Contraceptive Discontinuation and Unintended Pregnancy: An Imperfect Relationship

Abstract

Context Contraceptive discontinuation is a common event. We hypothesize that a significant proportion of contraceptive discontinuations are associated with low motivation to avoid pregnancy; this will be reflected in a significant proportion of pregnancies following discontinuation being reported as intended. Methods We use Demographic and Health Survey (DHS) data from 6 countries to explore the extent to which women report pregnancies following contraceptive discontinuation as intended and to identify the characteristics of women who report pregnancies following contraceptive failure or discontinuation for non-pregnancy reasons as intended. Results We found that relatively high percentages of births are reported as intended following contraceptive failure and discontinuation for non-pregnancy reasons (16–50% for failure and around 40% for discontinuation for reasons other than desire for pregnancy). While there were few consistent patterns in socio-economic factors associated with reporting births following discontinuation and failure as intended, stronger and more consistent associations were found with variables expected to be linked to motivation such as number of living children, reason for discontinuation, and the time elapsed between discontinuation and pregnancy. Conclusions These findings suggest that underlying variation in motivation to avoid pregnancy is an important factor in contraceptive discontinuation.

Contraceptive Discontinuation, Method Switching and Associated Factors among Reproductive Age Women in Jimma Town, Southwest Ethiopia, 2013

“…It might be due to these groups of women tending to use short term contraceptive methods. However, this result is in line with other study which showed the women who have discontinued contraception were somewhat concentrated in the 25-34 ages [24].…”

“…Never married women were less likely to experience contraceptive discontinuation than women who were married. This could be due to single women are more likely to be careful about not getting unwanted pregnancies [2,[24][25][26][27].…”

Medical students’ knowledge, attitudes and perceptions towards contraceptive use and counselling: a cross-sectional survey in Maharashtra, India

“…Studies have shown that improving the quality of care increases and sustains contraceptive use by women 13. Providers need adequate knowledge of contraceptive methods and training in counselling skills in order to provide reliable information to women 14. Despite the availability of effective methods of contraception in India, many pregnancies remain unintended.…”

Nuevas recomendaciones para el consejo anticonceptivo basadas en el estilo de vida. Resultados de un estudio Delphi

“…Los estudios muestran que el cumplimiento anticonceptivo es menor entre las adolescentes, así como la existencia de distintos factores pronóstico específicos de mal cumplimiento [32][33][34][35] . La identificación de las adolescentes que presenten factores que aumenten el riesgo de discontinuación del uso de anticonceptivos presenta gran relevancia para enfocar los recursos en la atención preferencial de este grupo 28,[36][37][38] . El preservativo es el método más utilizado en España en todos los grupos de edad, siendo frecuente el uso inconsistente (25%) 28,39 .…”