Abstract

ObjectiveExamine patterns of contraceptive use and contraceptive transitions over time among an Australian cohort of women through their later reproductive years.Study designLatent Transition Analysis was performed using data on 8,197 women from the Australian Longitudinal Study on Women’s Health’s 1973–78 cohort to identify distinct patterns of contraceptive use across 2006, 2012 and 2018. Women were excluded from the analysis at time points where they were not at risk of an unintended pregnancy. Latent status membership probabilities, item-response probabilities, transitions probabilities and the effect of predictors on latent status membership were estimated and reported.ResultsPatterns of contraceptive use were relatively consistent over time, particularly for high efficacy contraceptive methods with 71% of women using long-acting reversible contraceptives in 2012 also using long-acting reversible contraceptives in 2018. Multiple contraceptive use was highest in 2006 when women were aged 28–33 years (19.3%) but declined over time to 14.3% in 2018 when women were aged 40–45 years. Overall, contraceptive patterns stabilised as the women moved into their late 30s and early 40s.ConclusionsAlthough fertility declines with age, the stability of contraceptive choice and continued use of short-acting contraception among some women suggests that a contraceptive review may be helpful for women during perimenopause so that they are provided with contraceptive options most appropriate to their specific circumstances.

Highlights

  • In Australia, the rate of unintended pregnancy has been estimated to be as high as 40% with around one-third of these pregnancies ending with termination [1]

  • Studies from other high income countries suggest that multiple method use may be much higher [9, 18, 19] while a recent Australian study focused on women aged 18–23 years showed the use of 30 distinct contraceptive patterns at the time of last vaginal sex [7]

  • Women who had a history of Intimate partner violence (IPV) had around 50% higher odds for using sterilisation with other contraceptive methods (OR = 1.57, 95% CI = 1.19, 2.03) or for using long-acting reversible contraceptive (LARC) (OR = 1.52, 95% CI = 1.15, 2.00) and a 17% increase in odds for using a predominantly natural approach (OR = 1.17, 95% CI = 1.01, 1.38) when compared to women without a history of IPV and relative to use of short-acting contraceptives and condoms (Table 5)

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Summary

Objective

Examine patterns of contraceptive use and contraceptive transitions over time among an Australian cohort of women through their later reproductive years

Study design
Conclusions
Introduction
Materials and methods
Participants
Discussion
Strengths and limitations
Findings
Conclusion
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