Appropriate Methods for Analyzing the Effect of Method Choice on Contraceptive Discontinuation

Hormonal Contraception and Physiology: A Research‐based Theory of Discontinuation Due to Side Effects

“…Hence, the longer-acting method would be biased toward a lower discontinuation rate. Analyses of the 1997 DHS data from Indonesia confirmed that method choice is endogenous to contraceptive discontinuation in that population (Steele and Curtis 2003). In addition, these analyses suggested that women who choose IUDs or implants rather than pills or injectables are, contrary to the prediction above, at a higher risk of abandoning use.…”

“…In addition, these analyses suggested that women who choose IUDs or implants rather than pills or injectables are, contrary to the prediction above, at a higher risk of abandoning use. Nevertheless, when this endogeneity is controlled for, discontinuation of IUDs or implants is still significantly lower than for pills or injectables (Steele and Curtis 2003). The analyses also indicated that older users are more likely than younger users to abandon contraceptive use.…”

“…Analyses of discontinuation may also be biased if the choice of a method is endogenous to termination of contraceptive use (Steele and Curtis 2003). In other words, women at high risk for discontinuation may choose to use certain methods rather than others, which would bias analyses of the determinants of discontinuation.…”

“…This differential may occur principally because those women choosing the IUD have completed their families and have less desire to become pregnant again at the time they choose a method. As the analyses of Indonesian data (Steele and Curtis 2003) suggest, other factors may also play a role. For example, attributing discontinuation of oral contraceptive use to a desire to become pregnant may be one way that some women avoid being pressed to tolerate side effects that they find unacceptable.…”

Stakeholder and Provider Views Regarding Pericoital Contraceptive Pills in India and Uganda

“…(Studies in Family Planning 2013; 44[4]: 431-444) M ethod choice-the number and variety of methods available-is considered one of the six fundamental elements of quality of care (Bruce 1990) and is a longstanding tenet of family planning best practice. Offering women a broad array of methods is associated with increases in overall contraceptive prevalence and decreases in contraceptive discontinuation (Jain 1989;Steele and Curtis 2003). At the heart of the commitment to expanded method choice is the recognition that what a woman desires and needs regarding a contraceptive method varies over her reproductive life course.…”