strengthen relationships with partners in the community, such as shelters and advocacy organization. Screening for IPV among pregnant women should be a priority that all healthcare and social service providers should be made to understand as their responsibility. As a consequence, it can be incorporated into settings, such as family planning, primary care, prenatal care and pediatric clinics. In the absence of universal screening protocols, LHDs can make use of community resource guides or pocket reference...
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