Family Planning Use and Attitudes · Attitudes and Acceptability
Moreau C et al., 2007 · Contraception
This study examines contraceptive discontinuation due to method dissatisfaction among women in the United States. The study population, drawn from the 2002 National Survey of Family Growth, consisted of 6724 women (15-44 years of age) who had ever used a reversible contraceptive method. We first estimated the overall proportion of women who had ever discontinued their contraceptive due to dissatisfaction. We then calculated method-specific discontinuation risks due to dissatisfaction and analyzed the reasons for dissatisfaction given by women who had ever stopped using Norplant, Depo-Provera, oral contraceptives or condoms. Overall, 46% of women had ever discontinued at least one method because they were unsatisfied with it. Dissatisfaction-related discontinuation risks varied widely by the diaphragm and cervical cap showed the highest proportions of such discontinuation (52%), followed by long-acting hormonal methods (42%). Oral contraceptives were associated with an intermediate risk of dissatisfaction-related discontinuation (29%), while condoms had the lowest risk (12%). A broader understanding of women's concerns and experiences using contraception could help health care providers redesign counseling strategies to improve contraceptive continuation.
Comparative Studies · Discontinuation and Return of Fertility
Lewitt S et al., 1971 · Fertil Steril
The use-effectiveness of oral contraception and intrauterine contraception was studied in 3 family planning centers in the United States: Grady Memorial Hospital in Atlanta, Georgia; State University of New York, Downstate Medical Center, in Brooklyn; and the Planned Parenthood Center in Buffalo, New York. In each locality 1000 women were selected for the study. 2900 women accepted intrauterine devices (IUDs) or oral contraceptives (OCs) as their first method of contraception. In Brooklyn 3 out of 4 women chose OCs; in Atlanta and Buffalo roughly equal numbers selected each method. The mean age of admission was 25.7 years in Buffalo, 24 years in Brooklyn, and 23.8 years in Atlanta. IUD acceptors were older than those choosing OCs. The difference was greatest in Buffalo (3.3 years) and smallest in Atlanta (.8 years). A special one-page, self-coding questionnaire was designed to collect the information required. In all 3 clinics contraceptive termination rates were markedly lower for the IUDs than for OCs. At 1 year of use for the first method only about one-fourth the women who chose the IUD had discontinued its use. Women on OCs terminated at rates from 10-20% higher. Termination rates for all contraception, both first-method and substitution, were lower than for first-method alone and lower for IUDs than for OCs. The highest continuation rate for all contraception was 92.5% for IUD users in Brooklyn while OC users in Atlanta were at the lowest level at 60.5%. Pregnancy rate studies demonstrated higher failure rates with OCs than with IUDs in all 3 clinics. Statistics by age showed that termination rates for both IUD and OC users declined with age. Women who selected IUDs as their method of contraception were more persistent users of contraception. Even after discontinuing IUD use, they were more likely to adopt another contraceptive method.
Comparative Studies · Discontinuation and Return of Fertility
Lewit S et al., 1971 · Fam Plann Perspect
The extended use-effectiveness of IUD and oral pills as measured by 1) their theoretical effectiveness 2) consistency of use and 3) continuation of use in preventing unwanted pregnancies was studied for 2900 women who had chosen either method as their first contraceptive in family planning clinics in Atlanta Georgia and in Brooklyn and Buffalo New York for a 12-18 month period. The greater persistence among IUD users to continue the method or use another method and the less likelihood there was of these women to have an unplanned pregnancy (the difference between IUD users and pill users increasing with months of exposure) suggest the necessity of greater support from the clinics to help women using pills prevent unwanted pregnancies. IUD users were generally older than pill acceptors and among IUD contraceptors the greater tendency to continue using the IUD and contraception may indicate that older women use contraception to terminate rather than to space childbirth.