The Prevalence and Determinants of Using Withdrawal to Avoid Pregnancy in Tabriz, Iran

Abstract

Objectives: Despite the increasing knowledge about family planning and modern contraceptive methods, as well as high failure rates of the traditional method, a significant percentage of couples use withdrawal for contraception. Accordingly, the present study mainly aimed to investigate the determinants of using withdrawal to avoid pregnancy in Tabriz. Materials and Methods: The sample of the study included 383 married women aged 15-49 years. Multivariate logistic regression analyses were employed to determine factors associated with using withdrawal as a contraceptive method. Results: Based on the results, about 19.5% of the women were relying on withdrawal. In addition, 55% reported that they were currently using a modern method to avoid pregnancy while the remaining 25.5% used no method in order to prevent contraception. The results of multivariate logistic regression demonstrated that university-educated couples with no child who were within the age range of 15-24 and born in urban areas were more likely to use withdrawal rather than modern contraceptive methods (P<0.05). Conclusions: In general, the rate of employing the traditional method in Iran and, especially in Tabriz is increasing. Regarding higher proportion of withdrawal use among higher educated women due to the fear of side effects resulted from other methods, family planning providers and reproductive health services should be sensitive to the women’s concern and provide programs to decrease the unmet need of family planning.

Reasons for high prevalence of contraceptive withdrawal in Tehran, Iran

“…According to the findings, the number one reason reported by the withdrawal users for using withdrawal instead of modern methods was the 'adverse effects of modern methods' (70%), followed by 'reduction in sexual pleasure' (30%), and the 'fear' of the side effects of modern methods (24%). Though similar findings have been reported by previous studies 29,34 , the current study for the first time found that in addition to women's health concerns, 'lack of competence in using modern methods properly' was the other reason for using withdrawal, reported by 15% of withdrawal users. The inability to use a contraceptive method properly or being afraid of the accompanying side effects can be due to lack of accurate contraceptive knowledge and counselling, normally acquired from professional healthcare providers.…”

“…Evidence from analyzing 80 national surveys showed that traditional contraceptive methods, including withdrawal, are more widespread among young, sexually active unmarried women than their married counterparts 27 . Moreover, the findings from Iran show that withdrawal users are generally younger, well educated, wealthier, and from urban areas 28,29 . By contrast, evidence indicates that withdrawal users in Turkey are largely women with lower levels of education and wealth who live in rural areas, with a less-egalitarian gender relationship 30,31 .…”