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  • 1. Backhausen, Mette G
    et al.
    Ekstrand, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Tydén, Tanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Magnussen, Britta Kjeldberg
    Shawe, Jill
    Stern, Jenny
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Hegaard, Hanne K
    Pregnancy planning and lifestyle prior to conception and during early pregnancy among Danish women2014In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 19, no 1, p. 57-65Article in journal (Refereed)
    Abstract [en]

    Objective To investigate the extent to which Danish women attending antenatal care plan their pregnancies and to determine the association between pregnancy planning and the intake of folic acid, alcohol consumption and smoking habits prior to conception and before the 16th week of gestation. Methods A cross-sectional survey of 258 women. Main outcome measures: intake of folic acid, alcohol consumption and smoking. Pregnancy planning was assessed by the London Measure of Unplanned Pregnancy (LMUP) and the five graded Swedish Pregnancy Planning Scale. Results Most (77%) of the participants reported that their pregnancies were very or fairly well planned. Higher median LMUP scores were observed in women taking folic acid (p < 0.001), in those consuming less alcohol, and in women who stopped smoking prior to pregnancy (p = 0.043). However, 43% of the respondents with a high degree of pregnancy planning and 98% of those with a low degree of planning had not taken folic acid prior to pregnancy. Binge drinking during early pregnancy was reported by 20% of women with a high degree of planned pregnancy and 31% of those with a low degree (p = 0.1). Conclusion Pregnancy planning was associated with a healthier lifestyle but still many women could improve their lifestyle in connection to pregnancy. Their level of alcohol consumption is higher than that recommended for best pregnancy outcome.

  • 2.
    Bengtsdotter, Hanna
    et al.
    Örebro Univ, Dept Obstet & Gynaecol, Örebro, Sweden..
    Lundin, Cecilia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Reproductive Health.
    Danielsson, Kristina Gemzell
    Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden.;Karolinska Univ Hosp, Stockholm, Sweden..
    Bixo, Marie
    Umea Univ, Dept Clin Sci, Umea, Sweden..
    Baumgart, Juliane
    Örebro Univ, Dept Obstet & Gynaecol, Örebro, Sweden..
    Marions, Lena
    Karolinska Inst Sodersjukhuset, Dept Clin Sci & Educ, Stockholm, Sweden..
    Brynhildsen, Jan
    Linkoping Univ, Dept Obstet & Gynaecol, Linkoping, Sweden.;Linkoping Univ, Dept Clin & Expt Med, Linkoping, Sweden..
    Malmborg, Agota
    Linköping Univ, Dept Obstet & Gynaecol, Linköping, Sweden.;Linkoping Univ, Dept Clin & Expt Med, Linkoping, Sweden..
    Lindh, Ingela
    Gothenburg Univ, Sahlgrenska Univ Hosp, Sahlgrenska Acad, Dept Obstet & Gynaecol, Gothenburg, Sweden..
    Sundström Poromaa, Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Reproductive Health.
    Ongoing or previous mental disorders predispose to adverse mood reporting during combined oral contraceptive use2018In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 23, no 1, p. 45-51Article in journal (Refereed)
    Abstract [en]

    Purpose: Previous studies have emphasised that women with pre-existing mood disorders are more inclined to discontinue hormonal contraceptive use. However, few studies have examined the effects of combined oral contraceptives (COC) on mood in women with previous or ongoing mental disorders. Materials and methods: This is a supplementary analysis of an investigator-initiated, double-blinded, randomised clinical trial during which 202 women were treated with either a COC (1.5mg estradiol and 2.5mg nomegestrolacetate) or placebo during three treatment cycles. The Mini International Neuropsychiatric Interview was used to collect information on previous or ongoing mental disorders. The primary outcome measure was the total change score in five mood symptoms on the Daily Record of Severity of Problems (DRSP) scale in the intermenstrual phase of the treatment cycle. Results: Women with ongoing or previous mood, anxiety or eating disorders allocated to COC had higher total DRSP -scores during the intermenstrual phase of the treatment cycle in comparison with corresponding women randomised to placebo, mean difference 1.3 (95% CI 0.3-2.3). In contrast, among women without mental health problems, no difference in total DRSP -scores between COC- and placebo users was noted. Women with a risk use of alcohol who were randomised to the COC had higher total DRSP -scores than women randomised to placebo, mean difference 2.1 (CI 95% 1.0-3.2). Conclusions: Women with ongoing or previous mental disorders or risk use of alcohol have greater risk of COC-induced mood symptoms. This may be worth noting during family planning and contraceptive counselling.

  • 3.
    Bengtsdotter, Hanna
    et al.
    Örebro Univ, Sweden.
    Lundin, Cecilia
    Uppsala Univ, Sweden.
    Gemzell Danielsson, Kristina
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Bixo, Marie
    Umeå Univ, Sweden.
    Baumgart, Juliane
    Örebro Univ, Sweden.
    Marions, Lena
    Karolinska Inst Södersjukhuset, Sweden.
    Brynhildsen, Jan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Malmborg, Agota
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Lindh, Ingela
    Gothenburg Univ, Sweden.
    Poromaa, Inger Sundstrom
    Uppsala Univ, Sweden.
    Ongoing or previous mental disorders predispose to adverse mood reporting during combined oral contraceptive use2018In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 23, no 1, p. 45-51Article in journal (Refereed)
    Abstract [en]

    Purpose: Previous studies have emphasised that women with pre-existing mood disorders are more inclined to discontinue hormonal contraceptive use. However, few studies have examined the effects of combined oral contraceptives (COC) on mood in women with previous or ongoing mental disorders. Materials and methods: This is a supplementary analysis of an investigator-initiated, double-blinded, randomised clinical trial during which 202 women were treated with either a COC (1.5mg estradiol and 2.5mg nomegestrolacetate) or placebo during three treatment cycles. The Mini International Neuropsychiatric Interview was used to collect information on previous or ongoing mental disorders. The primary outcome measure was the total change score in five mood symptoms on the Daily Record of Severity of Problems (DRSP) scale in the intermenstrual phase of the treatment cycle. Results: Women with ongoing or previous mood, anxiety or eating disorders allocated to COC had higher total DRSP -scores during the intermenstrual phase of the treatment cycle in comparison with corresponding women randomised to placebo, mean difference 1.3 (95% CI 0.3-2.3). In contrast, among women without mental health problems, no difference in total DRSP -scores between COC- and placebo users was noted. Women with a risk use of alcohol who were randomised to the COC had higher total DRSP -scores than women randomised to placebo, mean difference 2.1 (CI 95% 1.0-3.2). Conclusions: Women with ongoing or previous mental disorders or risk use of alcohol have greater risk of COC-induced mood symptoms. This may be worth noting during family planning and contraceptive counselling.

  • 4. Bengtsdotter, Hanna
    et al.
    Lundin, Cecilia
    Gemzell Danielsson, Kristina
    Bixo, Marie
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynecology.
    Baumgart, Juliane
    Marions, Lena
    Brynhildsen, Jan
    Malmborg, Agota
    Lindh, Ingela
    Sundström Poromaa, Inger
    Ongoing or previous mental disorders predispose to adverse mood reporting during combined oral contraceptive use2018In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 23, no 1, p. 45-51Article in journal (Refereed)
    Abstract [en]

    Purpose: Previous studies have emphasised that women with pre-existing mood disorders are more inclined to discontinue hormonal contraceptive use. However, few studies have examined the effects of combined oral contraceptives (COC) on mood in women with previous or ongoing mental disorders.

    Materials and methods: This is a supplementary analysis of an investigator-initiated, double-blinded, randomised clinical trial during which 202 women were treated with either a COC (1.5mg estradiol and 2.5mg nomegestrolacetate) or placebo during three treatment cycles. The Mini International Neuropsychiatric Interview was used to collect information on previous or ongoing mental disorders. The primary outcome measure was the total change score in five mood symptoms on the Daily Record of Severity of Problems (DRSP) scale in the intermenstrual phase of the treatment cycle.

    Results: Women with ongoing or previous mood, anxiety or eating disorders allocated to COC had higher total DRSP Δ-scores during the intermenstrual phase of the treatment cycle in comparison with corresponding women randomised to placebo, mean difference 1.3 (95% CI 0.3-2.3). In contrast, among women without mental health problems, no difference in total DRSP Δ-scores between COC- and placebo users was noted. Women with a risk use of alcohol who were randomised to the COC had higher total DRSP Δ-scores than women randomised to placebo, mean difference 2.1 (CI 95% 1.0-3.2).

    Conclusions: Women with ongoing or previous mental disorders or risk use of alcohol have greater risk of COC-induced mood symptoms. This may be worth noting during family planning and contraceptive counselling.

  • 5.
    Blom, Helena
    et al.
    Umea Univ, Dept Clin Sci Obstet & Gynaecol, Umea, Sweden.;Umea Univ, Dept Obstet & Gynaecol, S-90187 Umea, Sweden..
    Högberg, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Olofsson, Niclas
    Umea Univ, Dept Publ Hlth & Res, S-90187 Umea, Sweden..
    Danielsson, Ingela
    Umea Univ, Dept Clin Sci Obstet & Gynaecol, Umea, Sweden.;Umea Univ, Dept Publ Hlth & Res, S-90187 Umea, Sweden..
    Multiple violence victimisation associated with sexual ill health and sexual risk behaviours in Swedish youth2016In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 21, no 1, p. 49-56Article in journal (Refereed)
    Abstract [en]

    Objectives: To address the associations between emotional, physical and sexual violence, specifically multiple violence victimisation, and sexual ill health and sexual risk behaviours in youth, as well as possible gender differences. Methods: A cross-sectional population-based survey among sexually experienced youth using a questionnaire with validated questions on emotional, physical, and sexual violence victimisation, sociodemographics, health risk behaviours, and sexual ill health and sexual risk behaviours. Proportions, unadjusted/adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Results: The participants comprised 1192 female and 1021 male students aged 15 to 22 years. The females had experienced multiple violence (victimisation with two or three types of violence) more often than the males (21% vs. 16%). The associations between multiple violence victimisation and sexual ill health and sexual risk behaviours were consistent for both genders. Experience of/involvement in pregnancy yielded adjusted ORs of 2.4 (95% CI 1.5-3.7) for females and 2.1 (95% CI 1.3-3.4) for males, and early age at first intercourse 2.2 (95% CI 1.6-3.1) for females and 1.9 (95% CI 1.2-3.0) for males. No significantly raised adjusted ORs were found for non-use of contraceptives in young men or young women, or for chlamydia infection in young men. Conclusions: Several types of sexual ill health and sexual risk behaviours are strongly associated with multiple violence victimisation in both genders. This should be taken into consideration when counselling young people and addressing their sexual and reproductive health.

