Fertility Awareness Methods Are Not Modern Contraceptives: Defining Contraception to Reflect Our Priorities

Austad, Kirsten; Chary, Anita; Colom, Alejandra; Barillas, Rodrigo; Luna, Danessa; Menjívar, Cecilia; Metz, Brent; Petrocy, Amy; Ruch, Anne; Rohloff, Peter

doi:10.9745/ghsp-d-16-00044

Cited by 12 publications

(10 citation statements)

References 12 publications

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“…However, the finding is expected considering evidence that majority of AGYW in SSA do not use modern contraceptives but rather traditional contraceptives for various reasons including stigma and discrimination by healthcare providers and fear of side effects [ 30 – 32 ]. Several studies have also argued that compared to modern methods of contraception, traditional contraceptives are not effective in preventing pregnancy [ 31 , 56 , 57 ]. There is the need for further studies on the trend and extent to which the use of traditional methods of contraception contribute to unintended pregnancy among AGYW in high fertility countries in SSA.…”

Section: Discussionmentioning

confidence: 99%

Individual and contextual factors associated with mistimed and unwanted pregnancies among adolescent girls and young women in selected high fertility countries in sub-Saharan Africa: A multilevel mixed effects analysis

Ahinkorah

2020

PLoS ONE

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Introduction Unintended pregnancies are associated with a number of risk factors such as malnutrition, mental illness, unsafe abortion, maternal mortality and horizontal transmission of HIV to children. These risks are predominant among adolescent girls and young women compared to older women. This study examined the individual and contextual factors associated with unintended pregnancy among adolescent girls and young women in selected high fertility countries in sub-Saharan Africa. Materials and methods Data for this study was obtained from recent Demographic and Health Surveys carried out between 2010 and 2018 in 10 countries in sub-Sahara Africa. The sample size for this study was made up of 6,791 adolescent girls and young women (aged 15–24), who were pregnant during the surveys and had complete responses on all the variables considered in the study. Unintended pregnancy was the outcome variable in this study. Descriptive and multilevel logistic regression analyses were performed and the fixed effect results of the multilevel logistic regression analysis were reported as adjusted odds ratios at 95% confidence interval. Results Unintended pregnancy in the selected countries was 22.4%, with Angola, recording the highest prevalence of 46.6% while Gambia had the lowest prevalence of 10.2%. The likelihood of unintended pregnancy was high among adolescent girls and young women aged 15–19 [aOR = 1.48; 95% CI = 1.26–1.73], those with primary [aOR = 1.99; 95% CI = 1.69–2.33] and secondary/higher [aOR = 2.30; 95% CI = 1.90–2.78] levels of education, single (never married/separated/divorced/widowed) adolescent girls and young women [aOR = 9.23; 95% CI = 7.55–11.28] and those who were cohabiting [aOR = 2.53; 95% CI = 2.16–2.96]. The odds of unintended pregnancy also increased with increasing birth order, with adolescent girls and young women having three or more births more likely to have unintended pregnancies compared to those with one birth [aOR = 1.99; 95% CI = 1.59–2.48]. Adolescent girls and young women who had ever used contraceptives (modern or traditional), had higher odds of unintended pregnancies compared to those who had never used contraceptives [aOR = 1.32; 95% CI = 1.12–1.54]. Finally, adolescent girls and young women who belonged to the rich wealth quintile were more likely to have unintended pregnancy compared to those in the poor wealth quintile [1.28; 95% CI = 1.08–1.51]. Conclusion The study found that age, marital status, level of education, parity, use of contraceptives and wealth quintile are associated with unintended pregnancy among adolescent girls and young women in high fertility sub-Saharan African countries. These findings call for the need for government and non-governmental organisations in high fertility sub-Saharan African countries to restructure sexual and reproductive health services, taking into consideration these individual and contextual level characteristics of adolescent gir...

