Prevalensi KB paska persalinan

Contraception, 673697
barrier methods of, 687691
for breast-feeding women, 652, 652t
chronic hypertension and, 993
counseling on, postpartum, 657
for diabetic patient, 1112, 1121
emergency, 10
for sexual assault victim, 937
for epileptic patients, 1167
failed
body mass index (BMI) and, 951
and ectopic pregnancy, 238239
failure of, during first year of use, 675t
heart disease and, 962963
for HIV-infected (AIDS) patients, 1253
hormonal, 673682
implant, for breast-feeding women, 652t
injectable
medroxyprogesterone acetate, 682683
norethisterone enanthate, 682683
progestin, 682683
intramuscular administration of, 682
and lactation, 680, 694
methods, 674, 675t
mechanical, 684694
nonuse, prepregnancy prevalence of, 175t
obesity and, 951
periodic (rhythmic) abstinence methods,
675t, 692
postpartum, 657
progestational, 682683
progestin implants, 683
prosthetic heart valves and, 964
rheumatoid arthritis and, 1157
safety of, 674
in sickle-cell hemoglobinopathy, 1089
sickle-cell trait and, 1089
spermicidal, 688690, 690f
and spontaneous abortion, 218
systemic lupus erythematosus and, 1151
systemic sclerosis and, 1158
transdermal administration of, 681, 681f
use of
and determination of gestational age,
195
in U.S., 674, 674f, 675f, 675t
World Health Organization (WHO)
guides for, 674
Contraceptive patch (EVRA), failure of,
during first year of use, 675t
Contraceptive patch (Ortho Evra), 681, 681f
failure of, risk factors for, 681
Contraceptive sponge, 691, 691f
failure of, during first year of use, 675t

Williams Obstetric

Family Planning Services

Politics and religion over the years have led to a variety of governmental

interferences with the reproductive rights of women.

These interferences have disparately affected indigent women
and teenagers. An example from the recent past is the consideration
by Congress in 1998 of the Title X Parental Notification
Act to mandate parental notification for minors seeking contraception
at federally funded clinics. Reddy and colleagues (2002)
reported that this would have dissuaded almost half of girls
younger than 17 years from seeking contraceptive services and
testing or treatment for sexually transmitted disease. The increased
number of unintended teenage pregnancies and abortions
that would inevitably ensue are discussed subsequently.
A recent example is the tug-of-war over emergency contraception,
and more specifically over the morning-after pill (see
Chap. 32, p. 692). The 2004 decision by the Bush Administration
to override the 23 to 4 vote to approve Plan B for over-thecounter
sales to 17-year-old women was decried appropriately
by editorials in the New England Journal of Medicine (Drazen
and colleagues, 2004; Steinbrook, 2004). This was overturned
in April 2009 by a federal district court in New York that ordered
the Food and Drug Administration (FDA) to make emergency
contraception available over the counter to women 17
years or older. The American College of Obstetricians and Gynecologists
(2009b) lauded the decision, citing the more than
800,000 yearly teenage pregnancies in this country and the fact
that many are terminated. Also cited were data showing that
most adolescents have sex for the first time at age 17.
Perhaps the most egregious example of both federal and state
governmental intrusion into womens reproductive rights is the often
poor availability of federally funded family planning services
for indigent women. This is despite all reports of the overwhelming
success of such programs. According to the Guttmacher Institute
(2009), publicly funded family planning services in 2006 prevented
nearly 2 million unintended pregnancies and 800,000
abortions in the United States (Fig. 1-5). They conclude that
without such funding the abortion rate would be nearly two thirds
higher for all women, and nearly twice as high for poor women.