  • 6.
    Blom, Helena
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Högberg, Ulf
    Department of Women´s and Children´s Health, Uppsala University .
    Olofsson, Niclas
    Department of Public Health and Research, Sundsvall Hospital .
    Danielsson, Ingela
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Multiple violence victimisation associated with sexual ill health and sexual risk behaviours in Swedish youth2016In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 21, no 1, p. 49-56Article in journal (Refereed)
    Abstract [en]

    Objectives: To address the associations between emotional, physical and sexual violence, specifically multiple violence victimisation, and sexual ill health and sexual risk behaviours in youth, as well as possible gender differences.

    Methods: A cross-sectional population-based survey among sexually experienced youth using a questionnaire with validated questions on emotional, physical, and sexual violence victimisation, sociodemographics, health risk behaviours, and sexual ill health and sexual risk behaviours. Proportions, unadjusted/adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.

    Results: The participants comprised 1192 female and 1021 male students aged 15 to 22 years. The females had experienced multiple violence (victimisation with two or three types of violence) more often than the males (21% vs. 16%). The associations between multiple violence victimisation and sexual ill health and sexual risk behaviours were consistent for both genders. Experience of/involvement in pregnancy yielded adjusted ORs of 2.4 (95% CI 1.5-3.7) for females and 2.1 (95% CI 1.3-3.4) for males, and early age at first intercourse 2.2 (95% CI 1.6-3.1) for females and 1.9 (95% CI 1.2-3.0) for males. No significantly raised adjusted ORs were found for non-use of contraceptives in young men or young women, or for chlamydia infection in young men.

    Conclusions: Several types of sexual ill health and sexual risk behaviours are strongly associated with multiple violence victimisation in both genders. This should be taken into consideration when counselling young people and addressing their sexual and reproductive health.

  • 7. Cea Soriano, Lucía
    et al.
    Wallander, Mari-Ann
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Andersson, Susan
    Filonenko, Anna
    García Rodríguez, Luis Alberto
    Use of long-acting reversible contraceptives in the UK from 2004 to 2010: Analysis using The Health Improvement Network Database2014In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 19, no 6, p. 439-447Article in journal (Refereed)
    Abstract [en]

    Objectives To determine the use of long-acting reversible contraceptives (LARCs) in the UK over the period 2004 to 2010, using the general practice database The Health Improvement Network (THIN).

    Methods Women in THIN, aged 18 to 44 years during 2004 to 2010, who had been registered with their general practitioner for at least five years, with a prescription history of at least one year were included. THIN was searched using the Read and MULTILEX codes for: copper intrauterine devices (Cu-IUDs), the levonorgestrel releasing-intrauterine system (LNG-IUS), progestogen-only implants, and progestogen-only injections.

    Results The prevalence of progestogen-only implant use rose from 0.5 to 3.4%, and that of the LNG-IUS from 3.1 to 5.2%. The annual incidence and prevalence of progestogen-only implant use increased for all age groups but was most marked in younger women, whereas the use of the LNG-IUS augmented with increasing age. For all women, there was a small decrease in the prevalence of use of Cu-IUDs (from 5.4 to 4.8%) and progestogen-only injections (from 3.6 to 3.2%).

    Conclusions Uptake of progestogen-only implants and the LNG-IUS increased over the period 2004 to 2010 in the UK, but LARC use in young women remains low.

  • 8.
    Christianson, Monica
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Eriksson, Carola
    Umeå University, Faculty of Medicine, Department of Nursing.
    Promoting women's human rights: A qualitative analysis of midwives' perceptions about virginity control and hymen 'reconstruction'2015In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 20, no 3, p. 181-192Article in journal (Refereed)
    Abstract [en]

    Objectives To explore midwives' perceptions regarding virginity control and hymen 'reconstructions', and how these practices can be debated from a gender perspective. Methods An international group of 266 midwives answered an open-ended question in a Web survey. The great majority came from the Western world, among them, the majority were from Europe. Data were analysed using qualitative content analysis. Results Three themes emerged: misogynistic practices that cement the gender order, which revealed how the respondents viewed virginity control and hymen 'reconstructions'; raising public awareness and combatting practices that demean women, which were suggested as strategies by which to combat these practices; and promoting agency in women and providing culturally sensitive care, which were considered to improve health care encounters. Conclusions Virginity control and hymen 'reconstructions' are elements of patriarchy, whereby violence and control are employed to subordinate women. To counter these practices, macro and micro-level activities are needed to expand women's human rights in the private and the public spheres. Political activism, international debates, collaboration between sectors such as health care and law-makers may lead to increased gender equality. A women-centred approach whereby women are empowered with agency will make women more capable of combatting virginity control and hymen 'reconstruction'.

  • 9.
    Degni, Filio
    et al.
    Dept. of Public Health, University of Turku, Finland.
    Mazengo, Charles
    Dept. of Public Health, University of Kuopio, Finland.
    Vaskilampi, Tuula
    Dept. of Public Health, University of Kuopio, Finland.
    Essén, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Religious beliefs prevailing among Somali men living in Finland regarding the use of the condom by men and that of other forms of contraception by women2008In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 13, no 3, p. 298-303Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to explore religious beliefs of Somali men residing in Finland that may influence their use of condoms and their perceptions of contraceptive use by women of their community. Both quantitative and qualitative methods were used to study 98 refugee Somali married men aged 30-65 years. Participants filled in self-administered questionnaires (in English or in Somali) but were also interviewed. The interviews were semi-structured, featuring thematically clustered open-ended questions; they were conducted in Somali or in English. Participants had arrived in Finland between 1990-1998. They had from 2-12 children. For religious reasons, 63% of the men avoided using condoms and were opposed to women's contraceptive use. The remaining 37% were not deterred by religious beliefs from using condoms and from approving women's contraceptive practices. In conclusion, for religious reasons, most Somali men assessed avoided using condoms and disapproved of the use of contraception by women.

  • 10.
    Ekstrand, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Engblom, Camilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Larsson, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Tydén, Tanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Sex education in Swedish schools as described by young women2011In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 16, no 3, p. 210-224Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate sex education in Swedish schools regarding content, satisfaction, and suggested improvements, as described by teenagers and young adults. Methods: Waiting-room survey conducted among 225 female patients (aged 13-25) at youth and student health clinics in one large-, and one medium-sized Swedish city. Results: Most participants (97%, n = 218) had received sex education in school, of varying content and quality. Sixty percent thought basic body development was sufficiently covered. Insufficiently covered topics included sexual assault (96%), sexual harassment (94%), pornography (90%), abortion (81%), emergency contraception (80%), fertility (80%), and pregnancy (59%). Thirty percent received no information about chlamydia, and almost half reported that condyloma and human papillomavirus had not been addressed. The youngest respondents (13-19 years) were significantly more likely to have been told about emergency contraception, homosexuality, bisexuality, and transsexuality. Nearly half (46%) considered ''acceptable'' the knowledge gained from sex education provided at school whereas more than a third considered it ''poor'' or ''very poor''. Suggested improvements included more information, more discussion, greater emphasis on sexual diversity, and more knowledgeable teachers. Conclusions: Content and quality of sex education varied greatly. Most respondents thought many topics were insufficiently covered, sex education should be more extensive, and teachers better educated.

  • 11.
    Ekstrand, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Tydén, Tanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Darj, Elisabeth
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Larsson, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Preventing pregnancy: A girls' issue. Seventeen-year-old Swedish boys' perceptions on abortion, reproduction and use of contraception2007In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 12, no 2, p. 111-118Article in journal (Refereed)
    Abstract [en]

    Objective To gain deeper understanding of how teenage males view abortion, adolescent   fatherhood, sexual behavior, and use of contraception.  Method We conducted six focus-group interviews with 17-year-old boys (n 1⁄4 40). The interviews were tape-recorded, transcribed verbatim, and analyzed using manifest content analysis.  Results Adolescent fatherhood was considered to be a catastrophe and abortion a moral   dilemma. Most participants agreed that the unrestricted right to decide on abortion rests upon the girl, but some were frustrated by not having any legal right to influence the decision. Contraceptive failure was viewed as common and mainly due to the influence of alcohol or in relation to unplanned sex. Boys perceived girls as having a greater responsibility in avoiding pregnancy, and they often put a blind trust in the girls’ use of hormonal contraceptives or initiation of emergency contraception. Several groups had insufficient knowledge about fetal development and other aspects of reproduction. Many were unsatisfied with the sex education they had received at school, but still considered it to be an important counterweight to other sources of information concerning sex, such as  pornography.  Conclusion Equal responsibility among boys and girls regarding reproductive issues is still a challenge, but nevertheless an important key to the prevention of unwanted pregnancies.