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Section: Discussionmentioning

confidence: 99%

Individual and contextual factors associated with mistimed and unwanted pregnancies among adolescent girls and young women in selected high fertility countries in sub-Saharan Africa: A multilevel mixed effects analysis

Ahinkorah

2020

PLoS ONE

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“…For example, self-reporting of traditional contraceptive use might reflect residual confounders such as maternal autonomy, which was not incorporated in this analysis but has been associated with stunting in other settings 42. In addition, we used DHS-aligned definitions of contraceptive type (modern or traditional), but the distinction between modern versus traditional methods has been debated 43. We justify the definitions used in this study as appropriate given that it is the classification scheme currently recommended by DHS.…”

Section: Discussionmentioning

confidence: 99%

Associations between contraception and stunting in Guatemala: secondary analysis of the 2014–2015 Demographic and Health Survey

Flood

Petersen

Martinez

et al. 2019

bmjpo

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BackgroundThere has been limited research on the relationship between contraception and child growth in low-income and middle-income countries (LMICs). This study examines the association between contraception and child linear growth in Guatemala, an LMIC with a very high prevalence of child stunting. We hypothesise that contraceptive use is associated with better child linear growth and less stunting in Guatemala.MethodsUsing representative national data on 12 440 children 0–59 months of age from the 2014–2015 Demographic and Health Survey in Guatemala, we constructed multivariable linear and Poisson regression models to assess whether child linear growth and stunting were associated with contraception variables. All models were adjusted for a comprehensive set of prespecified confounding variables.ResultsContraceptive use was generally associated with modest, statistically significant greater height-for-age z-score. Current use of a modern method for at least 15 months was associated with a prevalence ratio of stunting of 0.87 (95% CI 0.81 to 0.94; p<0.001), and prior use of a modern method was associated with a prevalence ratio of stunting of 0.93 (95% CI 0.87 to 0.98; p<0.05). The severe stunting models found generally similar associations with modern contraceptive use as the stunting models. There was no significant association between use of a modern method for less than 15 months and the prevalence ratio of stunting or severe stunting.ConclusionsContraceptive use was associated with better child linear growth and less child stunting in Guatemala. In addition to the human rights imperative to expand contraceptive access and choice, family planning merits further study as a strategy to improve child growth in Guatemala and other countries with high prevalence of stunting.

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“…are often classified as modernalthough these classifications are not universal (e.g., the United Nations Population Division does not classify these methods as modern)-and the nomenclature is imperfect. [17][18][19][20][21] In addition to FABMs, some people use menstrual tracking smartphone apps or devices to time sexual intercourse for pregnancy prevention. Although 2 apps have received clearance from the United States Food and Drug Administration for use as a contraceptive method (Natural Cycles in 2018, 22 which also received CE Marking in Europe, and Clue in 2021 23 ), most such apps or devices are not tested or indicated for this purpose and may offer predictions of unknown accuracy regarding the timing of fertile days.…”

Section: Introductionmentioning

confidence: 99%

Use of Fertility Awareness-Based Methods for Pregnancy Prevention Among Ghanaian Women: A Nationally Representative Cross-Sectional Survey

Polis

Otupiri

Bell

et al. 2021

Glob Health Sci Pract

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Standard approaches underestimate fertility awareness-based method (FABM) use; we posit that at least 18% of contracepting Ghanaian women likely use an FABM.n Economically and educationally advantaged women had higher odds of current FABM use (versus intrauterine device/hormonal method), which may suggest deliberateness of method selection (as opposed to limited access to alternatives).n Most (92%) rhythm users wish to improve the effectiveness of their method, and many are willing to track additional biomarkers, but only 17% ever discussed their method with a health professional.

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Fertility Awareness Methods Are Not Modern Contraceptives: Defining Contraception to Reflect Our Priorities

Cited by 12 publications

References 12 publications

Individual and contextual factors associated with mistimed and unwanted pregnancies among adolescent girls and young women in selected high fertility countries in sub-Saharan Africa: A multilevel mixed effects analysis

Individual and contextual factors associated with mistimed and unwanted pregnancies among adolescent girls and young women in selected high fertility countries in sub-Saharan Africa: A multilevel mixed effects analysis

Associations between contraception and stunting in Guatemala: secondary analysis of the 2014–2015 Demographic and Health Survey

Use of Fertility Awareness-Based Methods for Pregnancy Prevention Among Ghanaian Women: A Nationally Representative Cross-Sectional Survey

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