In XXX, one-third of women who did not want children did not use medical contraception; some of these women used natural methods of contraception, hoping for effective results.The objective of this study was to understand why, despite a need for contraception, some women in XXX use natural methods.The study was qualitative and phenomenological. The sampling was purposive and homogeneous. Recruitment from private practices and community health centers in XXX was gradual, allowing for a diversification of profiles. The interviews were individual and semi-structured.Thirteen interviews were conducted between June 9, 2023, and September 22, 2023, inclusive. The reasons for using medical contraception were: weariness following multiple trials of medical contraceptives, fear of side effects rather than infertility, and long-distance relationships. It should be noted that confidence in the effectiveness of natural contraception was not a prerequisite for its use. However, when confidence was present, it stemmed from three factors: the misleading scientific legitimacy of information sources, the illusion of knowledge bias based on school memories, and the positive experiences of other women. Knowledge about the natural contraception methods used was incomplete, thus increasing the risk of failure. This failure was the main reason for returning to medical contraception. Natural contraception was generally well-tolerated.The two predominant languages ​​of XXX were used for the interviews, allowing for more accurate expression from the participants. The fact that the researcher shared the same culture as the majority of the participants facilitated understanding of their context. However, due to this close relationship, a review of the expected responses was conducted to mitigate the illusion of knowledge bias.To avoid uninformed choices, establishing the legitimacy of healthcare professionals in providing advice on natural contraception is essential in a strategy to reduce the risk of unintended pregnancy. Similarly, the range of contraceptive options must be diversified to include male contraception, in order to address the dissatisfaction some women feel with medical contraceptive methods.

Recent legal changes in the Netherlands allow general practitioners (GPs) to provide medical termination of pregnancy (MToP). This development enhances accessibility and continuity of care but requires integration across clinical, organisational, and societal levels. Understanding how MToP fits within daily practice and broader health system structures is crucial, particularly in an international context where reproductive healthcare access remains uneven.To explore how MToP can be sustainably integrated into Dutch general practice using the Rainbow Model of Integrated Care (RMIC), and to identify facilitators/barriers across stakeholders.A qualitative study was conducted using the six RMIC domains as an analytic framework. Semi-structured interviews were held with GPs, psychologists and nurse practitioners, pharmacists, gynaecologists, midwives, abortion physicians, patients, policymakers, insurers, NGOs, and educators. Topic lists were tailored to each group, addressing practical, organisational, ethical, and normative dimensions. Mixed focus groups (GPs, pharmacists, midwives, abortion physicians, policymakers) explored shared challenges and cross-sector solutions. Sessions were recorded, transcribed, and thematically analysed per RMIC domain.Preliminary analysis indicates that many GPs emphasise being overworked and hesitant to take on additional responsibilities. Nonetheless, a subset recognises clear added value in offering MToP, particularly in terms of continuity, accessibility, and patient-centred care. For these GPs, existing trust-based relationships with patients are seen as a key facilitator. Pharmacists report dispensing MToP is feasible if supported by clear communication and standardised protocols. Collaboration with abortion clinics and gynaecologists is constructive, though responsibilities for consultation and complication management require clearer agreements. Barriers identified include uncertainty around legal procedures and documentation, inconsistent reimbursement structures, fragmented ICT systems, and persistent stigma affecting both patient help-seeking and professional comfort. Patients emphasised privacy, non-judgmental communication, and timely access. NGOs and educators highlighted the need for structured training and public information to normalise abortion care in primary care.Integrating MToP into general practice is feasible and welcomed by multiple stakeholders but depends on strengthened collaboration, clearer governance, functional ICT support, and ongoing education.The RMIC framework underscores that sustainable implementation requires not only clinical readiness but also shared values, supportive policies, and coordinated system design—insights relevant for other countries seeking to expand primary-care-based abortion services.