  • 12.
    Ekstrand, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Tydén, Tanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Larsson, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Exposing oneself and one's partner to sexual risk-taking as perceived by young Swedish men who requested a Chlamydia test2011In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 16, no 2, p. 100-107Article in journal (Refereed)
    Abstract [en]

    Objectives: To explore young men's perceptions of (i) the risk for themselves and their partners in connection with unprotected intercourse, and (ii) the main barriers to practising safe sex. Methods: Qualitative latent content analysis of interviews involving 22 Swedish males aged 16-20, who requested a Chlamydia test. Results:The main categories identified were: (1) Low perceived threat regarding sexual risk-taking - personal consequences in focus. Threats could be both immediate and distant with varying preventative strategies. The young men worried more about their personal consequences than about the consequences for their partner. They were confident that an unintended pregnancy would be terminated, leading to decreased motivation for sharing pregnancy-preventing practices with their partner. (2) Perceived barriers to practising safe sex. Main barriers to condom use were interference with spontaneity, pleasure reduction, fear of loosing one's erection, and embarrassment or distrust. Other obstacles were the girl's use of hormonal contraception, and difficulties in communicating about safe sex. Conclusion The young men did not seem to worry about risks when having unprotected sex. To protect men's - and women's - sexual and reproductive health, efforts are needed to increase the former's contraceptive responsibilities and awareness of consequences related to unprotected sex.

  • 13. Ekstrand Ragnar, Maria
    et al.
    Grandahl, Maria
    Stern, Jenny
    Sophiahemmet University.
    Mattebo, Magdalena
    Important but far away: adolescents' beliefs, awareness and experiences of fertility and preconception health2018In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 23, no 4, p. 265-273Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim was to explore adolescents' beliefs and awareness regarding fertility and preconception health, as well as their views and experiences of information about fertility and preconception health directed at their age group.

    METHODS: We performed seven semi-structured focus group interviews among upper secondary school students (n = 47) aged 16-18 years in two Swedish counties. Data were analysed by qualitative content analysis.

    RESULTS: One theme ('important but far away') and five categories ('starting a family far down on the list'; 'high awareness but patchy knowledge of fertility and preconception health'; 'gender roles influence beliefs about fertility and preconception health'; 'wish to preserve fertility and preconception health in order to keep the door to procreation open'; 'no panacea - early and continuous education about fertility and preconception health') emerged from the interviews. Participants recognised the importance of preconception health and were highly aware of the overall importance of a healthy lifestyle. Their knowledge, however, was patchy and they had difficulties relating to fertility and preconception health on a personal and behavioural level. Participants wanted more information but had heterogeneous beliefs about when, where and how this information should be given.

    CONCLUSION: The adolescents wanted information on fertility and preconception health to be delivered repeatedly as well as through different sources.

  • 14.
    Ekstrand Ragnar, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research.
    Grandahl, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research.
    Stern, Jenny
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Sophiahemmet Univ, Dept Hlth Promoting Sci, Stockholm, Sweden.
    Mattebo, Magdalena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research. Malardalen Univ, Sch Hlth Care & Social Welf, Vasteras, Sweden.
    Important but far away: adolescents' beliefs, awareness and experiences of fertility and preconception health2018In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 23, no 4, p. 265-273Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim was to explore adolescents' beliefs and awareness regarding fertility and preconception health, as well as their views and experiences of information about fertility and preconception health directed at their age group.

    Methods: We performed seven semi-structured focus group interviews among upper secondary school students (n = 47) aged 16-18 years in two Swedish counties. Data were analysed by qualitative content analysis.

    Results: One theme ('important but far away') and five categories ('starting a family far down on the list'; 'high awareness but patchy knowledge of fertility and preconception health'; 'gender roles influence beliefs about fertility and preconception health'; 'wish to preserve fertility and preconception health in order to keep the door to procreation open'; 'no panacea - early and continuous education about fertility and preconception health') emerged from the interviews. Participants recognised the importance of preconception health and were highly aware of the overall importance of a healthy lifestyle. Their knowledge, however, was patchy and they had difficulties relating to fertility and preconception health on a personal and behavioural level. Participants wanted more information but had heterogeneous beliefs about when, where and how this information should be given.

    Conclusion: The adolescents wanted information on fertility and preconception health to be delivered repeatedly as well as through different sources.

  • 15.
    Falk, Gabriella
    et al.
    Div Obstet & Gynaecol, Dept Clin & Expt Med, Fac Hlth Sci, Linköping Univ, Linköping, Sweden.
    Ivarsson, Ann-Britt
    Örebro University, School of Health and Medical Sciences.
    Brynhildsen, Jan
    Div Obstet & Gynaecol, Dept Clin & Expt Med, Fac Hlth Sci, Linköping Univ, Linköping, Sweden.
    Teenagers' struggles with contraceptive use: What improvements can be made?2010In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 15, no 4, p. 271-279Article in journal (Refereed)
    Abstract [en]

    Objective To study the experiences of teenagers using contraceptives at an out-patient abortion clinic and to explore the reasons behind their choices. Methods Twelve teenagers who had applied for induced abortion were interviewed three to four weeks after abortion. The interviews comprised open questions about contraceptive experiences focusing on hindrance for contraceptive use. Qualitative content analysis was used. Results One theme was identified: Struggling with feelings of uncertainty and patterns of behaviour. Three categories emerged from the analysis. Uncertainty dealt with decisions and behaviours that varied with time and between the different individuals. Factors that influence contraceptive use dealt with the persons that the participants had discussed contraceptives with, how they acquired knowledge about contraceptive use and the nature of their behaviour. Anxiety dealt with the side effects of contraception and feelings of fear related to contraceptive use. Conclusion The participants had feelings of uncertainty, anxiety and fear towards contraceptive use which led to non use and inconsistent use. Guidance from health care providers and access to youth clinics varied and was unsatisfactory. Parents were supportive of contraceptive use but not active in the process of getting their child to initiate it. Friends and the Internet were the main sources for acquiring information.

  • 16.
    Georgsson, Susanne
    et al.
    Swedish Red Cross Univ Coll, Huddinge, Sweden; Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden.
    Krautmeyer, Stina
    Sophiahemmet Univ, Dept Hlth Promoting Sci, Stockholm, Sweden.
    Sundqvist, Emilia
    Sophiahemmet Univ, Dept Hlth Promoting Sci, Stockholm, Sweden.
    Carlsson, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Clinical Psychology in Healthcare. Sophiahemmet Univ, Dept Hlth Promoting Sci, Stockholm, Sweden.
    Abortion-related worries, fears and preparedness: A Swedish Web-based exploratory and retrospective qualitative study2019In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 24, no 5, p. 380-389Article in journal (Refereed)
    Abstract [en]

    Objective: A survey was conducted to explore worries, fears and preparedness relating to the recollected experience of having an induced abortion.

    Methods: The Web-based survey was carried out in Sweden among 185 women. Respondents answered open-ended questions and gave retrospective self-reported ratings about their abortion-related worries, fears, preparedness and satisfaction with information obtained from health professionals and the Web. Data were analysed using qualitative content analysis and descriptive statistics.

    Results: Worries and fears included the abortion process, physical reactions and psychosocial aspects. The abortion was associated with unexpected events, including the abortion process, poor health professional treatment and support, and side effects and complications. Respondents described a lack of preparatory information, leading to uncertainties due to insufficient information. Many searched for Web-based information, but respondents experienced difficulties finding high-quality sources. Respondents also recounted that the preparatory information received did not reflect the actual abortion experience.

    Conclusion: There is room for improvement with regard to informing, preparing and supporting women who seek an abortion. The results emphasise the importance of health professionals’ giving sufficient preparatory information to enable preparedness and lessen the impact of possible unexpected events. There is a need for the development of a trustworthy Web-based service that contains honest and high-quality information.

     

  • 17.
    Georgsson, Susanne
    et al.
    The Swedish Red Cross University College. Karolinska Institutet.
    Krautmeyer, Stina
    Sophiahemmet University.
    Sundqvist, Emilia
    Sophiahemmet University.
    Carlsson, Tommy
    Sophiahemmet University / Uppsala University.
    Abortion-related worries, fears and preparedness: a Swedish Web-based exploratory and retrospective qualitative study2019In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 24, no 5, p. 380-389Article in journal (Refereed)
    Abstract [en]

    Objective: A survey was conducted to explore worries, fears and preparedness relating to the recollected experience of having an induced abortion. Methods: The Web-based survey was carried out in Sweden among 185 women. Respondents answered open-ended questions and gave retrospective self-reported ratings about their abortion-related worries, fears, preparedness and satisfaction with information obtained from health professionals and the Web. Data were analysed using qualitative content analysis and descriptive statistics. Results: Worries and fears included the abortion process, physical reactions and psychosocial aspects. The abortion was associated with unexpected events, including the abortion process, poor health professional treatment and support, and side effects and complications. Respondents described a lack of preparatory information, leading to uncertainties due to insufficient information. Many searched for Web-based information, but respondents experienced difficulties finding high-quality sources. Respondents also recounted that the preparatory information received did not reflect the actual abortion experience. Conclusion: There is room for improvement with regard to informing, preparing and supporting women who seek an abortion. The results emphasise the importance of health professionals' giving sufficient preparatory information to enable preparedness and lessen the impact of possible unexpected events. There is a need for the development of a trustworthy Web-based service that contains honest and high-quality information.

  • 18. Georgsson, Susanne
    et al.
    Krautmeyer, Stina
    Sundqvist, Emilia
    Carlsson, Tommy
    Sophiahemmet University.
    Abortion-related worries, fears and preparedness: a Swedish web-based exploratory and retrospective qualitative study2019In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 24, no 5, p. 380-389Article in journal (Refereed)
    Abstract [en]

    Objective: A survey was conducted to explore worries, fears and preparedness relating to the recollected experience of having an induced abortion. Methods: The Web-based survey was carried out in Sweden among 185 women. Respondents answered open-ended questions and gave retrospective self-reported ratings about their abortion-related worries, fears, preparedness and satisfaction with information obtained from health professionals and the Web. Data were analysed using qualitative content analysis and descriptive statistics. Results: Worries and fears included the abortion process, physical reactions and psychosocial aspects. The abortion was associated with unexpected events, including the abortion process, poor health professional treatment and support, and side effects and complications. Respondents described a lack of preparatory information, leading to uncertainties due to insufficient information. Many searched for Web-based information, but respondents experienced difficulties finding high-quality sources. Respondents also recounted that the preparatory information received did not reflect the actual abortion experience. Conclusion: There is room for improvement with regard to informing, preparing and supporting women who seek an abortion. The results emphasise the importance of health professionals' giving sufficient preparatory information to enable preparedness and lessen the impact of possible unexpected events. There is a need for the development of a trustworthy Web-based service that contains honest and high-quality information.

