Victoria Newton

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    ‘I know it's something to do with 28 days': young women's fertility knowledge

    Victoria Newton The Open University, Milton Keynes, UK - victoria.newton@open.ac.uk

    Objectives: This project sought to investigate what young women know about fertility and how this knowledge is interpreted at an individual level. Misunderstandings about fertility can result in some young women engaging in risk-taking behaviour (Williamson et al 2009, Hoggart et al 2010). The Department of Health Framework for Sexual Health (March 2013) identifies fertility perceptions and their influence on contraceptive use as an area for suggested action (Annex C). This project therefore addressed this need by exploring young women's awareness of their fertility in relation to menstruation, contraception and pregnancy risk. Methods: Ten semi-structured qualitative interviews were undertaken with participants aged 16-20. Topics explored include what young women know about their fertility; when they think they are most and least at risk of falling pregnant; to what extent they perceive themselves to be at risk of pregnancy; their contraception use and risk taking; their knowledge of STIs and other factors affecting fertility. Results: It was found that despite a blanket desire to avoid pregnancy, all participants took risks. Almost all had used emergency contraception.

    Although some participants had limited knowledge of when it is easier to get pregnant, there was no evidence that they were more careful during their fertile time. Conclusions: Young women may benefit from a greater knowledge and understanding of their fertility. A better understanding of their fertility may help young women to assess their risk of pregnancy, and when desiring to avoid pregnancy, to take extra precautions during their most fertile time. A greater knowledge may also empower them in the future should they wish to plan for a family.

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    Menstruation and contraception: social and cultural issues on young women's decision-making

    Victoria Newton, Lesley Hoggart The Open University, Milton Keynes, UK - victoria.newton@open.ac.uk

    Objectives: This study examined the attitudes of young women (aged 16-21) towards menstruation and contraception. The study had two main research objectives: to document and investigate what young women think and feel about menstruation and contraception, and to explore young women's preferences regarding the intersection of contraceptives and bleeding patterns. Methods: A qualitative study in which twelve young women were interviewed in-depth, along with six focus group discussions. Results: Although participants held a broad view that menstruation can be an inconvenience, they did ascribe positive values to having a regular bleed. Bleeding was seen as a signifier of non-pregnancy and also an innate part of being a woman. A preference for a ‘natural' menstruating body was a strong theme, and the idea of selecting a hormonal contraceptive that might stop the bleeding was not popular, unless the young woman suffered with painful natural menstruation. Contraceptives that mimicked the menstrual cycle were acceptable to most suggesting that cyclic bleeding may hold a symbolic function for many women. Conclusions: When counselling young women about the effect of hormonal contraception on their bleeding, it would be helpful for practitioners to explore how the young women feel about their bleeding, and ask the young women to recall a ‘worst case scenario' in terms of their bleeding patterns with reference to how they might feel about it. It may also be helpful for practitioners to outline the therapeutic interventions available to alleviate breakthrough bleeding associated with some LARC methods, such as prescribing the COC pill, during their initial contraceptive consultation. Finally, the subjective understanding of the ‘natural body' as held by some women could be acknowledged more fully and in these cases practitioners could be encouraged to support them in their choice and seeking out of non-hormonal methods of contraception.