Testicular contraception (TC) works, with an estimated Pearl Index (PI) of 2.34, calculated over a total of 512 months of pregnancy exposure. The PI is comparable to that of female oral contraceptives in common use.The primary objective was to explore users' expectations regarding TC devices. The secondary objectives were to understand the reasoning behind choosing a TC, gather TC users' experience, analyze their perceptions of the associated benefits and risks, and identify areas requiring improvement in medical supervision.A qualitative study using semi-structured individual interviews was conducted with users of testicular contraception. The population surveyed consisted of adult men who had already used testicular contraception for more than 30 consecutive days, in conjunction with the Thomas Bouloù association (XXX)TC users perceived it as an act of activism and solidarity with their partner, but also as a means of empowerment. Despite social, personal, and practical obstacles, their paths were often similar: seeking information, meeting with the Thomas Bouloù association, medical consultation, and then a spermogram. This step was often negatively experienced.One of the major obstacles preventing users from initiating and continuing TC was the semen analysis. There are no recent studies on masturbation in laboratories, the quality of the erotic magazines and videos provided, or the reception or rendering of the sample, which appeared to be the obstacles identified during the study. No study has analysed the experience of spermograms in a contraceptive pathway. Future prospects include greater accessibility to spermograms, improved laboratory reception, and institutional recognition of TC.Users of testicular contraction become information relays, carrying a feminist vision and strong societal expectations.

Unintended pregnancies remained common in Europe in 2023. IUDs (intrauterine devices) are a highly effective form of long-acting contraception that is widely used in XXX and around the world. They are over 99% effective, have low complication rates and are generally well tolerated. However, discontinuation still occurs; the main reasons for removal were bleeding and abdominal pain, alongside spotting, mood changes and the desire to become pregnant. Although several studies suggested that characteristics such as age, parity, BMI or STI history may influence early removal, the results were inconsistent. Therefore, understanding the determinants of early IUD discontinuation was essential to improve counselling and satisfaction, and to promote long-term contraceptive use.This study aimed to compare the characteristics of XXX women aged 18–50 who removed their IUD less than one year after insertion with those who retained it for over one year. A secondary objective was to explore discontinuation reasons by IUD type and duration of use.An epidemiological, retrospective, analytical, cross-sectional multicentre study was conducted in XXX from February to June 2024. A 31-question survey was distributed in healthcare settings and via digital platforms. Socio-demographics, IUD insertion details, and self-reported reasons for discontinuation data were collected from women who had a copper or levonorgestrel IUD removed within the last 10 years. Descriptive analyses, as well as univariate and adjusted multivariable logistic regressions, were performed.Of 380 respondents, 26% removed their IUD within a year. Having a body mass index ≥ 30, a history of miscarriage, and insertion by a non-gynaecologist were associated with early removal. Common reasons included pain, heavy or irregular bleeding, and mood changes. Women with copper IUDs often reported heavy bleeding, while those with levonorgestrel IUDs cited spotting or mood shifts.These findings suggest that BMI, prior miscarriage, and the healthcare provider’s professional background may predict early IUD discontinuation. Nonetheless, most other characteristics were not associated with early removal, indicating that such factors need not deter IUD use.Comprehensive counselling on potential side-effects and robust follow-up could enhance satisfaction and prolong IUD retention.

Insertion of an intrauterine device (IUD) is frequently painful and technically challenging, particularly in nulliparous women. Clinical experience suggests that bladder filling may reduce uterine anteflexion and thereby facilitate cervical–uterine alignment, yet evidence remains limited. The influence of bladder volume on uterine flexion has never been precisely quantified.To assess the variation in uterine flexion angle before and after voiding in nulliparous women with anteverted uteri. Secondary objectives were to determine: (1) the proportion of women whose uterine flexion angle changed from acute to obtuse with bladder filling; (2) the prevalence of uterine anteversion; and (3) the variation in the distance between the external cervical os and the flexion point.This monocentric cross-sectional study included 250 healthy nulliparous women aged ≥18 years. Each participant underwent suprapubic pelvic ultrasound with a full bladder, followed by a second scan after voiding. Uterine version and flexion angles were measured using standardized anatomical axes; distances from the external os to the flexion point were recorded. Paired comparisons were performed using Wilcoxon signed-rank tests.Among 212 women with interpretable anteverted uteri post-void, the mean flexion angle increased significantly with bladder filling (130.9° vs. 83.0°, mean difference +47.9°, p < 0.001; Cohen’s d = 1.31). Overall, 60.8% of participants shifted from an acute to an obtuse flexion angle, rising to 70.8% among women with anteverted uteri. The prevalence of uterine anteversion was 87.0%. The mean distance between the external os and the flexion point increased slightly with bladder filling (21.4 mm vs. 20.3 mm).Bladder filling induces a large and clinically meaningful straightening of the uterus in most nulliparous women, supporting the physiological rationale for improving IUD insertion conditions through simple pre-procedural bladder filling. Heterogeneity in bladder volumes and the use of suprapubic ultrasound may have influenced individual measurements, but the magnitude and consistency of the effect suggest robust findings.A full bladder markedly reduces uterine anteflexion in nulliparous women. These data justify clinical trials evaluating bladder filling as a strategy to improve technical ease and comfort during IUD insertion.

