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Abortus in Nederland 2001-2002 The Contraceptive Cycle Charles Picavet ISBN 9789077289082 Rutgers WPF Postbus 9022 3506 GA Utrecht tel: 030-2313431 [email protected] / www.rutgers.nl AllthatChas [email protected] / www.allthatchas.nl © 2016 Rutgers / AllthatChas All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, mechanically, by photocopy, by recording, or otherwise, without permission from the author. The Contraceptive Cycle De anticonceptiecyclus (met een samenvatting in het Nederlands) Proefschrift ter verkrijging van de graad van doctor aan de Universiteit Utrecht op gezag van de rector magnificus, prof.dr. G.J. van der Zwaan, ingevolge het besluit van het college van promoties in het openbaar te verdedigen op vrijdag 27 mei 2016 des middags te 12.45 uur door Charles Bernard Cornelis Picavet geboren op 21 april 1972 te Druten Promotoren: Prof.dr. E.M. Woertman Prof.dr. J.B.F. de Wit iv Dankwoord (Acknowledgements) Mijn moeder was 21 toen ze mij kreeg. Ook in 1972 was dat jong om aan kinderen te beginnen. Gemiddeld waren vrouwen toen 24,5 bij het eerste kind. Ik was zeker wel gewenst, maar toch niet gepland. Tijdens de tienerjaren van mijn moeder was de pil geïntroduceerd en in die beginjaren waren er nog veel vragen en onzekerheden, bijvoorbeeld over effecten op gezondheid. Toch maakte de pil een enorme opmars. In 1976 gebruikte 41% van de vrouwen in vruchtbare leeftijd de pil, vergelijkbaar met het huidige percentage. Tussen 1965 en 1975 is het aantal geboorten daardoor scherp gedaald. Door effectieve anticonceptie kan men nu onbezorgd(er) met elkaar vrijen. De loskoppeling van seks en voortplanting was al gaande, maar heeft een enorme stimulans gekregen door de pil. Het is goed om te bedenken hoe recent dit is gebeurd en de impact die het heeft gehad. Alleen daarom al doe ik graag onderzoek naar anticonceptiegebruik. Ik wil iedereen bedanken die heeft bijgedragen aan de totstandkoming van dit proefschrift. Voor alles zijn dat mijn promotoren prof.dr. E.M. Woertman en prof.dr. J.B.F. de Wit. Liesbeth en John, misschien was dit proefschrift er ook wel gekomen zonder jullie, maar jullie hebben mij net het zetje gegeven dat nodig was om er eindelijk eens aan te beginnen. Jullie waren niet de meest voor de hand liggende mensen om een promotie over anticonceptiegebruik te begeleiden, maar dat jullie dit voor mij wilden doen, gaf warmte en vertrouwen. Ik herinner mij onze afspraken in de Faculty Club met veel plezier. Als we met elkaar spraken, dan konden er belangrijke stappen worden gezet. Natuurlijk gaat mijn dank uit naar de overige coauteurs van mijn artikelen: Maaike Goenee, Ciel Wijsen en Ineke van der Vlugt, en naar degenen die hebben meegelezen, meegedacht en commentaar gegeven: Linda van der Leest, Floor Bakker, Elizabeth Westley, Henny Bos, Rens van de Schoot, Nelleke Buijs en Mieke van Kooten Niekerk. Ik heb ook veel gehad aan de commentaren van redacteuren en reviewers van de tijdschriften waarin de artikelen zijn geplaatst. De interesse en aanmoedigingen van familie, collega’s en vrienden hebben ook geholpen. Het schrijven zelf is misschien eenzaam werk, maar alles eromheen zeker niet! Ik heb een groot deel van dit proefschrift geschreven in Egmond. Hele dagen heb ik bij Strandpaviljoen de Schelp gezeten, met stopcontact en wifi (we hadden geen stroom in ons duinhuisje), grote flessen bubbelwater, ‘Tapas de Schelp’ en v ander lekkers tot mijn beschikking. Zo is schrijven geen beproeving! Zelfs niet op een klein 10 inch laptopje. Dit proefschrift gaat over vrouwen. De wereld om mij heen bestaat grotendeels uit vrouwen. Daarom gaat mijn dank tot slot uit naar die belangrijke vrouwen in mijn leven. Dat is allereerst mijn moeder. Ik ben net zo trots op haar als zij op mij. Ook zijn dat mijn paranimfen Hanneke en Thea, samen met wie ik me heb ontwikkeld tot de onderzoeker die ik nu ben. En natuurlijk zijn dat mijn lief Floor, en mijn twee supermeiden Sarah en Marijn. Sarah, speciaal bedankt voor figuur 2.1 die jij hebt gemaakt! Jullie hebben het zwaar gehad met me. Een beetje in de tijd dat ik aan dit boek schreef, maar nog veel meer in de tijd daarvóór. Ik ben blij dat ik er weer meer voor jullie kan zijn. Ik ben trots op dit proefschrift en hoe het tot stand is gekomen. Ik heb het gedaan naast mijn werk, in een tijd dat ik onder meer een bestaan als zelfstandige heb opgebouwd. Maar het schrijven ging als een speer. Dit leverde heel veel energie op, al was het aan het einde nog even ploeteren. Ik ben blij dat het zover is, en zal mijn werk met plezier verdedigen! Charles Picavet vi Contents Chapter 1 General Introduction ........................................................................... 1 1.1 The Problem of Contraception ........................................................................... 