Abstract
BackgroundInformed consent in family planning includes knowledge of mechanism of action. Some methods of family planning occasionally work after fertilization. Knowing about postfertilization effects may be important to some women before choosing a certain family planning method. The objective of this survey is to explore women's attitudes towards postfertilization effects of family planning methods, and beliefs and characteristics possibly associated with those attitudes.MethodsCross-sectional survey in a sample of 755 potentially fertile women, aged 18–49, from Primary Care Health Centres in Pamplona, Spain. Participants were given a 30-item, self-administered, anonymous questionnaire about family planning methods and medical and surgical abortion. Logistic regression was used to identify variables associated with women's attitudes towards postfertilization effects.ResultsThe response rate was 80%. The majority of women were married, held an academic degree and had no children. Forty percent of women would not consider using a method that may work after fertilization but before implantation and 57% would not consider using one that may work after implantation. While 35.3% of the sample would stop using a method if they learned that it sometimes works after fertilization, this percentage increased to 56.3% when referring to a method that sometimes works after implantation. Women who believe that human life begins at fertilization and those who consider it is important to distinguish between natural and induced embryo loss were less likely to consider the use of a method with postfertilization effects.ConclusionInformation about potential postfertilization effects of family planning methods may influence women's acceptance and choice of a particular family planning method. Additional studies in other populations are necessary to evaluate whether these beliefs are important to those populations.
Highlights
Informed consent in family planning includes knowledge of mechanism of action
We assumed that a fraction of respondents who will consider not using a family planning method sometimes acting after fertilization but before implantation will be in the range between 20 and 40% and we sought to estimate this proportion with ± 3% confidence interval, requiring a sample size of approximately 700 participants
39.4% reported that they would not consider using an family planning (FP) method that sometimes works after fertilization but before implantation and 57% would not consider using a method that sometimes works after implantation
Summary
Informed consent in family planning includes knowledge of mechanism of action. Knowing about postfertilization effects may be important to some women before choosing a certain family planning method. To ensure women's right to a free choice in family planning (FP), the World Health Organization (WHO) recommends that information related to FP should include, at a minimum, the following for each method: effectiveness, correct use, mechanism of action, side-effects, health risks and benefits, reversibility, and protection against sexually transmitted infections [1]. We assumed that a fraction of respondents who will consider not using a family planning method sometimes acting after fertilization but before implantation will be in the range between 20 and 40% and we sought to estimate this proportion with ± 3% confidence interval, requiring a sample size of approximately 700 participants. We decided to include around 50–80 women per centre, depending on the population in each area; resulting in a total of 755 participants which is a sufficient sample size for the multivariate analyses of the study [22]
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