Family Planning Programs Research Articles

Reasons for contraceptive discontinuation among women of reproductive age in Kano, Nigeria: A qualitative study

Women’s attempts to achieve their desired levels of fertility are hindered when they stop using contraceptives, which could lead to unwanted pregnancies. This study aimed to assess reasons for contraceptive discontinuation among women of reproductive age in urban and rural areas of Kano State, Nigeria. Qualitative data were collected in urban and rural communities of Kano State in February to May, 2022 from women of reproductive age group, their male partners, family planning service providers, and community and religious leaders. Focus group discussions (FGD), and key informant interviews (KII), using multi-stage sampling methods explored previous experience with contraceptive use, fertility consequences and reasons for contraceptive discontinuation. Following data collection, digitally recorded data were transcribed verbatim, translated, and coded using thematic analysis through an inductive approach. Study reported the high discontinuation rates and identified side effects as the primary reason for discontinuation, with injectable contraceptives being the most commonly discontinued method. Other reported reasons for contraceptive discontinuation by respondents in both urban and rural groups were: method failure, intention to get pregnant, health concerns, husband disapproval, methods not available, inconvenience to use and interference with body structure or functions. The high contraceptive discontinuation poses significant risks of unintended pregnancies and unsafe abortions, thereby increasing maternal morbidity and mortality rates in Kano State. These consequences emphasize the need for family planning interventions that incorporate quality of care in service provision to address contraceptive discontinuation. Engaging men and other social influencers in family planning programs and services will help gather support for contraception, rather than focusing exclusively on women.

Factors associated with modern contraceptive utilization among reproductive age women in Cambodia; evidenced by the recent Cambodia demographic and health survey

IntroductionCambodia is a low-income country with limited access to family planning (FP) in terms of modern contraceptive utilization. Despite several FP programs designed to make contraceptives accessible, adoption of contraceptives has been difficult in Cambodia, which has high rates of fertility and maternal mortality. This gap in essential care can put women and adolescent girls at greater risk of adverse outcomes such as stillbirth, spontaneous abortion, unwanted pregnancy, or even maternal death. One of the goals set by the government to decrease both maternal and child mortality and morbidity was increasing the modern contraceptives utilization. So, the main objective of this study was to evaluate spatial variations in modern contraceptives utilization and its contributing factors among women.MethodsData from the Cambodia 2021–22 Demographic and Health Survey datasets were used for secondary data analysis. A total of 19,496 women of reproductive age participated in the study. A spatial and multilevel mixed effects analysis was done on the factors affecting modern contraceptives utilization among Cambodian women. Finally, the percentage, odd ratio, together with their 95% confidence intervals and the results of the spatial analysis were provided.ResultThe prevalence of modern contraceptive use was 31.2% in Cambodia. Living in an urban area [AOR = 1.224; 95% CI = (1.126.1.330); P = 0.0001]; being married [AOR = 34.131; 95% CI= (12.673, 91.921); P = 0.0001]; and having a history of terminated pregnancy [AOR = 1.137; 95% CI= (1.055, 1.225); P = 0.0001] were found to be positively associated with modern contraceptive utilization. In contrast to this, being between the age range of 46–49 [AOR = 0.421; 95% CI = (0.364, 0.487); P = 0.0001]; being a female-headed household [AOR = 0.784; 95% CI = (0.723, 0.850); P = 0.0001]; and current breast feeding [AOR = 0.84; 95% CI = (0.75, 0.93); P = 0.010] were found to be negatively associated with modern contraceptive utilization. Additionally, the spatial analysis of modern contraceptive utilization showed that a higher proportion was utilized in the southern and southwest regions of Cambodia.ConclusionIn this study, living in urban area, being married and having history of terminated pregnancy were found positively associated with modern contraceptive utilization. In contrast to this, being old age, being female headed household and being currently breast-feeding women were found negatively associated with modern contraceptive utilization. In addition to this, there were geographic (spatial) variations in modern contraceptive utilization among Cambodian’s women across the country.