3 1.2 The Contraceptive Cycle ..................................................................................... 4 1.3 Theoretical Framework ....................................................................................... 5 1.4 This Thesis .......................................................................................................... 9 Chapter 2 The Contraceptive Cycle: Improving Contraceptive Choices and Use .................................................................................................... 13 Abstract ................................................................................................................... 14 2.1 Introduction ....................................................................................................... 15 2.2 Contraception or no Contraception, That’s the Question .............................. 19 2.3 Which Method? ................................................................................................. 22 2.4 Correct and Consistent Use ............................................................................. 25 2.5 What if Anything Goes Wrong? ........................................................................ 28 2.6 Method Re-Evaluation ...................................................................................... 30 2.7 Conclusion ......................................................................................................... 31 Chapter 3 Contraceptive Decision-Making: What Women Found Important When They Chose Their Method ........................................................ 33 Abstract ................................................................................................................... 34 3.1 Introduction ....................................................................................................... 35 3.2 Methods ............................................................................................................. 36 3.3 Results ............................................................................................................... 41 3.4 Discussion ......................................................................................................... 50 3.5 Conclusion ......................................................................................................... 53 Chapter 4 Social-Demographic Differences in Oral Contraceptive Pill Adherence and the Mediating Function of Social Cognitive Factors 55 Abstract ................................................................................................................... 56 4.1 Introduction ....................................................................................................... 57 vii 4.2 Methods ............................................................................................................. 59 4.3 Results ............................................................................................................... 62 4.4 Discussion ......................................................................................................... 64 4.5 Conclusion ......................................................................................................... 69 Chapter 5 Skipping the Pill-Free Interval: Data from a Dutch National Sample 69 Abstract ................................................................................................................... 70 5.1 Introduction ....................................................................................................... 71 5.2 Methods ............................................................................................................. 72 5.3 Results ............................................................................................................... 74 5.4 Discussion ......................................................................................................... 74 Chapter 6 Intention to Use Emergency Contraceptive Pills and the Role of Knowledge in a Dutch National Sample ............................................ 75 Abstract ................................................................................................................... 76 6.1 Introduction ....................................................................................................... 77 6.2 Methods ............................................................................................................. 78 6.3 Results ............................................................................................................... 80 6.4 Discussion ........................................................................................................
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