  • 19.
    Gingnell, Malin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Bannbers, Elin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Engman, Jonas
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Frick, Andreas
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Moby, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Wikström, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Sundström-Poromaa, Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    The effect of combined hormonal contraceptives use on brain reactivity during response inhibition2016In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 21, no 2, p. 150-157Article in journal (Refereed)
    Abstract [en]

    Objectives Cognitive control, which can be described as the ability to moderate impulses, has not previously been investigated in users of combined hormonal contraception (CHC). Given the suggested modulatory role of ovarian steroids in prefrontal dopaminergic function, which in turn taps into cognitive control, this randomised, double-blinded, placebo-controlled oral contraceptive trial set out to investigate the brain activity pattern during response inhibition in CHC users. Methods Thirty-four women were randomised to one treatment cycle with a levonorgestrel-containing CHC or placebo. The women performed a Go/NoGo task to measure brain activity during response inhibition by use of event-related functional magnetic resonance imaging (fMRI) prior to and during the CHC/placebo treatment cycle. Results No differences between CHC and placebo users in number of correct inhibitions were found during treatment, but only women on CHC significantly improved their performance between the baseline and treatment assessments. During the treatment cycle CHC users displayed decreased activity in the right middle frontal gyrus in comparison with placebo users. No other significant activations were evident between treatment groups or within groups. Conclusion Overall, CHC use had marginal effects on brain activity during response inhibition. If anything, the findings of the study may suggest reduced effort or increased efficiency in maintaining orbitofrontal cortex inhibitory cognitive control when using a combined oral contraceptive.

  • 20.
    Gottvall, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Larsson, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Höglund, Anna T
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
    Tydén, Tanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    High HPV vaccine acceptance despite low awareness among Swedish upper secondary school students2009In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 14, no 6, p. 399-405Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate knowledge of human papillomavirus (HPV) and attitudes to HPV vaccination and condom use among Swedish first year upper secondary school students. METHODS: Classroom questionnaire filled in by 608 students from a strategic sample of seven upper secondary schools in Sweden. RESULTS: Only 13.5% (n = 82) of the students had heard about HPV and 6% (n = 35) were aware of HPV vaccination. As many as 84% (n = 508) would like to be vaccinated against HPV. The high cost of vaccination was the greatest obstacle (total group 37%, n = 227); among girls the second major hindrance was the fear of needles (19%, n = 65). Before considering an HPV vaccination 73% (n = 443) wanted more information and 36% (n = 220) would like to receive such information from the school nurse. The students considered it less likely that they would use a condom when having intercourse with a new partner if they were vaccinated than if they were not (p < 0.001). CONCLUSION: Despite intensive marketing directed at potential vaccine consumers, knowledge of HPV and of HPV vaccines was very low among first year upper secondary school students. Their attitude towards vaccination was positive but most of them wanted more information before considering vaccination.

  • 21.
    Gottvall, Maria
    et al.
    Uppsala universitet, Vårdvetenskap.
    Larsson, Margareta
    Uppsala universitet, Institutionen för kvinnors och barns hälsa.
    Höglund, Anna T
    Uppsala universitet, Centrum för forsknings- och bioetik.
    Tydén, Tanja
    Uppsala universitet, Vårdvetenskap.
    High HPV vaccine acceptance despite low awareness among Swedish upper secondary school students2009In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 14, no 6, p. 399-405Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate knowledge of human papillomavirus (HPV) and attitudes to HPV vaccination and condom use among Swedish first year upper secondary school students. METHODS: Classroom questionnaire filled in by 608 students from a strategic sample of seven upper secondary schools in Sweden. RESULTS: Only 13.5% (n = 82) of the students had heard about HPV and 6% (n = 35) were aware of HPV vaccination. As many as 84% (n = 508) would like to be vaccinated against HPV. The high cost of vaccination was the greatest obstacle (total group 37%, n = 227); among girls the second major hindrance was the fear of needles (19%, n = 65). Before considering an HPV vaccination 73% (n = 443) wanted more information and 36% (n = 220) would like to receive such information from the school nurse. The students considered it less likely that they would use a condom when having intercourse with a new partner if they were vaccinated than if they were not (p < 0.001). CONCLUSION: Despite intensive marketing directed at potential vaccine consumers, knowledge of HPV and of HPV vaccines was very low among first year upper secondary school students. Their attitude towards vaccination was positive but most of them wanted more information before considering vaccination.

  • 22.
    Hammarström, Sofia
    et al.
    Department of Medical and Health Science, Division of Community Medicine, Linköping University, Linköping, Sweden.
    Nilsen, Per
    Department of Medical and Health Science, Division of Community Medicine, Linköping University, Linköping, Sweden.
    Lindroth, Malin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT. Faculty of Health and Society, Centre for Sexology and Sexuality Studies, Malmö University, Malmö, Sweden.
    Stenqvist, Karin
    Närhälsan Knowledge Center for Sexual Health, Gothenburg, Sweden.
    Bernhardsson, Susanne
    Närhälsan Research and Development Primary Health Care, Gothenburg, Sweden.
    Identifying young people exposed to or at risk of sexual ill health: pilot implementation of an evidence-informed toolkit (SEXIT) at Swedish youth clinics2019In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 24, no 1, p. 45-53Article in journal (Refereed)
    Abstract [en]

    Objectives 

    We aimed to develop and pilot-implement an evidence-informed toolkit (SEXual health Identification Tool; SEXIT) for identifying young people exposed to or at risk of sexual ill health, at Swedish youth clinics, and to investigate SEXIT’s potential to identify young people in need of special care and monitoring.

    Methods

    The SEXIT toolkit was developed, validated and pilot-implemented at three Swedish youth clinics. Pre-implementation staff readiness was assessed and youth clinic visitors’ responses to SEXIT were analysed.

    Results 

    All staff perceived a need for screening for sexual risk-taking and exposure. The response rate from 268 youth clinic visitors (aged 15–24 years) was 86%. Half of the visitors had one or no variable associated with sexual ill health, a third had two or three, and 15% reported between four and seven variables. The most common variables were alcohol use, three or more sexual partners in the past year and previous chlamydia. Visitors rated SEXIT as important and not uncomfortable or difficult to answer.

    Conclusions

    The SEXIT toolkit was found to be feasible and highly acceptable in a clinical setting. The use of SEXIT may facilitate important questions on sexual risk-taking and sexual ill health to be raised with youth clinic visitors. 

  • 23.
    Hammarström, Sofia
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Narhalsan Knowledge Ctr Sexual Hlth, Sweden.
    Nilsen, Per
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Lindroth, Malin
    Jonkoping Univ, Sweden; Malmo Univ, Sweden.
    Stenqvist, Karin
    Narhalsan Knowledge Ctr Sexual Hlth, Sweden; Univ Gothenburg, Sweden.
    Bernhardsson, Susanne
    Narhalsan Res and Dev Primary Hlth Care, Sweden; Univ Gothenburg, Sweden.
    Identifying young people exposed to or at risk of sexual ill health: pilot implementation of an evidence-informed toolkit (SEXIT) at Swedish youth clinics2019In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 24, no 1, p. 45-53Article in journal (Refereed)
    Abstract [en]

    Objectives: We aimed to develop and pilot-implement an evidence-informed toolkit (SEXual health Identification Tool; SEXIT) for identifying young people exposed to or at risk of sexual ill health, at Swedish youth clinics, and to investigate SEXITs potential to identify young people in need of special care and monitoring. Methods: The SEXIT toolkit was developed, validated and pilot-implemented at three Swedish youth clinics. Pre-implementation staff readiness was assessed and youth clinic visitors responses to SEXIT were analysed. Results: All staff perceived a need for screening for sexual risk-taking and exposure. The response rate from 268 youth clinic visitors (aged 15-24 years) was 86%. Half of the visitors had one or no variable associated with sexual ill health, a third had two or three, and 15% reported between four and seven variables. The most common variables were alcohol use, three or more sexual partners in the past year and previous chlamydia. Visitors rated SEXIT as important and not uncomfortable or difficult to answer. Conclusions: The SEXIT toolkit was found to be feasible and highly acceptable in a clinical setting. The use of SEXIT may facilitate important questions on sexual risk-taking and sexual ill health to be raised with youth clinic visitors.

  • 24.
    Häggström-Nordin, Elisabet
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH), Sweden.
    Borneskog, Catrin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi, Sweden.
    Eriksson, Mats
    Örebro University Hospital, Örebro, Sweden.
    Tydén, Tanja
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap, Sweden.
    Sexual behaviour and contraceptive use among Swedish high school students in two cities: comparison between genders, study programme, and over time2011In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 16, no 1, p. 36-46Article in journal (Refereed)
    Abstract [en]

    Objectives To investigate sexual behaviour and contraceptive use among first-year high school students in two Swedish cities in 2009, to compare male and female students, students in theoretical and vocational study programmes, and their sexual behaviour with that reported in 1979, 1989 and 1999. Methods In a cluster sample of 20 classes, students (N = 387), median age 16 years, completed a questionnaire consisting of 46 questions. Results More girls than boys had experienced petting (p <= 0.003) and had received oral sex (p <= 0.01). More boys than girls had masturbated (p <= 0.0001) and watched pornography (p <= 0.0001). The median age at first sexual intercourse was 15 years. Students in vocational programmes were more sexually experienced compared to their theoretical peers. The proportion of students having had sexual intercourse (p <= 0.0002), and contraceptive use at first (p <= 0.0001) and latest (p <= 0.0001) sexual intercourse increased from 1979 to 2009. Alcohol use at first intercourse decreased over the period (p <= 0.0001). Conclusions Girls were more sexually experienced than boys, as were students in vocational programmes compared to their theoretical peers; this should be considered when tailoring sex education and counselling. Over time, an increase in students having had sexual intercourse, and contraceptive use at first and latest sexual intercourse was found.