Validity and Reliability of the Turkish Version of the Reproductive Autonomy Scale

Objective: This study aimed to determine the reliability and validity of the Reproductive Autonomy Scale (RES), which is a measurement tool that will determine the views of women in Turkey regarding reproductive autonomy by adapting it to the Turkish language and culture. Material and Methods: This was a cross-sectional, methodological research study. A purposive sampling technique was employed to recruit 237 women who applied to the gynecology polyclinic between February 2019 and August 2019. Results: The consistency of the scale, which was translated into Turkish and then back to English, was determined with expert opinion (Kendall W =0.101; p>0.05). The Cronbach's alpha coefficient was 0.72 for the total scale and 0.70 to 0.85 for the subscales. Factor analysis revealed three subscales that explained 58.4% of the total variance. Based on the confirmatory factor analysis, the goodness of fit index was 0.92, the comparative fit index was 0.95, and the non-normed fit index was 0.94. Conclusion: The RAS is valid and reliable for the determination of reproductive autonomy among Turkish women. These results suggested that RAS could be used in family planning programs to identify coercion or barriers against contraception, understand the limitations of reproductive autonomy, and improve women's health.

Men’s involvement in family planning programs: an exploratory study from Karachi, Pakistan

BackgroundIn Pakistan, family planning has traditionally been perceived as primarily a women’s concern, resulting in the exclusion of men from relevant initiatives. This situation is further exacerbated by cultural and social barriers that hinder men’s access to family planning services. This study addresses a significant research gap by assessing the extent of family planning service provision for men in urban areas of Karachi. It delves into the exploration of men’s involvement in family planning service delivery, identifies existing gaps in services catering to men, records men’s perceptions of accessibility and acceptability of these services, and ultimately offers recommendations to enhance men’s involvement and strengthen service provision to better meet their needs.MethodsWe employed a qualitative exploratory research design using semi-structured interviews to investigate perceptions regarding family planning service provision to men. This approach involved 25 interviews, comprising eight key informant interviews with stakeholders, eight with service providers, and nine in-depth interviews with married men.ResultsThis study highlights the limited engagement of men in family planning programs, primarily due to entrenched sociocultural norms that confine female healthcare providers to serving women, hindering men’s involvement. While national and provincial policies endorse men’s participation, they lack defined roles for male providers. Behavioral and information-sharing barriers at the community level discourage male healthcare providers from collaborating with females. Family planning programs, except for NGO-led vasectomy projects, fail to adequately address men’s needs. Despite policy recognition, implementation remains inadequate. Bridging the men’s involvement gap necessitates more male providers and improved contraceptive stigma combat training. Further research is vital to explore effective methods for involving men in community and service delivery in family planning.ConclusionThere is a need to change the perception that contraception is solely the responsibility of women, as men’s participation in family planning in Karachi is limited. Engaging men can yield positive health and non-health outcomes. Culturally sensitive services, developed with community input using a couple-centered approach, are crucial for equitable family planning. Further research is needed to explore men’s inclusion strategies in service provision and utilization.

Societal Upheaval and the Contraceptive Transition

AbstractHuman development and family planning programs since the 1970s have led to a fast‐rising prevalence of modern contraceptive means at the global level. However, countries with rising but still low levels of contraceptive use experienced an increasing number of societal upheavals, including armed conflicts, sudden and high‐intensity natural disasters, as well as dramatic effects of health epidemics. This may challenge the continued diffusion of modern means of birth regulation as well as their adherent use. To better understand the role of societal upheavals in the contraceptive transition, we provide a narrative literature review of their multidimensional pathways of influence in the contraceptive decision‐making process. The review suggests four main findings. First, well‐known contemporary barriers to contraceptive use become more salient during societal upheavals. Second, historical barriers reemerge predominantly. Third, societal upheavals exert specific effects on the contraceptive transition, such as through birth replacement, the repopulation of communities, and the sexual vulnerability of girls and young women. Fourth, there are more pathways leading to a reduced (rather than a heightened) contraceptive prevalence. The conclusion discusses the implications of those insights for the contraceptive transition, provides a critical perspective of the literature, and draws avenues for future research.

