Impact of Structured Counseling on the Selection of Hormonal Contraceptive Methods: Results of a Multi-Centric, Observational Study in India

Abstract

To determine the influence of "structured contraception counseling" on Indian women's selection of contraceptive methods. Women (≥18 and ≤40years) requesting contraception were enrolled at 36 sites. "Structured contraception counseling" was provided by a health care professional on the available contraceptive methods. Questionnaires on the women's pre- and post-counseling contraceptive choice, her perceptions, and the reasons behind her post-counseling decision were filled. Significant reductions were observed in the proportion of women who were indecisive (n=260; 31.5% pre-counseling vs. n=30; 3.6%, post-counseling [P<0.001]) and women opting for non-hormonal method (24.6% pre-counseling vs. 6.8% post-counseling, [P<0.001]). Of all the women counseled (n=825), 89.6% (739/825) of women chose a hormonal contraceptive method. There were significant difference (P<0.001) in the women's choice of contraceptive in the pre- and post-counseling sessions, respectively (combined oral contraceptive: 30.8 vs. 40.7%; vaginal ring: 1.8 vs. 14.1%; progestogen only pills: 1.6 vs. 7.9%; injectable-depot medroxyprogesterone acetate: 5.9 vs. 13.6%; levonorgestrel-intrauterine system: 3.8 vs. 13.3%). Structured contraception counseling using standardized protocol and aids resulted in a significant increase in the selection of modern contraceptive methods. Post-counseling majority of women opted for hormonal methods with an increase in selection of pills and newer alternatives.