  • 25.
    Häggström-Nordin, Elisabet
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Borneskog, Catrin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Eriksson, Mats
    Tydén, Tanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Sexual behaviour and contraceptive use among Swedish high school students in two cities: Comparisons between genders, study programmes, and over time2011In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 16, no 1, p. 36-46Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate sexual behaviour and contraceptive use among first-year high school students in two Swedish cities in 2009, to compare male and female students, students in theoretical and vocational study programmes, and their sexual behaviour with that reported in 1979, 1989 and 1999. Methods In a cluster sample of 20 classes, students (N387), median age 16 years, completed a questionnaire consisting of 46 questions. Results More girls than boys had experienced petting (p≤0.003) and had received oral sex (p≤0.01). More boys than girls had masturbated (p≤0.0001) and watched pornography (p≤0.0001). The median age at first sexual intercourse was 15 years. Students in vocational programmes were more sexually experienced compared to their theoretical peers. The proportion of students having had sexual intercourse (p≤0.0002), and contraceptive use at first (p≤0.0001) and latest (p≤0.0001) sexual intercourse increased from 1979 to 2009. Alcohol use at first intercourse decreased over the period (p≤0.0001). Conclusion sGirls were more sexually experienced than boys, as were students in vocational programmes compared to their theoretical peers; this should be considered when tailoring sex education and counselling. Over time, an increase in students having had sexual intercourse, and contraceptive use at first and latest sexual intercourse was found.

  • 26.
    Häggström-Nordin, Elisabet
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Borneskog, Catrin
    Eriksson, Mats
    Orebro Univ Hosp.
    Tydén, Tanja
    Uppsala Univ.
    Sexual behaviour and contraceptive use among Swedish high school students in two cities: Comparisons between genders, study programmes, and over time2011In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 16, no 1, p. 36-40Article in journal (Refereed)
    Abstract [en]

     Objectives To investigate sexual behaviour and contraceptive use among first-year high school students in two Swedish cities in 2009, to compare male and female students, students in theoretical and vocational study programmes, and their sexual behaviour with that reported in 1979, 1989 and 1999. Methods In a cluster sample of 20 classes, students (N = 387), median age 16 years, completed a questionnaire consisting of 46 questions. Results More girls than boys had experienced petting (p <= 0.003) and had received oral sex (p <= 0.01). More boys than girls had masturbated (p <= 0.0001) and watched pornography (p <= 0.0001). The median age at first sexual intercourse was 15 years. Students in vocational programmes were more sexually experienced compared to their theoretical peers. The proportion of students having had sexual intercourse (p <= 0.0002), and contraceptive use at first (p <= 0.0001) and latest (p <= 0.0001) sexual intercourse increased from 1979 to 2009. Alcohol use at first intercourse decreased over the period (p <= 0.0001). Conclusions Girls were more sexually experienced than boys, as were students in vocational programmes compared to their theoretical peers; this should be considered when tailoring sex education and counselling. Over time, an increase in students having had sexual intercourse, and contraceptive use at first and latest sexual intercourse was found.

  • 27.
    Häggström-Nordin, Elisabet
    et al.
    Mälardalen University, Västerås, Sweden; Uppsala University, Uppsala, Sweden.
    Borneskog, Catrin
    Mälardalen University, Västerås, Sweden; Örebro University Hospital, Örebro, Sweden.
    Eriksson, Mats
    Örebro University Hospital, Örebro, Sweden; .
    Tydén, Tanja
    Uppsala University, Uppsala, Sweden.
    Sexual behaviour and contraceptive use among Swedish high school students in two cities: comparisons between genders, study programmes, and over time2011In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 16, no 1, p. 36-46Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate sexual behaviour and contraceptive use among first-year high school students in two Swedish cities in 2009, to compare male and female students, students in theoretical and vocational study programmes, and their sexual behaviour with that reported in 1979, 1989 and 1999.

    Methods: In a cluster sample of 20 classes, students (N = 387), median age 16 years, completed a questionnaire consisting of 46 questions.

    Results: More girls than boys had experienced petting (p ≤ 0.003) and had received oral sex (p ≤ 0.01). More boys than girls had masturbated (p ≤ 0.0001) and watched pornography (p ≤ 0.0001). The median age at first sexual intercourse was 15 years. Students in vocational programmes were more sexually experienced compared to their theoretical peers. The proportion of students having had sexual intercourse (p ≤ 0.0002), and contraceptive use at first (p ≤ 0.0001) and latest (p ≤ 0.0001) sexual intercourse increased from 1979 to 2009. Alcohol use at first intercourse decreased over the period (p ≤ 0.0001).

    Conclusions: Girls were more sexually experienced than boys, as were students in vocational programmes compared to their theoretical peers; this should be considered when tailoring sex education and counselling. Over time, an increase in students having had sexual intercourse, and contraceptive use at first and latest sexual intercourse was found.

  • 28.
    Häggström-Nordin, Elisabet
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Tydén, T
    Uppsala universitet.
    Hanson, U
    Uppsala universitet.
    Larsson, M
    Uppsala universitet.
    Experiences of and attitudes towards pornography among a group of Swedish high school students2009In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 14, no 4, p. 277-284Article in journal (Refereed)
    Abstract [en]

    Objectives To investigate consumption of and attitudes toward pornography in relation to demographic factors and relationships to parents among third-year high school students. Methods A random sample of 718 students with a mean age 18 years range 1721 completed a classroom questionnaire consisting of 89 questions. Results More students in practical than in theoretical study programmes had parents with a practical profession p < 0.001. More parents to students attending theoretical programmes owned their housing p < 0.001. More men than women had ever consumed pornography 98 vs. 72; p < 0.001. More practical than theoretical students were influenced by watching pornographic films, fantasising about p < 0.05 or having performed acts inspired by pornography p < 0.05. Both theoretical and practical male students had more favourable attitudes toward pornography than either group of female students p < 0.001; p 0.037. More female, than male students, were of the opinion that pornography could create uncertainty and demands. Conclusion Students' high school programme choices partly reflect their social background. Pornography was consumed mainly by male students, who also had the most favourable attitudes, while females mainly had negative attitudes. To promote sexual health these differences between genders and study programmes should be taken into consideration in counselling, and in sex- and relationships education.

  • 29.
    Häggström-Nordin, Elisabet
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Tydén, Tanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Hanson, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Larsson, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Experiences of and attitudes towards pornography among a group of Swedish high school students2009In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 14, no 4, p. 277-284Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To investigate consumption of and attitudes toward pornography in relation to demographic factors and relationships to parents among third-year high school students. METHODS: A random sample of 718 students with a mean age 18 years (range 17-21) completed a classroom questionnaire consisting of 89 questions. RESULTS: More students in practical than in theoretical study programmes had parents with a practical profession (p < 0.001). More parents to students attending theoretical programmes owned their housing (p < 0.001). More men than women had ever consumed pornography (98% vs. 72%; p < 0.001). More practical than theoretical students were influenced by watching pornographic films, fantasizing about (p < 0.05) or having performed acts inspired by pornography (p < 0.05). Both theoretical and practical male students had more favourable attitudes toward pornography than either group of female students (p < 0.001; p = 0.037). More female, than male students, were of the opinion that pornography could create uncertainty and demands. CONCLUSION: Students' high school programme choices partly reflect their social background. Pornography was consumed mainly by male students, who also had the most favourable attitudes, while females mainly had negative attitudes. To promote sexual health these differences between genders and study programmes should be taken into consideration in counselling, and in sex- and relationships education.

  • 30.
    Höglund, Berit
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research.
    Larsson, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research.
    Midwives' work and attitudes towards contraceptive counselling and contraception among women with intellectual disability: focus group interviews in Sweden2019In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 24, no 1, p. 39-44Article in journal (Refereed)
    Abstract [en]

    Objectives: Family planning counselling is an essential part of sexual and reproductive health care; however, health care professionals often fail to offer sexual and reproductive health services to women with intellectual disability (ID), based on a misconception of inactive sexuality. The aims of this study were to gain a deeper understanding of midwives' perceptions of sexual health and contraceptive use of women with ID, and of midwives' practices in providing contraceptive counselling to women with ID.

    Methods: Five focus group interviews were conducted with 19 midwives at five antenatal/family planning clinics in central Sweden between December 2016 and February 2017.

    Results: The findings are presented in a paradigm model comprising the following components: context, causal conditions for women with ID needing contraception, intervening conditions, action and interaction strategies based on the midwives' approach and performance during the consultation, and finally consequences. Midwives strived to enhance informed choice, whenever possible, and tried to maintain a neutral attitude during counselling. They wanted to provide the most suitable contraceptive method balanced against any risk of long-term use and possible side effects. Midwives raised the need for teamwork and inter-professional support to improve health care, security and access to other related services for women with ID.

    Conclusions: Few women with ID request contraceptive counselling, which limits midwives' knowledge, experience and competence. Midwives, therefore, plan consultations carefully and strive to enable women with ID to make informed contraceptive choices. Increased teamwork could be a way to strengthen the role of midwives and thereby improve counselling.