FAKTOR YANG MEMPENGARUHI PENGGUNAAN KONTRASEPSI IUD (Intra Uterine Device) DI PUSKESMAS TINGGEDE

The Family Planning (FP) program has been proven to be one of the most effective efforts to reduce maternal mortality rates. This study aims to identify factors influencing the use of intrauterine device (IUD) contraception in Tinggede Community Health Center, Sigi Regency, Central Sulawesi Province in 2024. The study uses a cross-sectional analytical method with a sample size of 130 FP acceptors at Tinggede Community Health Center. The results show that knowledge, attitude, and the husband's support significantly influence the use of IUD. The higher the knowledge, attitude, and husband's support, the higher the rate of IUD usage. The study also finds that subjective norms do not significantly influence the use of IUD. This indicates that community norms do not greatly affect women's decisions to use IUDs. In conclusion, knowledge, attitude, and the husband's support are important factors influencing the use of IUD at Tinggede Community Health Center, Sigi Regency, Central Sulawesi Province. Therefore, efforts are needed to improve husbands' knowledge and support for IUD to increase the use of this contraceptive method in the community. Keywords: IUD, knowledge, attitude, subjective norms, husband's support

Analisis Faktor-Faktor yang Mempengaruhi Penggunaan Alat Kontrasepsi dan Fertilitas yang Ada di Kecamatan Denpasar Utara

Based on data from the Central Statistics Agency (BPS) for 2021, the number of couples of childbearing age (PUS) in Denpasar City ranks third with a total of 81,575. In Denpasar City, the number of active family planning (FP) participants is 63,024, while those not using contraception number 10,730, and new FP participants amount to 7,840. Choosing contraception is not an easy task for healthcare providers or related agencies, as the decision must align with the individual needs of each person. In North Denpasar, there are 21,545 PUS, with 15,854 active FP participants and 5,691 not using contraception. The relatively low number of active FP participants in Denpasar City indicates a lack of understanding of the importance of contraception within families. The main issue in Denpasar City regarding the family planning program is the insufficient use of contraceptives, as evidenced by many families having more than two children, some even reaching five. This study aims to analyse the factors affecting contraceptive use in North Denpasar. Data analysis was performed using path analysis with SPSS software. The results indicate that: 1) education level negatively affects contraceptive use in North Denpasar; 2) income level and patriarchal culture positively affect contraceptive use in North Denpasar. This implies that higher income and stronger patriarchal culture are associated with higher contraceptive use in North Denpasar; 3) education level and income negatively but not significantly affect fertility in North Denpasar, suggesting that these factors do not have a significant impact on fertility; 4) patriarchal culture and contraceptive use positively but not significantly affect fertility in North Denpasar, indicating that these factors also do not significantly impact fertility.

How to estimate causal effects associated with family planning? An introduction to Prince BART, a new approach to effect estimation based on principal stratification and Bayesian non-parametric models

There is interest in learning about the causal effect of family planning (FP) on empowerment-related outcomes. Experimental data related to this question are available from trials in which FP programs increase access to FP. However, estimating the effect of interest is challenging because FP and empowerment-related variables are likely to be confounded. We propose a new approach, Prince BART, to estimate the causal effect of FP on other outcomes of interest, among women affected by a FP program. Prince BART combines principal stratification, to account for differences in FP behavior based on exposure to a FP program, with Bayesian Additive Regression Trees (BART), to non-parametrically model stratum membership and relationships between variables. Prince Bart allows for estimation of effect heterogeneity. We use Prince BART to assess the causal effect of modern contraceptive use on employment in six cities in Nigeria, based on quasi-experimental data from a FP program trial during the first half of the 2010s. In the sample, we find a positive overall effect of contraceptive use on employment and substantial differences in effect sizes across subgroups defined by baseline covariates such as marital status, work at baseline, and wealth or education. The modeling approach and results can be used to inform future analyses seeking to understand the causal relationship between family planning use and other outcomes, e.g., related to empowerment.

HUBUNGAN PERAN BIDAN DAN DUKUNGAN SUAMI TERHADAP PENGGUNAAN IUD DI WILAYAH KERJA PUSKESMAS SRANDAKAN

Indonesia prioritizes the Family Planning (KB) program, especially Long Term Contraceptive Methods (MKJP) such as the Intrauterine Device (IUD). The use of IUDs in DI Yogyakarta is more popular even though injectable hormonal contraceptives are still dominant in Indonesia, the Srandakan Community Health Center in Bantul recorded the highest use of IUDs (44.5%). National development targets in the strategic plan and target setting for the 2020-2024 BKKBN program, as well as international agreements in the SDGs development goals to increase participation rates in the use of MKJP, this makes it an important issue for participation in the use of MKJP, especially the IUD, which is a contraceptive device that is considered effective. The availability of information and social support from midwives and husbands is key in increasing the acceptance and continued use of IUD contraception by WUS. This study aims to determine the relationship between the role of midwives and husband's support on the use of IUDs by WUS in the Srandakan Community Health Center Work Area, Bantul Yogyakarta. This research is a quantitative study with a correlational analytical design and a cross-sectional approach. The sampling technique used accidental sampling with a total population of 1,034 WUS and a sample of 92 respondents. The research instrument used a questionnaire. The research results were obtained from the Fisher's Exact Test which showed a significant relationship between the role of the midwife (p=0.019) and husband's support (p= <0.001) on IUD use. Based on these results, it can be concluded that the role of the midwife and the husband's support influence the decision to use IUD contraception.

