Martha Silva

Pregnancy outcomes and intimate partner violence in New Zealand

Aim: This study aims to describe pregnancy outcomes for a population‐based sample of New Zealand women, and to explore the relationship between lifetime experience of intimate partner violence (IPV) and two non‐birth pregnancy outcomes: spontaneous abortion (miscarriage) and termination of pregnancy (abortion).

Post abortion contraception and its effect on repeat abortions in Auckland, New Zealand

BACKGROUND Many misconceptions still prevail about the appropriateness of use of the intrauterine device (IUD), particularly for younger women. This study examines the factors associated with post abortion IUD use as compared to the combined oral contraceptive pill (COC). It then examines the effect of type of post abortion contraception with the likelihood of seeking subsequent abortions. STUDY DESIGN This prospective cohort study followed, for a period of 3 years, 1422 women who had a first trimester surgical abortion between November 2004 and January 2005 in Aucklands public abortion clinic. RESULTS Compared to women who left the clinic with COC, those leaving with an IUD (OR 0.3) at baseline were less likely to return for a subsequent abortion. Among women who had not had a previous termination, younger women were less likely than older women to have had an IUD inserted post abortion. With every additional live birth, women were three times as likely to have left the abortion clinic with an IUD. Among women who had had a previous termination, age was no longer significantly associated with post abortion IUD insertion. However, parity was still significantly associated, as was having a negative sexually transmitted infection test. CONCLUSIONS Young and nulliparous women are less likely to use an IUD as a method of contraception following an abortion. However, those women who have an IUD inserted following an abortion are much less likely to return for a subsequent abortion. IUDs are a safe and effective method of contraception that are currently still underused among the younger population.

Contraceptive use and associations with intimate partner violence among a population-based sample of New Zealand women.

Aim:  To outline the use of contraception among a representative sample of New Zealand women, and explore associations with intimate partner violence (IPV), and contraception and condom use.

Violence during pregnancy: Associations with pregnancy intendedness, pregnancy‐related care, and alcohol and tobacco use among a representative sample of New Zealand women

Aim:  To explore the extent of intimate partner violence during pregnancy and its association with pregnancy intendedness and pregnancy‐related behaviours among a representative sample of New Zealand women.

Geographical access to termination of pregnancy services in New Zealand

Background: The New Zealand government has made a commitment to reducing inequalities in health among its population through the New Zealand Health Strategy. Termination of Pregnancy (TOP) services are an important part of womens health services, and equity in access to services must be ensured.

Health Care Experiences of HIV-Infected Women With Fertility Desires in Mexico: A Qualitative Study

&NA; Increased access to antiretroviral therapy has enabled Mexican HIV‐infected women to resume healthy sexual and reproductive lives and reduce the risk of mother‐to‐child transmission of HIV infection. However, little information is available on the experiences of HIV‐infected women desiring children. In this qualitative study, we conducted in‐depth interviews with 31 HIV‐infected women in four Mexican cities. The findings indicated that most of the women were given limited information on their pregnancy options. With some exceptions, the women felt they were denied the option to have (or to have more) children and advised to undergo tubal ligations or abortions. The findings of this study indicate that ongoing efforts are needed to promote the reproductive rights of HIV‐infected women in Mexico and to ensure that they receive options aligned with their fertility desires.

Factors affecting delays in first trimester pregnancy termination services in New Zealand

Objective: To identify the factors affecting the timeliness of services in first trimester abortion service in New Zealand.

Ladies in waiting: the timeliness of first trimester services in New Zealand.

BackgroundTermination of pregnancy (TOP) services are a core service in New Zealand. However, compared to other developed countries, TOP services are accessed significantly later in the first trimester, increasing the risk for complications. The aim of this study is to examine the timeliness of access to first trimester TOP services and establish the length of delay between different points in the care pathway for these services.MethodologyData were collected from all patients attending nine TOP clinics around the country between February and May 2009 (N = 2950). Patient records were audited to determine the timeline between the first point of entry to the health system to the date of termination. In addition, women were invited to fill out a questionnaire to identify personal level factors affecting access to services (N = 1086, response rate = 36.8%).ResultsWomen waited an average of almost 25 days between the date of the first visit with the referring doctor and the date of their termination procedure. There was a delay of 10 days between the first visit with the referring doctor and the date that the appointment for the procedure was booked, and a further 10 days delay between the date the appointment was booked and the first appointment date. Over half of the women in this study had their pregnancy terminated at ten weeks or above.ConclusionWomen in New Zealand are subject to a lengthy delay while seeking TOP services. Efforts should be made by TOP clinics as well as referring doctors to reduce the waiting times for this service.