  • 31.
    Jansson, Caroline
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Reproductive biology.
    Volgsten, Helena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Huffman, Carolyn
    College of Health Sciences, Appalachian State University, USA.
    Skoog Svanberg, Agneta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Reproductive Health.
    Swanson, Kristen M
    School of Nursing, Seattle University, Seattle, WA, USA.
    Stavreus-Evers, Anneli
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Reproductive biology.
    Validation of the Revised Impact of Miscarriage Scale for Swedish conditions and comparison between Swedish and American couples' experiences after miscarriage2017In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 22, no 6, p. 412-417Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: There is a lack of knowledge in women's and men's experience of miscarriage. The Revised Impact of Miscarriage Scale (RIMS) has been used in United States to measure the experiences after miscarriage. The first objective was to test the consistency of RIMS for Swedish conditions. The second purpose of this study was to compare Swedish and American couples' experience of miscarriage by use of the RIMS.

    METHODS: Forward and back translation was used for translating RIMS into Swedish. This is a hospital-based comparative study including Swedish couples (n = 70) and American couples (n = 70). The couples were matched by the women's age, week of miscarriage and number of children. All participants answered socio-demographic, fertility and depression-scale questions in addition to RIMS.

    RESULTS: Cronbach's alpha analysis was above 0.650, the mean value was 0.824. There was no significant difference between the Swedish and American participants on the factors 'Isolation/Guilt' and 'Devastating event', but the Swedish women and men scored significantly lower on the factor 'Loss of baby' than the American women and men. The men, Swedish and American combined, scored lower than the women in all factors but the correlation within the couples was similar for both Swedish and American couples.

    CONCLUSIONS: The high consistency between the countries suggests that the RIMS questionnaire is reliable for both women and men to be used in both countries and two of three factors were similar between the two countries.

  • 32. Juth, Niklas
    et al.
    Tannsjö, Torbjörn
    Hansson, Sven-Ove
    KTH, School of Architecture and the Built Environment (ABE), Philosophy and History of Technology, Philosophy.
    Lynöe, Niels
    Honour-related threats and human rights: A qualitative study of Swedish healthcare providers' attitudes towards young women requesting a virginity certificate or hymen reconstruction2013In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 18, no 6, p. 451-459Article in journal (Refereed)
    Abstract [en]

    Objectives To investigate the preferred actions of healthcare staff, as well as their reasoning and attitudes about young females' requests for a virginity certificate or hymen restoration. Method A qualitative study, consisting of semi-structured interviews of healthcare providers from different parts of Sweden and from different medical specialties and professions, who had experience of women who asked for a virginity certificate or a hymen repair. Results Using content analysis, ten themes emerged regarding healthcare personnel's attitudes and reasoning about young female patients and their requests for demonstration of virginity. The themes logically were categorised as values, beliefs, and cultural affiliation. Conclusions Responders had a more pragmatic and permissive view than the restrictive, official Swedish policy opposing hymenoplasties within the public healthcare system. There were degrees of willingness to accommodate such requests, due, for example, to different moral beliefs and medical concerns. Responders expressed frustration over the difficulty of following up patients, a situation likely due to the restrictive policy. The patient-centred approach adopted by a Dutch team of health professionals would probably better enable quality assurance.

  • 33. Juth, Niklas
    et al.
    Tännsjö, Torbjörn
    Stockholm University, Faculty of Humanities, Department of Philosophy.
    Hansson, Sven Ove
    Lynöe, Niels
    Honour-related threats and human rights: A qualitative study of Swedish healthcare providers’ attitudes towards young women requesting a virginity certificate or hymen reconstruction2013In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 18, no 6, p. 451-459Article in journal (Refereed)
    Abstract [en]

    Objectives To investigate the preferred actions of healthcare staff, as well as their reasoning and attitudes about young females’ requests for a virginity certificate or hymen restoration.

    Method A qualitative study, consisting of semi-structured interviews of healthcare providers from different parts of Sweden and from different medical specialties and professions, who had experience of women who asked for a virginity certificate or a hymen repair.

    Results Using content analysis, ten themes emerged regarding healthcare personnel's attitudes and reasoning about young female patients and their requests for demonstration of virginity. The themes logically were categorised as values, beliefs, and cultural affiliation.

    Conclusions Responders had a more pragmatic and permissive view than the restrictive, official Swedish policy opposing hymenoplasties within the public healthcare system. There were degrees of willingness to accommodate such requests, due, for example, to different moral beliefs and medical concerns. Responders expressed frustration over the difficulty of following up patients, a situation likely due to the restrictive policy. The patient-centred approach adopted by a Dutch team of health professionals would probably better enable quality assurance.

  • 34.
    Kero, Anneli
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Högberg, Ulf
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Lalos, Ann
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Contraceptive risk-taking in women and men facing legal abortion2001In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 6, no 4, p. 205-218Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of the study was to gain knowledge about contraceptive use, reproductive risk-taking and sexuality in Swedish women seeking abortion and their partners.

    Methods: Two hundred and eleven women and 75 men answered a questionnaire before the abortion. The data have been divided into six subgroups: women with and without previous experience of abortion, single women and women with a partner relationship, and women whose partner participated in the study and the male partners.

    Results: The main findings showed that there are more similarities than differences between the subgroups. Overall, there were no differences regarding use of contraceptives, sexual life and psychosocial characteristics. However, women with previous abortion experience were found to be older, had longer partner relationships and more often had children. Some gender differences were also found, i.e. women favored coitus-dependent contraceptives to a larger extent and took more responsibility for preventing unwanted pregnancies. At the time of conception, half the participants had not used any contraceptive methods and one-fifth had relied on 'natural family planning'. The most common reasons for not using contraceptives were related to risk-taking and/or to strong sexual desire. Twelve per cent of the women had felt pressure/threat from their partner in connection with the conception.

    Conclusion: In efforts to prevent undesired pregnancies, this study highlights the need to incorporate a gender perspective both in communication about risk-taking and in counselling about contraceptives.

  • 35.
    Kero, Anneli
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology. Umeå University, Faculty of Social Sciences, Department of Social Work.
    Lalos, Ann
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Wulff, Marianne
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Home abortion - experiences of male involvement2010In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 15, no 4, p. 264-270Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To gain knowledge about the male partner's experience of being present during an induced home abortion. METHODS: Twenty-three couples, whose male partner had been present when the woman aborted at home, were interviewed one to two weeks post-abortion. RESULTS: Each of the men supported his partner in her decision to have a home abortion, as this gave him the possibility of being near and of caring for her needs on the expulsion day. All the men were present and all their partners confirmed that they had been supportive. Half the men had been anxious prior to the expulsion, but most considered that their experiences during the expulsion had been 'easier than expected' and their dominant feeling was one of relief. CONCLUSIONS: Abortion is an important life event. When taking place at home, it increases the possibility for the couple to share the experience. Sharing an abortion may have a positive impact on those men who lack a sense of responsibility regarding reproductive issues, such as contraceptive use. This could facilitate society's efforts to involve men as a target group in this field. Designing an abortion policy that caters for the needs of both partners is a challenge.

  • 36.
    Kero, Anneli
    et al.
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Lalos, Ann
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Wulff, Marianne
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Why shouldn't one report on women's positive feelings with regard to abortion?2010In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 15, no 2, p. 150-151Article in journal (Other academic)
  • 37.
    Kilander, Helena
    et al.
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Salomonsson, Birgitta
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden .
    Thor, Johan
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Brynhildsen, Jan
    Department of Obstetrics and Gynaecology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden .
    Alehagen, Siw
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden .
    Contraceptive counselling of women seeking abortion – a qualitative interview study of health professionals’ experiences2017In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 22, no 1, p. 3-10Article in journal (Refereed)
    Abstract [en]

    Objectives: A substantial proportion of women who undergo an abortion continue afterwards without switching to more effective contraceptive use. Many subsequently have repeat unintended pregnancies. This study, therefore, aimed to identify and describe health professionalś experiences of providing contraceptive counselling to women seeking an abortion.

    Methods: We interviewed 21 health professionals (HPs), involved in contraceptive counselling of women seeking abortion at three differently sized hospitals in Sweden. The interviews were recorded and transcribed verbatim and analysed using conventional qualitative content analysis.

    Results: Three clusters were identified: ‘Complex counselling’, ‘Elements of counselling’ and ‘Finding a method’. HPs often experienced consultations including contraceptive counselling at the time of an abortion as complex, covering both pregnancy termination and contraceptive counselling. Women with vulnerabilities placed even greater demands on the HPs providing counselling. The HPs varied in their approaches when providing contraceptive counselling but also in their knowledge about certain contraception methods. HPs described challenges in finding out if women had found an effective method and in the practicalities of arranging intrauterine device (IUD) insertion post-abortion, when a woman asked for this method.

    Conclusions: HPs found it challenging to provide contraceptive counselling at the time of an abortion and to arrange access to IUDs post-abortion. There is a need to improve their counselling, their skills and their knowledge to prevent repeat unintended pregnancies.

  • 38.
    Kilander, Helena
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Eksjo Nassjo Hospital, Sweden.
    Salomonsson, Birgitta
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Thor, Johan
    Jönköping University, Sweden.
    Brynhildsen, Jan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Alehagen, Siw
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Contraceptive counselling of women seeking abortion - a qualitative interview study of health professionals experiences2017In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 22, no 1Article in journal (Refereed)
    Abstract [en]

    Objectives: A substantial proportion of women who undergo an abortion continue afterwards without switching to more effective contraceptive use. Many subsequently have repeat unintended pregnancies. This study, therefore, aimed to identify and describe health professionalg experiences of providing contraceptive counselling to women seeking an abortion. Methods: We interviewed 21 health professionals (HPs), involved in contraceptive counselling of women seeking abortion at three differently sized hospitals in Sweden. The interviews were recorded and transcribed verbatim and analysed using conventional qualitative content analysis. Results: Three clusters were identified: Complex counselling, Elements of counselling and Finding a method. HPs often experienced consultations including contraceptive counselling at the time of an abortion as complex, covering both pregnancy termination and contraceptive counselling. Women with vulnerabilities placed even greater demands on the HPs providing counselling. The HPs varied in their approaches when providing contraceptive counselling but also in their knowledge about certain contraception methods. HPs described challenges in finding out if women had found an effective method and in the practicalities of arranging intrauterine device (IUD) insertion post-abortion, when a woman asked for this method. Conclusions: HPs found it challenging to provide contraceptive counselling at the time of an abortion and to arrange access to IUDs post-abortion. There is a need to improve their counselling, their skills and their knowledge to prevent repeat unintended pregnancies.