Examining the access to benefits and quality sterilization services among Muslim women in India

BackgroundThis research article examines the efficiency with which the Indian family planning programme provides care to Muslim women who opt to undergo tubectomies from public health facilities in terms of access to benefits/compensation as well as quality of services. The research subsequently intends to suggest suitable policies of affirmative action if required.MethodsThe research uses data from the women’s file from the latest round of the National Family Health Survey (NFHS-5, 2019–21). Adjusted odds ratios are used to examine the likelihood of Muslim women (i) receiving compensations offered for undergoing tubectomies in public health facilities by the government, (ii) receiving comprehensive information prior to their tubectomies and (iii) reporting a good quality of care during their procedures, in comparison with non-Muslim women.ResultsThe findings from the research indicate that Muslim women in India have lower odds of receiving state sponsored compensations in comparison with non-Muslim women in India (AOR = 0.67; CI: 0.60—0.76). Consequently, a lesser proportion of Muslim women reported receiving compensations in comparison with non-Muslim women. The difference in the receipt of compensations was 18 percentage points between both cohorts. Critically, despite their challenges in obtaining compensations, the findings from this research also indicate how Muslim women in India have higher odds of receiving comprehensive family planning information prior to their operation in comparison with non-Muslim women (AOR = 1.15; CI: 1.02—1.29).DiscussionGiven the existing dearth of evidence in family planning literature on the issue, this research article calls for greater attention and investments in understanding the reproductive health vulnerabilities of Indian Muslims, especially in the context of increasing social hostilities towards the community in India. In this regard, to promote the equitable delivery of family planning services, the findings from this research highlight the urgent need for institutional reforms that facilitate an easier access to public benefits among Indian Muslims.

Intimate Mediators: Field Workers in the National Family Planning Program, South Korea, 1960–1980s

Intimate Mediators: Field Workers in the National Family Planning Program, South Korea, 1960–1980s

Demographic behaviour of the Scheduled Castes People of Dhubri District of Assam with a focus on their attitude to family planning and the adoption behaviour of family planning measures.

Knowledge and practice of family planning is one of the important variables regulation fertility of a couple. Bongaarts has suggested that family planning programmes not only reduce fertility, but they also help in diffusion of knowledge about fertility regulation1. Contraceptives use take place because of two reasons - for fertility control and for spacing. Initially, family planning methods were adopted only for birth control, but at present most of the newly married couples use it for spacing. The acquisition of knowledge and practice of family planning, a proximate determinant of fertility differentials, depend on different socio-economic and demographic variables. (Such as education of the mothers, occupation of the wives, total family income, live birth, age at marriage etc.) The immediate objective of the National Population Policy (2000) is to address unmet needs for contraception. Couples protection rate is an indicator of the prevalence of contraceptives practice in a population. It is defined as percent of eligible couples effectively protected against childbirth by one or other approved methods of family planning.2 Thegeneral objective of the research study is to highlight thedemographic behaviour of the Scheduled Castes People of Assam and their attitudes towards family planning and family planning measures. The specific objectives of the study is to study the level of penetration of family planning knowledge and the level of practicing such knowledge among the respondent females Scheduled Castes of Assam. The research project will be primarily based on field data collected from the sample households of the sample villages with the help of a series of questionnaires prepared for the purpose. The samples will be selected with the help of multi-phased (Stratified) sample technique both random and purposive.

Peningkatan Pengetahuan Masyarakat tentang Program Keluarga Berencana

The Family Planning (KB) Program is one of the government's main strategies in controlling population growth and improving the quality of life of the community. However, uneven knowledge among the community often becomes an obstacle in the implementation of this program. This community service activity aims to increase community knowledge about the KB program. The activity was carried out in May 2024 in Mojosongo Village, Jebres, Surakarta, with participants consisting of fertile couples, cadres, and mothers of toddlers. The methods used included interactive counseling and group discussions. The results showed a significant increase in knowledge in participants, measured through pre-tests and post-tests. It is hoped that this increase in knowledge will encourage active community participation in the KB program and the implementation of recommended practices, which will ultimately also improve maternal and child health.

