Correlates of use of withdrawal for contraception among women in Vietnam

Abstract

Background: Despite its relatively low effectiveness, withdrawal is a common contraceptive practice. In Vietnam, health concerns about hormonal contraception are strong and account for substantial method discontinuation. Given the paucity of evidence on withdrawal, our objective was to identify correlates of using withdrawal among women not desiring pregnancy. Methods: We conducted a secondary analysis of data from a cross-sectional study of sexually-active adult women attending a public hospital in Hanoi, who did not desire pregnancy. We enrolled a stratified sample of women using the intrauterine device, combination oral contraception, or neither method. Participants completed a questionnaire on demographics and reproductive history and behaviors. We used multinomial logistic regression to evaluate correlates of using a tier 3 contraception method (without withdrawal) and using withdrawal (alone or with a tier 3 method) compared to the referent category of using a tier 1 or 2 method (without withdrawal). Results: Of the 489 participants in the analysis, 52.3% reported using tier 1 or 2 method (without withdrawal); 19.8% reported tier 3 contraception (without withdrawal) and 27.9% reported using withdrawal (alone or with a tier 3 method). Compared to those using a tier 1 or 2 method, women using withdrawal had lower odds of reporting that avoiding pregnancy was very important or important to them (aOR, 0.4; 95% CI, 0.3-0.7). Women using withdrawal had higher odds of reporting that their husband/partner refuses to give them money for household expenses, even when he has the money (aOR, 2.8; 95% CI, 1.4-5.6). Conclusions: Women using withdrawal might have less relationship power than nonusers. They also might rely on the practice because they are more ambivalent about pregnancy.

Investigating the Reasons for Using the Withdrawal Method and Quitting of Women Applying to the Family Planning Clinic to Use an Effective Family Planning Method

“…26 Nguyen ve ark. 'nın 16 çalışmasında da gebelikten kaçınmanın önemi ile geri çekme yöntemi kullanma durumu arasında anlamlı fark olduğu belirtilmiştir. 16 Berber'in 19 çalışmasında, kadınların ideal çocuk sayıları ile yöntemleri arasında istatiksel olarak anlamlı fark saptanmıştır.…”

“…[12][13][14] Bu yöntem, eşler arasında uyum, disiplin ve motivasyon gerektirmektedir. 2,15,16 Uygulama kolaylığı ve maliyetsiz olması nedeni ile Türkiye'de hâlen evli kadınlar arasında en yaygın olarak kullanılan yöntem olan geri çekme, etkisi sınırlı bir yöntemdir. 7,11,[17][18][19] Doğru kullanıldığında emzirmeyi etkilememesi ve her zaman birincil kullanım veya yedek yöntem olarak kullanım için mevcut olması, yöntemin diğer olumlu yönlerindendir.…”

“…Geri çekme yöntemi, Cinsel Yolla Bulaşan Hastalıklara (CYBH) karşı korumaz. 12,16,[19][20][21] Ayrıca erkeklerin çoğu kendi verdiği karar nedeniyle bu yöntemi kullanmakta, kadınların görüşü alınmamaktadır. Geri çekme yöntemine bağlı istenmeyen gebelikler ve CYBH'lar ise kadın sağlığını olumsuz etkilemektedir.…”

Beyond The Realms Of Pregnancy – How Conversations About Contraception Can Contribute To Improving The Health Of Sexual Minority Women

“…These methods continue to be commonly used outside of Africa. Jones et al (2014) found that 33 per cent of people have used the pull-out (withdrawal) method at least once, despite having a failure rate of approximately 20 per cent (Nguyen et al, 2020). However, many people use the withdrawal method in combination, or in rotation with condoms and other effective methods (Jones et al, 2014;Nguyen et al, 2020).…”