What are the clinical, ethical, social, and economic consequences of unintended pregnancy
Please respond to your peer’s posts. Minimum of a 100 words.To ensure that your responses are substantive, use at least two of these prompts:
- Do you agree with your peers’ assessment?
- Take an opposing view to a peer and present a logical argument supporting an alternate opinion.
- Share your thoughts on how you support their opinion and explain why.
- Present new references that support your opinions.
Please be sure to validate your opinions and ideas with citations and references in APA format. Substantive means that you add something new to the discussion, you aren’t just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion and should be correlated to the literature.
Tracie’s Response:
What are the clinical, ethical, social, and economic consequences of unintended pregnancy? Why is it important for advance practice nurses to remain cognizant of this information?
Unintended pregnancy is one of the most troubling public health issues worldwide that poses substantial socioeconomic burden on people and the society (Mansureh, Fatemeh, Arezoo, & Abolghasem, 2015). It can be a huge shock to any family, especially to a single woman. Ideally, couples like to plan pregnancies for social and economic reasons. The consequence of not doing this could lead to economic burden and financial strain. It’s not always the right time to have a baby for some couples. Socially, some people may be too young, not mature enough, or their lives are just too busy. Having a baby during these times can be very stressful. 68% of the 1.5 million unplanned births are paid for by public insurance programs, primarily Medicaid (Unintended Pregnancy in the United States, 2017). Of the two million publicly funded births in 2010, about half were unplanned. Total expenditures on unintended pregnancies nationwide were estimated to be 21 billion (Unintended Pregnancy in the United States, 2017). Ethically, I think that unplanned pregnancies can cause depression because mothers are upset that things didn’t turn out according to plan or may feel ashamed due to family or religious values.
Another perspective I would like to add this to discussion is the fact that America gives a lot of aid to women and children. I think this is great but it also in a way can promote pregnancies. You get a lot more aid if you have a child. You can get food stamps, WIC, more money back from tax returns, and also financial help with school. I have heard many people say “I need to have a kid”, just so they can get some financial assistance.
It’s very important for ARNP’s to remain educated in these issues because we can use the information and statistics to help people. For example, unplanned birth may predispose children to greater risk factors later in life, including physical health issues due to delayed prenatal care and dropping out of high school.
References
Mansureh, Y., Fatemeh, A., Arezoo, P., & Abolghasem, P. (2015). Unintended Pregnancy and Its Adverse Social and Economic Consequences on Health System: A Narrative Review Article. Iran Journal Public Health, 44(1), 12-21. Retrieved from https://www.ncbi.nlm.nih.
Unintended Pregnancy in the United States. (2017, September). Retrieved from https://www.guttmacher.
Charli’s Response:
What are the clinical criteria for selection of contraceptives, including emergency contraception?
There are many forms of contraceptives that are available for women. Depending on their age, reason for needing contraceptive such as symptoms, plans to have children or not will all affect which type of contraceptive should be prescribed. Emergency contraception is needed to prevent a possible pregnancy. Emergency contraception has two options. A ParaGard IUD can be implanted within 5 days of sexual intercourse or taking the morning after pill within 3 days (Planned parenthood, 2019). There are a few options of the morning after pills that include a pill with ulipristal acetate that is called Ella and needs to be a prescription from a provider and can be taken within 120 hours after unprotected sex (Planned parenthood, 2019). Or the other pills can be bought over the counter and they contain levonorgestrel, but are recommended to be taken within 72 hours of having unprotected sex (Planned parenthood, 2019). Patients cannot be pregnant, have PID, sepsis within the last three months, STIs, abnormal bleeding that has not been determined the cause, malignancy of the genital tract, or anything that would cause problematic insertion (Smith & Daley, 2012).
What resources would you utilize in your decision-making?
During the decision-making process, I would ask the patient about their sexual history, medical history, future plans for children, and their reasoning for wanting contraceptives. They would need to have a pregnancy test, STI testing, and a Pap smear on file to check for any malignancy. A patient wanting emergency contraceptives should also be counseled about risks of STIs when having unprotected sex. Patients with a current STI such as chlamydia or gonorrhea can cause sterility if the infection spreads into the uterus (Smith & Daley, 2012).
IUDs are a great contraceptive for those that do not want to remember to take a pill everyday. They are also good for 5 to 10 years and can be great for young women or those that do not wish to have children within that time frame (Smith & Daley, 2012).
Identify two evidence-based interventions which increase compliance and successful utilization of contraceptives?
Two types of contraceptives that are highly effective and create compliance are IUDs and nexplanon. The problem with these options is that many women do not know that these options exist. They are highly effective and do not require women to have to do anything with them once they are in. They are easily implanted by a trained professional and are associated with minor complications. The most common symptoms associated with these devices are irregular bleeding, but most likely will only be spotting (Smith and Daley, 2012). The nexplanon can be used postpartum and during breast feeding allowing it to be a popular option (Carcio & Secor, 2019). One of the reasons that these two options have great compliance is that they do not require monthly stops to the pharmacy to pick up the prescription and they do not have to be taken every single day to be affective. It is a great option for many women, but the option needs to be offered more often and patients need to be educated on what options they have.
References
Carcio, H., & Secor, M. (2019). Advanced health assessment of women (4th ed.). New York, NY: Springer Publishing Co.
Planned Parenthood. (2019). Which kind of emergency contraception should I use? Planned Parenthood Federation of America Inc. Retrieved from https://www.
Smith, E., & Daley, A. M. (2012). A clinical guideline for intrauterine device use in adolescents(Links to an external site.)Links to an external site.. Journal of the American Academy of Nurse Practitioners, 24(8), 453-462. doi:10.1111/j.1745-7599.2012.
Kathleen response
Timing is an important consideration when patients request contraception initiation. Compliance is usually improved when patients are able to start contraception immediately. There are things to consider when initiating contraception such as last menstrual period, timing of last unprotected intercourse, and type of contraception. The attached file provides an algorithm for decision-making and options for quick start methods.
Take some time to review the attachment. How would you utilize this information in clinical practice? How do you think the quick start method would benefit your patient population especially when you think about the rates of unintended pregnancy in the United States?
Answer preview What are the clinical, ethical, social, and economic consequences of unintended pregnancy
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