Challenges of Smallholder Farmers in Sub-Saharan Africa: A Perspective from Roger Thurow's, The Last Hunger Season

Small holder farmers are the small-scale farmers who own the land from one hectare to less than ten hectares. These farmers often depend on the family labour for farming activities, and a significant portion of their production is used to support their own livelihoods. Africa is a region where eighty percent of the farmland is cultivated and food is produced by small holders, yet they face multiple obstacles in sustaining their routine. The death rate of children is increasing due to poverty and malnutrition. Major challenges include the lack of sustainable agricultural practices, insufficient planting techniques, inadequate access to fertilizers and markets, water scarcity, and the impacts of climate change. The author aims to raise awareness about global hunger and the importance of long-term viability and economic development. He delves into the lives of small farmers, revealing the complexities of market failures, food insecurity, and the inability to access modern agricultural tools. The author also highlights the efforts of organizations and initiatives, such as One Acre Fund, which provide farmers with high-quality seeds and fertilizers on credit, and require them to attend local farming classes. This paper focuses on the challenges faced by smallholder farmers in Africa, as depicted by Roger Thurow in "The Last Hunger Season”. The objective of the study is to emphasize the need for awareness and policy interventions, including family planning and literacy programs, to empower rural communities, achieve food security and improve economic resilience in the face of population growth and agricultural challenges.

Comparison of two survey methods for estimating unplanned pregnancy, Bangladesh.

To compare the prevalence of unintended pregnancy measured by the Demographic and Health Survey (DHS) and the London Measure of Unplanned Pregnancy in Bangladesh, and explore the extent of discordance between the measures and the factors associated with the discordance. In 2023, we conducted a cross-sectional survey in four randomly selected districts in Bangladesh: Kurigram, Mymensingh, Pabna and Satkhira. We randomly selected 20 hospitals, five from each district. We collected data from 1200 women who had recently delivered a baby and were visiting the hospitals for postnatal care. We interviewed the women about their pregnancy intention in their last pregnancy using questions in the DHS and the London Measure of Unplanned Pregnancy and examined the discordance in their responses. We used multivariable logistic regression analysis to identify factors associated with discordant responses in reported pregnancy intention. The prevalence of unintended pregnancy was 24.3% (292/1200) using the DHS measure and 31.0% (373/1200) using the London Measure of Unplanned Pregnancy. Discordance in responses to pregnancy intention between the two measures was 27.1% (325/1200). Factors associated with discordance were older age, female sex of the last child born, having more than two children, being in a poorer wealth quintile, living in a rural area and living in Kurigram district. The prevalence of unintended pregnancy in Bangladesh measured by the DHS measure may be an underestimate, suggesting that the adverse effects of unintended pregnancy are greater than realized and emphasizing the need to bolster Bangladesh's family planning programme.

Insights into Retrofitting Fellowships in Family Planning with Principles of Equality, Race, and Cultural Literacy

The Centering Equality, Race, and Cultural Literacy in Family Planning (CERCL-FP) program aims to break racial silence and dismantle structural racism in the field of family planning, by providing racial equity workshops and trainings. ObjectiveThe objective of this study was to begin a multi-phased, rigorous evaluation to determine the impact and outcomes of the work of CERCL-FP. Study DesignA needs assessment with former graduates and current directors of fellowships in family planning was conducted using qualitative interviews. The focus of these interviews was to determine the ability, readiness, and willingness of the field of family planning to retrofit new curricula grounded in equity, race, and cultural literacy. ResultsNine (N=9) interviews were completed with seven board certified obstetrician-gynecologists and two board certified family medicine physicians. Three themes were identified: 1) Establishing the Distribution of Work; 2) The Push/Pull of Change from Inside and Outside: Curricula and Faculty Responsibilities; and 3) Reproductive Justice and Fellowships in Family Planning. Despite acknowledging the need to retrofit the field of family planning with content grounded in equity, race, and cultural literacy, there are structural, institutional, and individual level barriers that have limited the adoption of CERCL-FP curricula within family planning curriculum nationwide. ConclusionFindings from this study illuminate multiple barriers that should be considered when expanding foundational knowledge of clinicians and researchers.