  • 39.
    Kristjansdottir, Jona
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Olsson, Gunilla I.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Sundelin, Claes
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Naessén, Tord
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Self-reported health in adolescent girls varies according to the season and its relation to medication and hormonal contraception: A descriptive study2013In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 18, no 5, p. 343-354Article in journal (Refereed)
    Abstract [en]

    Objectives To study seasonal variations in self-rated health and depressive symptoms in adolescent girls and possible differences in reported health with regard to use of medications. Method The SF-36 questionnaire was completed by 1250 girls with a mean age of 17 years, who visited a health centre in the course of one year. From January to July inclusive, depressive symptoms in 453 of the participants were also assessed using MADRS-S. Age and regular medication data were recorded. Results Significantly better mental health and less depressive symptoms were reported during the summer, than in winter months. Seasonality was more related to the SF-36 mental, than physical health subscales. Respondents treated with hormonal contraceptives (HCs) only and those not taking any medication scored better on several SF-36 subscales, than girls on antidepressives and other medications. Respondents taking HCs tended to report better physical health and less depressive symptoms on MADRS-S than those taking no medication. Conclusions Adolescent girls showed seasonal variations in self-reported health and depressive symptoms, with more symptoms during winter months. HC users tended to report better physical health and less depressive symptoms than those on no medication. The high prevalence of suspected depression during the winter months deserves attention.

  • 40.
    Kristjánsdóttir, Jóna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Gynecological endocrinology.
    Sundelin, Claes
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
    Naessén, Tord
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Gynecological endocrinology.
    Health-related quality of life in young women starting hormonal contraception: a pilot study2018In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 23, no 3, p. 171-178Article in journal (Refereed)
    Abstract [en]

    Objectives: Our purpose was to study whether there is a difference in self-rated health-related quality of life (HRQOL) and changes in HRQOL perception after 3 months of hormonal contraceptive use in adolescents. Seasonal variations in symptoms of depression were also studied. Methods: A test group (T1) (n=193) and a selected control group (n=238) of women aged 14-20 years who were visiting a young person's clinic completed the 36-item short-form health survey (SF-36) and answered additional questions on menstrual history and pattern, need for menstrual pain relief medication, and other regular medication. The test group was reassessed after 3 months of hormonal contraception (T2). Seasonal variations in reported SF-36 scores were studied for the whole group. Results: The selected control group and test group at T1 were similar with regard to age at menarche and menstrual pattern. The duration of bleeding and use of painkillers were significantly reduced and the impact on everyday life was significantly improved after 3 months of hormonal contraception (p=.000, two-tailed). No changes in HRQOL or symptoms of possible depression were found after 3 months of hormonal contraception. The highest prevalence odds ratio for possible depression (SF-36 mental health scale score <= 48), adjusted for group, season and age, for spring vs winter, was 2.15 (95% confidence interval 0.95, 4.85). Conclusions: After 3 months of hormonal contraception both the number of days of menstrual bleeding and the use of medication to relieve menstrual pain were reduced, but there were no significant changes in self-rated HRQOL perception. Seasonal effects on HRQOL were reported.

  • 41.
    Larsson, Margareta
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Aneblom, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Eurenius, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Tydén, Tanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Limited impact of an intervention regarding emergency contraceptive pills in Sweden: repeated surveys among abortion applicants2006In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 11, no 4, p. 270-276Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate a community-based intervention consisting of an information campaign and advance provision of emergency contraceptive pills (ECP) to abortion applicants. METHODS: Submission of repeated waiting room questionnaires to abortion applicants in two cities in mid-Sweden; one intervention city (IC) and one comparison city (CC) in 2002 (IC = 92, CC = 95) and 2003 (IC = 244, CC = 204). RESULTS: The overall response rate was 90%. The percentage of women who had undergone an abortion within the previous year had decreased in the intervention group but not in the comparison group. Almost two-thirds (63%) of the targeted women had noticed the information campaign and one out of three (33%) who had visited a family planning clinic recalled being given information about ECP. There was a small decline in the use of combined oral contraceptives and intrauterine devices over time. After the intervention, women in the intervention city had better knowledge of ECP and had used it more than women in the comparison city did. CONCLUSIONS: More than half of the targeted women had noticed the information campaign and it may have had a limited impact. Further investigations are needed to determine whether advance supply of ECP to abortion applicants can reduce repeat abortions.

  • 42.
    Larsson, Margareta
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Tydén, Tanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Hanson, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Häggström-Nordin, Elisabet
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Contraceptive use and associated factors among Swedish high school students2007In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 12, no 2, p. 119-124Article in journal (Refereed)
    Abstract [en]

    Objectives To investigate self-reported sexual experiences, abortions, sexually transmitted infections (STIs), use of contraception and possible influencing factors on contraceptive use among Swedish high school students. Methods An anonymous classroom survey was distributed to a random sample (n = 924) of 18-year-old high school students in a medium-sized Swedish city. The response rate was 78% (n = 718). Results Three out of four students had experienced intercourse and the majority of them stated that they were satisfied with their sexual life. Few students reported having had an abortion (5%) or a STI (4%). Alcohol use appeared the most important contributing risk factor for non-use of contraception in relation to both first and latest intercourse, and the young men reported more unprotected latest intercourse than the young women did. Conclusion The fact that young men appear less inclined to use contraception is disturbing, and must be addressed in sexual education and individual counseling to promote a better sexual health for adolescents.

  • 43. Larsson, Margareta
    et al.
    Tydén, Tanja
    Hansson, Ulf
    Häggström-Nordin, Elisabet
    Mälardalen University, Department of Caring and Public Health Sciences.
    Contraceptive use and associated factors among Swedish high school students2007In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 12, no 2, p. 119-124Article, review/survey (Other (popular science, discussion, etc.))
    Abstract [en]

    OBJECTIVES: To investigate self-reported sexual experiences, abortions, sexually transmitted infections (STIs), use of contraception and possible influencing factors on contraceptive use among Swedish high school students. METHODS: An anonymous classroom survey was distributed to a random sample (n = 924) of 18-year-old high school students in a medium-sized Swedish city. The response rate was 78% (n = 718). RESULTS: Three out of four students had experienced intercourse and the majority of them stated that they were satisfied with their sexual life. Few students reported having had an abortion (5%) or a STI (4%). Alcohol use appeared the most important contributing risk factor for non-use of contraception in relation to both first and latest intercourse, and the young men reported more unprotected latest intercourse than the young women did. CONCLUSION: The fact that young men appear less inclined to use contraception is disturbing, and must be addressed in sexual education and individual counseling to promote a better sexual health for adolescents.

  • 44.
    Lindberg, Malou
    et al.
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Foldemo, Anniqa
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Josefsson, Ann
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Wiréhn, Ann-Britt
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Arts and Sciences.
    Differences in prescription rates and odds ratios of antidepressant drugs in relation to individual hormonal contraceptives: A nationwide population-based study with age-specific analyses2012In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 17, no 2, p. 106-118Article in journal (Refereed)
    Abstract [en]

    Objectives To examine, among young women, the association of individual hormonal contraceptives, within two broad groupings, with antidepressant therapy. less thanbrgreater than less thanbrgreater thanMethods In a nationwide register-based study, we examined the prescription rates of antidepressant drugs in relation to individual combined hormonal and progestin-only contraceptives among Swedish women aged 16-31 years (N = 917,993). Drug data were obtained from the Swedish Prescribed Drug Register for the period 1 July 2005-30 June 2008. Data on the total population of women aged 16-31 in 2008 were obtained from the Total Population Register of Statistics Sweden. The proportion of women using both hormonal contraception and antidepressants, and odds ratios (ORs) for antidepressant use for hormonal contraceptive users versus non-users, were calculated, the latter by logistic regression, for each formulation. less thanbrgreater than less thanbrgreater thanResults The highest antidepressant OR in all age groups, particularly in the 16-19 years age group, related to medroxyprogesterone-only, followed by etonogestrel-only, levonorgestrel-only and ethinylestradiol/norelgestromin formulations. Oral contraceptives containing ethinylestradiol combined with lynestrenol or drospirenone had considerably higher ORs than other pills. ORs significantly lower than 1 were observed when ethinylestradiol was combined with norethisterone, levonorgestrel or desogestrel. less thanbrgreater than less thanbrgreater thanConclusion The association between use of hormonal contraceptives and antidepressant drugs varies considerably within both the combined hormonal contraceptive and the progestin-only groups.

  • 45.
    Lindroth, Malin
    et al.
    Malmö högskola.
    Löfgren-Mårtenson, Lotta
    Malmö högskola.
    Sexual chance taking: A qualitative study on sexuality among detained youths2013In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 18, no 5, p. 335-342Article in journal (Refereed)
    Abstract [en]

    Background: Many, although not all, juvenile detainees are known to be sexual risk-takers but little attention has been paid to why they engage in early sexual intercourse, have more partners, often have sex under the influence of drugs or alcohol, and without protection.

    Objective: To understand the rationale behind sexual risk-taking among detained adolescents.

    Method: Qualitative study of interviews with nine girls and 11 boys, aged 15 to 20 years, at detention centres in southern Sweden. Two major categories surface in the analysis of the interviews: contradictions and vulnerability. A core category, chance outdoes risk that describes the adolescents' pragmatic view on sexual risk-taking as being a chance of something good rather than a risk of something bad, captures the connection between these categories and the individual.

    Conclusion: Among our interviewees, sexual chance taking appears rewarding. Recognising this rationality is valuable for all professionals promoting sexual health within similar groups of youths.