Abortion and contraception are essential for reproductive autonomy and equity, and family physicians can provide both. However, xxx has imposed growing policy restrictions on abortion that will likely affect contraception.This study examines differences in family physician contraceptive service provision in abortion-restrictive regions compared to non-restrictive regions in xxx.This cross-sectional, observational study used a national-level medical and prescription claims dataset (xxxx), which has detailed medical encounter information on xxx million patients in xxx. We analyzed contraceptive methods provided by family physicians in 2024: prescriptions (pill, patch, and/or ring), IUDs, implants, Depot Medroxyprogesterone Acetate (DMPA), tubal sterilizations, and vasectomies. Combining this data with xxx data, we calculated the regional ratio of family physicians to the population of reproductive age by policy category, as well as interquartile ranges to assess variation within categories. This abstract reports early findings from an ongoing study, with full results anticipated in early 2026.We enumerated family physicians providing implants (9,025), IUDs (7,707), DMPA (22,373), prescriptions (91,437), tubal sterilizations (809), and vasectomies (1,099). For abortion-restrictive regions, the ratios of family physicians providing implants, IUDs, and DMPA were 7.7 (interquartile range: 8.9), 5.6 (IQR: 14.3), and 21.3 (IQR: 24.1)/ 100,000 women of reproductive age, respectively. Non-restrictive regions had ratios of 14.2 (IQR: 15.7) for implants, 12.8 (IQR: 16.4) for IUDs, and 33.8 (IQR: 36.0) for DMPA. Prescriptions had relatively higher ratios of 110 (IQR: 61.3) in restrictive regions and 123 (IQR: 68.6) in non-restrictive regions. Tubal sterilization and vasectomy had low ratios overall.We found substantial region-level variation in the ratio of family physicians providing contraception. We found higher ratios of family physicians to population in regions with fewer abortion restrictions for methods implant, IUD, and DMPA; we found little or no difference for prescription methods pill, patch, and/ or ring, tubal sterilization, or vasectomy.As abortion access has become substantially restricted across xxx, access to contraception is critical. Family physicians are access points, especially in rural areas but may face additional barriers to providing care in regions that restrict access to reproductive health.

Industrialization and modernity have shifted India’s joint families to nuclear ones, influencing family planning decisions. Family structure affects women’s autonomy, fertility, and health service use. In nuclear families, women have greater reproductive freedom, while joint families—dominated by elders—often discourage contraception, limiting maternal health access and family planning adoption.To examine the relationship between family structure and family planning use in India using data from the third, fourth, and fifth rounds of the National Family Health Survey (NFHS), and to assess how household composition influences contraceptive adoption and reproductive health behavior.The study used data from the NFHS (2005–06, 2015–16, 2019–21) conducted by IIPS, Mumbai, covering over 99% of India’s population. The outcome variable was family planning use among married women (15–49 years), categorized as modern limiting, modern spacing, traditional, or non-use. The key explanatory variable was family structure (nuclear, joint, extended), along with demographic and socioeconomic factors such as age, caste, education, residence, wealth, parity, and region.Results show that family structure significantly influences family planning use across NFHS rounds. Women in nuclear (51.7%) and joint families (40.3%) were more likely to use contraception than those in extended families. Modern limiting methods remained dominant, while traditional methods increased, reflecting social and access barriers. Family planning use was higher among older, educated, wealthier, and media-exposed women. Regional variation showed higher use in southern and northeastern states, and lower in northern and central zones. Logistic regression confirmed that nuclear and joint family women had higher odds of using family planning, even after controlling for socioeconomic and demographic factors.This study using NFHS-3, 4, and 5 data found that family structure significantly affects family planning use in India. Women in nuclear families use contraception more than those in joint or extended families. Modern limiting methods dominate, with education, wealth, media exposure, and regional differences strongly influencing contraceptive behavior.The study concludes that family structure, education, wealth, parity, and media exposure strongly influence family planning use in India. Addressing unmet needs and promoting modern spacing methods, particularly in northern and northeastern regions, is essential to improve equitable and effective family planning outcomes.