Injection Depot Medroxyprogesterone Acetate as an Early Postpartum Contraceptive Measure: Evaluation of Its Acceptability, Efficacy, and Impact on Lactation.

Introduction Through its National Family Planning Programme, India has been relentlessly working to decrease society's unmet contraception needs. The postpartum period is of paramount importance for addressing these contraceptive needs owing to alterations in fertility and coital behavior associated with childbirth. Depot medroxyprogesterone acetate (DMPA), a long-actingreversible contraceptive, is one of the safe options available in the early postpartum period. In this study, we aimed to evaluate its efficacy and acceptability among postpartum women delivering in Guru Gobind Singh Medical College and Hospital. Methodology We recruited206 early postpartum women for the study. After thorough counseling and ensuring establishment of lactation, we administered DMPA 150mg by injection intramuscularly and repeated it at intervals of three months in willing patients. We then evaluated them for their symptoms, side effects, and lactation status using a predesigned proforma either during their follow-up visits or telephonically. Results We found DMPA to be 100% efficacious as an early postpartum contraceptive measure. The main reasons for acceptance were its ease of use, long-term effects of a single dose, and noninterference with lactation. However, the continuation rate for the second dose was only 18% in our study, highlighting the need for better counseling and improving awareness among our patients. Ninety-nine percent of our patients were satisfied with their lactation. Conclusion We found injectable DMPA used as a contraceptive in the immediate postpartum period to be a safe and effective alternate method with no deleterious effect on lactation and an acceptable side effect profile. However, more awareness programs are necessary to encourage women, especially those in low-resource areas, to continue using DMPA.

Increasing the capacity of family planning cadres using ABPK in Puskesmas Lepasan, Bakumpai District

Indonesia is projected to experience a significant population increase by 2035. The Family Planning (KB) Program is a key control measure. KB cadre involvement is crucial for providing information and motivation to potential acceptors. However, enhancing cadre counseling capacity, particularly using Counseling Demonstration Tools (ABPK), remains essential. This community service aimed to improve KB cadre knowledge and skills in providing contraceptive counseling using ABPK. Methods included counseling, mentoring, and distributing ABPK pocketbooks to cadres. Evaluations measured pre- and post-activity cadre knowledge increases. Results showed a significant rise in cadre knowledge about contraception and ABPK use, with the percentage of cadres demonstrating good knowledge increasing from 33.3% to 87%. This improvement is expected to impact contraceptive use within the Lepasan Health Center's area.

Concept of KAP & Other Modalities by PEO Regarding Family Planning

The article discusses the Family Planning (FP) program’s wide spread evaluation by the Program Evaluation Organization (PEO) of the planning commission from 1963 to 1969. The article brings out the Knowledge, Attitude & Practices (KAP) concept given by the PEO. The concept is still used by the large scale surveys like National Family Health Surveys since the 1992-93 period. The KAP approach was given by the FP but it is being used regularly to evaluate other programs as well. After the KAP, the concept of Rapid Anthropological Surveys (RAP) also came up to monitor & evaluate programs. Subsequently, the concept of Culture, Attitude & Practices (CAP) also came to be used to assess programs.

Are Contraceptive Method Preferences Stable? Measuring Change in the Preferred Method among Kenyan Women.

Contraceptive preferences are important for reproductive outcomes, such as contraceptive continuation and pregnancy. Current approaches to measuring reproductive preferences in population surveys are limited to exploring only fertility preferences and implicitly assume that contracepting people are using a method they want. We know that people change their fertility preferences over the life course as a response to life events, but there is no information about changes in contraceptive preferences, given the limited evidence about the measurement and distribution of contraceptive preferences. In this study, we examined the extent of change in women's contraceptive preferences over one year and identified characteristics associated with this change in Kenya using three rounds of nationally representative longitudinal data. Over one year, 18 percent of contraceptive users and 46 percent of contraceptive nonusers reported changes in their preferred contraceptive. Experiencing a pregnancy or birth and changes in marital status were associated with changes in contraceptive preferences for users and nonusers. We found that contraceptive preferences are dynamic, suggesting that family planning programs should ensure people's access to various methods to respond to women's changing circumstances and preferences.