  • 46. Lundell, Inger Wallin
    et al.
    Poromaa, Inger Sundstrom
    Frans, Orjan
    Helstrom, Lotti
    Hogberg, Ulf
    Moby, Lena
    Nyberg, Sigrid
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Sydsjo, Gunilla
    Ohman, Susanne Georgsson
    Ostlund, Ingrid
    Svanberg, Agneta Skoog
    The prevalence of posttraumatic stress among women requesting induced abortion2013In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 18, no 6, p. 480-488Article in journal (Refereed)
    Abstract [en]

    Objectives To describe the prevalence and pattern of traumatic experiences, to assess the prevalence of posttraumatic stress disorder (PTSD) and posttraumatic stress symptoms (PTSS), to identify risk factors for PTSD and PTSS, and to analyse the association of PTSD and PTSS with concomitant anxiety and depressive symptoms in women requesting induced abortion. Methods A Swedish multi-centre study of women requesting an induced abortion. The Screen Questionnaire - Posttraumatic Stress Disorder was used for research diagnoses of PTSD and PTSS. Anxiety and depressive symptoms were evaluated by the Hospital Anxiety and Depression Scale (HADS). Results Of the 1514 respondents, almost half reported traumatic experiences. Lifetime-and point prevalence of PTSD were 7% (95% confi dence interval [CI]: 5.8-8.5) and 4% (95% CI: 3.1-5.2), respectively. The prevalence of PTSS was 23% (95% CI: 21.1-25.4). Women who reported symptoms of anxiety or depression when requesting abortion were more likely to have ongoing PTSD or PTSS. Also single-living women and smokers displayed higher rates of ongoing PTSD. Conclusions Although PTSD is rare among women who request an induced abortion, a relatively high proportion suffers from PTSS. Abortion seeking women with trauma experiences and existing or preexisting mental disorders need more consideration and alertness when counselled for termination.

  • 47.
    Lundell, Inger Wallin
    et al.
    Dept Womens & Childrens Hlth, Uppsala Univ, Uppsala, Sweden; Sophiahemmet Univ, Stockholm, Sweden.
    Poromaa, Inger Sundstrom
    Dept Womens & Childrens Hlth, Uppsala Univ, Uppsala, Sweden.
    Frans, Orjan
    Dept Psychol, Uppsala Univ, Uppsala, Sweden.
    Helstrom, Lotti
    Dept Clin Sci & Educ, Karolinska Inst, Stockholm, Sweden.
    Hogberg, Ulf
    Dept Womens & Childrens Hlth, Uppsala Univ, Uppsala, Sweden.
    Moby, Lena
    Dept Womens & Childrens Hlth, Uppsala Univ, Uppsala, Sweden.
    Nyberg, Sigrid
    Dept Clin Sci Obstet & Gynaecol, Umeå Univ, Umeå, Sweden.
    Sydsjo, Gunilla
    Fac Hlth Sci, Dept Clin & Expt Med, Linköping Univ, Linköping, Sweden.
    Ohman, Susanne Georgsson
    Stockholm, Sweden; Dept Womens & Childrens Hlth, Karolinska Inst, Stockholm, Sweden; Sophiahemmet Univ, Stockholm, Sweden.
    Östlund, Ingrid
    Örebro University Hospital. Dept Obstet & Gynaecol, Örebro University Hospital, Örebro, Sweden.
    Svanberg, Agneta Skoog
    Dept Womens & Childrens Hlth, Uppsala Univ, Uppsala, Sweden.
    The prevalence of posttraumatic stress among women requesting induced abortion2013In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 18, no 6, p. 480-488Article in journal (Refereed)
    Abstract [en]

    Objectives To describe the prevalence and pattern of traumatic experiences, to assess the prevalence of posttraumatic stress disorder (PTSD) and posttraumatic stress symptoms (PTSS), to identify risk factors for PTSD and PTSS, and to analyse the association of PTSD and PTSS with concomitant anxiety and depressive symptoms in women requesting induced abortion. Methods A Swedish multi-centre study of women requesting an induced abortion. The Screen Questionnaire - Posttraumatic Stress Disorder was used for research diagnoses of PTSD and PTSS. Anxiety and depressive symptoms were evaluated by the Hospital Anxiety and Depression Scale (HADS). Results Of the 1514 respondents, almost half reported traumatic experiences. Lifetime-and point prevalence of PTSD were 7% (95% confi dence interval [CI]: 5.8-8.5) and 4% (95% CI: 3.1-5.2), respectively. The prevalence of PTSS was 23% (95% CI: 21.1-25.4). Women who reported symptoms of anxiety or depression when requesting abortion were more likely to have ongoing PTSD or PTSS. Also single-living women and smokers displayed higher rates of ongoing PTSD. Conclusions Although PTSD is rare among women who request an induced abortion, a relatively high proportion suffers from PTSS. Abortion seeking women with trauma experiences and existing or preexisting mental disorders need more consideration and alertness when counselled for termination.

  • 48.
    Makenzius, Marlene
    et al.
    Department of Womens and Childrens Health, Uppsala University, Sweden.
    Gådin, Katja Gillander
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Tydén, Tanja
    Department of Public Health and Caring Sciences, Uppsala University, Sweden.
    Larsson, Margareta
    Department of Womens and Childrens Health, Uppsala University, Sweden.
    Romild, Ulla
    Swedish National Institute of Public Health, Östersund, Sweden.
    Male students' behaviour, knowledge, attitudes, and needs in sexual and reproductive health matters2009In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 14, no 4, p. 268-276Article in journal (Refereed)
    Abstract [en]

    Objectives To investigate young male students' behaviour, knowledge, attitudes, and needs related to sexual and reproductive health (SRH). Differences between students on vocational and academic study programmes were also investigated. Method A questionnaire consisting of 87 multiple choice questions was distributed to 253 male students attending three upper secondary schools in a single Swedish county. Results A response rate of 76% (n=192) was achieved. Vocational students displayed more risk behaviour than those in academic study programmes regarding use of tobacco and sexual behaviour. Eighteen percent of those who were sexually experienced had suggested or provided the emergency contraception pill (ECP) to a girl. Insufficient knowledge of sexually transmitted infections (STIs) was identified, especially among the vocational students. No one reported the upper secondary school as their main source of knowledge and both groups requested more information about both genders' reproductive systems, and STIs. Some discriminatory attitudes regarding gender equality in SRH matters were identified. Both groups stated that male-friendly Youth Health Clinics (YHCs), easier access to condoms and Internet-service for Chlamydia test are important. Conclusions Improvements in the quality and quantity of sex education in upper secondary schools are needed; they should be tailored to the spectrum of students' situations and needs. A structure of the YHC adapted to male youths' needs and alternative, easily accessible STI tests are important factors for reaching young men and having them participate in a responsible way in protecting their own and their partners' SRH.

  • 49.
    Makenzius, Marlene
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Gådin, Katja Gillander
    Tydén, Tanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Romild, Ulla
    Larsson, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Male students' behaviour, knowledge, attitudes, and needs in sexual and reproductive health matters2009In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 14, no 4, p. 268-276Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To investigate young male students' behaviour, knowledge, attitudes, and needs related to sexual and reproductive health (SRH). Differences between students on vocational and academic study programmes were also investigated. METHOD: A questionnaire consisting of 87 multiple choice questions was distributed to 253 male students attending three upper secondary schools in a single Swedish county. RESULTS: A response rate of 76% (n = 192) was achieved. Vocational students displayed more risk behaviour than those in academic study programmes regarding use of tobacco and sexual behaviour. Eighteen percent of those who were sexually experienced had suggested or provided the emergency contraception pill (ECP) to a girl. Insufficient knowledge of sexually transmitted infections (STIs) was identified, especially among the vocational students. No one reported the upper secondary school as their main source of knowledge and both groups requested more information about both genders' reproductive systems, and STIs. Some discriminatory attitudes regarding gender equality in SRH matters were identified. Both groups stated that male-friendly Youth Health Clinics (YHCs), easier access to condoms and Internet-service for Chlamydia test are important. CONCLUSIONS: Improvements in the quality and quantity of sex education in upper secondary schools are needed; they should be tailored to the spectrum of students' situations and needs. A structure of the YHC adapted to male youths' needs and alternative, easily accessible STI tests are important factors for reaching young men and having them participate in a responsible way in protecting their own and their partners' SRH.

  • 50.
    Makenzius, Marlene
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Tydén, Tanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Darj, Elisabeth
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Larsson, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Repeat induced abortion - a matter of individual behaviour or societal factors?: A cross-sectional study among Swedish women2011In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 16, no 5, p. 369-377Article in journal (Refereed)
    Abstract [en]

    Background: Almost 40% of all induced abortions in Sweden are repeat abortions; little is known about the risk factors.

    Objective: To investigate differences between women who had a first-time abortion and those with repeat abortion, and to identify factors associated with repeat abortion.

    Methods: A questionnaire was answered by 798 abortion-seeking women in Sweden during 2009. A regression model was used to assess risk factors for repeat abortions.

    Results: In the age range 20-49 years, 41% of women had experienced at least one previous abortion. Risk factors for repeat abortion were parity (OR 2.57), lack of emotional support (OR 2.09), unemployment or sick leave (OR 1.65), tobacco use (OR 1.56), and low educational level (OR 1.5). Some women (n = 55) considered economic support and work opportunities could have enabled them to continue the pregnancy. Increased Sex and Relationship Education (SRE), easy access to high-quality contraception and counselling, were suggested (n = 86) as interventions for preventing unintended pregnancies.

    Conclusions: Even in a country with long established SRE and a public health policy to enhance sexual and reproductive health over a third of women requesting abortion have experienced one previously and the rate is maintained. Some specific factors are identified but, overall, a picture of vulnerability among women seeking repeat abortion stands out that needs to be considered in the prevention of unintended pregnancies.

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