Reproductive health
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Reproductive health · Jan 2021
ReviewThe impact of the COVID-19 pandemic on maternal and perinatal health: a scoping review.
The Covid-19 pandemic affects maternal health both directly and indirectly, and direct and indirect effects are intertwined. To provide a comprehensive overview on this broad topic in a rapid format behooving an emergent pandemic we conducted a scoping review. ⋯ Pregnant women and mothers were not found to be at higher risk for COVID-19 infection than people who are not pregnant, however pregnant people with symptomatic COVID-19 may experience more adverse outcomes compared to non-pregnant people and seem to face disproportionate adverse socio-economic consequences. High income and low- and middle-income countries alike faced significant struggles. Further resources should be directed towards quality epidemiological studies. The Covid-19 pandemic impacts reproductive and perinatal health both directly through infection itself but also indirectly as a consequence of changes in health care, social policy, or social and economic circumstances. The direct and indirect consequences of COVID-19 on maternal health are intertwined. To provide a comprehensive overview on this broad topic we conducted a scoping review. Pregnant women who have symptomatic COVID-19 may experience more severe outcomes than people who are not pregnant. Intrauterine and breastmilk transmission, and the passage of the virus from mother to baby during delivery are unlikely. The guidelines for labor, delivery, and breastfeeding for COVID-19 positive patients vary, and this variability could create uncertainty and unnecessary harm. Prenatal care visits decreased, healthcare infrastructure was strained, and potentially harmful policies are implemented with little evidence in high and low/middle income countries. The social and economic impact of COVID-19 on maternal health is marked. A high frequency of maternal mental health problems, such as clinically relevant anxiety and depression, during the epidemic are reported in many countries. This likely reflects an increase in problems, but studies demonstrating a true change are lacking. Domestic violence appeared to spike. Women were more vulnerable to losing their income due to the pandemic than men, and working mothers struggled with increased childcare demands. We make several recommendations: more resources should be directed to epidemiological studies, health and social services for pregnant women and mothers should not be diminished, and more focus on maternal mental health during the epidemic is needed.
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Reproductive health · Jan 2021
Beliefs and misconceptions about contraception and condom use among adolescents in south-east Nigeria.
Misconceptions about the usefulness of condoms and other contraceptives still expose many unmarried adolescents to the risk of unwanted teenage pregnancies and sexually-transmitted infections (STIs). This study explored beliefs and misconceptions about condoms and other contraceptives among adolescents in Ebonyi state, south-east Nigeria. ⋯ Although majority adolescents have knowledge about contraception and condom use, some misconceptions still persist. These misconceptions put many adolescents at increased risk for pregnancy and STIs which are detrimental to their health and wellbeing. Concerted efforts should be made through educational and behaviour change interventions in schools and within communities to debunk persisting misconceptions about contraception including the use of condom, and properly educate adolescents on safe sex practices. Adolescents engage in unprotected sexual intercourse and other risky sexual behaviours because of some mistaken beliefs and wrong impressions about how to prevent unwanted pregnancy. These risky sexual behaviours predispose adolescents to sexually transmitted infections, unsafe abortion and other reproductive health problems. In this qualitative study, we explored some of these mistaken beliefs about condoms and other methods of preventing pregnancy. During focus group discussions, adolescents identified modern contraceptive methods, and described their modes of action and how they are used. They also discussed their contraceptive preferences and perceived effects of condoms on sexual pleasure. Although some of these adolescents were able to correctly mention various types of contraceptives and their modes of action, there were numerous wrong impressions. Hard drugs, laxatives, white chlorine and boiled alcoholic beverage were listed as emergency contraceptive methods. Emergency pills were perceived to work by flushing away spermatozoa from a girl's system after sexual intercourse. Male condoms were perceived to be potentially dangerous because they could break and enter into the body of the female sexual partner. Some adolescent boys had the notion that particular brands of male condoms could be washed and reused. Notions about condom use and sexual pleasure varied for girls and boys. Some adolescent girls perceived that condom use during sex increases sexual pleasure because of the assurance of being protected from STIs and pregnancy. Adolescent boys were of the opinion that condoms interfere with the pleasure of direct 'flesh to flesh' contact during sex. There was a general belief that contraceptive use in early age reduces fertility prospects for boys and girls. Mistaken beliefs about methods of preventing pregnancy persist among adolescents, and this raises concerns about the quality of information they receive. Concerted efforts should be made to debunk these wrong beliefs and properly educate adolescents on safe sex practices.