Preferred Contraceptive Method Research Articles

Preference of Contraceptive Methods Among Married Women of Rural Area of Faisalabad

Preference of Contraceptive Methods Among Married Women of Rural Area of Faisalabad

Are women in rural Malawi using their preferred contraceptive method?

Objectives: We aim to assess, among rural Malawian women, contraceptive method preferences and sociodemographic correlates for preferred method and to determine whether women’s current contraceptive methods match their preferences.

Teenage pregnancy - a study in São Tomé and Príncipe.

Introduction The increasing number of pregnant teenagers in São Tomé and Príncipe (STP) represents a serious public health issue. The aim of this study was to characterize the population of pregnant adolescents followed in a health facility dedicated to maternal health in STP. Methods A cross-sectional survey was conducted among pregnant teenagers that attended the Mother and Child Protection Center during the first quarter of 2017. The survey contained questions on sociodemographic characteristics, sexual and risk behaviors, family, partners and health support. Results The mean age of the 51 pregnant teenagers included was 16.37 ± 0.8 years. Eight girls reported that they had planned to fall pregnant. Teenagers whose pregnancy was unplanned usually present with a previous family history of adolescent pregnancy. About 59% of girls engaged in sexual activity before 16 years of age with a mean number of sexual partners of 1.84 ± 0.88. In this study, 51% of the girls do not use any contraceptive method, usually because their partner refuses to do so. The preferred contraceptive method are condoms. Information on contraception is given mainly at school. Pregnant girls' first medical consultation was at a mean gestational age of 6 weeks. Abortion was considered by 51% of girls after pregnancy was confirmed. Conclusion Teenage pregnancy imposes health problems for the mother and child and contributes to educational and socioeconomic disadvantages. The collaboration of healthcare providers, teachers and parents is needed to enhance sexual health education. This is the first study in STP on teenage pregnancy; although the sample is small, the authors believe that the results are representative of the general population.

Socio-demographic factors influencing contraceptive practice among married women attending the family planning clinic of UUTH, Uyo, south-south Nigeria

Background:Contraception is a topical issue globally considering its enormous benefits to individual users, families, communities, nations and the world at large. Its practice, especially among married women, is influenced by several factors at different settings. This study was done to find out the socio-demographic factors influencing the practice of contraception among married women age 15-49 years attending the family planning clinic of the University of Uyo Teaching hospital, Uyo, South-South Nigeria and to identify sources of information on contraception among the married women.Method: This was a cross sectional descriptive study involving 165 married women aged 15-49 years who attended the family planning clinic of UUTH, Uyo, between May and September 2013, recruited through simple random sampling technique. A semi-structured interviewer administered questionnaire was used to obtain information on socio-demographic factors and sources of information on contraception among the respondents. The data obtained were analysed using statistical package for social sciences (SPSS), version 17.0.Results: The mean age of the subjects were 32.22(±5.56). Results obtained showed that higher contraceptive use was found among older women, higher educational level, higher employment status, higher income level, husbands higher educational and employment status, urban residence, lower parity, Christian faith and mixed sexes of the respondents children. However, only parity (P=0.001) and Christian religious grouping (P=0.000) had statistically significant influence on contraceptive practices among the married women. Most respondents (76.9%) obtained their contraceptive information from health care wokers while IUCD was the most preferred method of contraception (38.2%).Conclusion: Contraceptive use among married women in the study is mainly influenced by their high social status. There is need therefore to step up information propagation to women across all social classes if the benefits of contraceptive use are to be achieved in the society.

Prevalence and Predictors of Prenatal and Postpartum Contraceptive Counseling in Two Texas Cities

ObjectivesWe investigated the prevalence of and sociodemographic associations with receiving prenatal and postpartum contraceptive counseling, including counseling on intrauterine devices (IUDs) and implants. MethodsWe used data from a prospective cohort study of 803 postpartum women in El Paso and Austin, Texas. We examined the prevalence of prenatal and postpartum counseling, provider discouragement of IUDs and implants, and associated sociodemographic characteristics using χ2 tests and logistic regression. ResultsOne-half of participants had received any prenatal contraceptive counseling, and 13% and 37% received counseling on both IUDs and implants prenatally and postpartum, respectively. Women with more children were more likely to receive any contraceptive counseling prenatally (odds ratio [OR], 1.99; p < .01). Privately insured women (OR, 0.53; p < .05) had a lower odds of receiving prenatal counseling on IUDs and implants than publicly insured women. Higher education (OR, 2.16; p < .05) and attending a private practice (OR, 2.16; p < .05) were associated with receiving any postpartum counseling. Older age (OR, 0.61; p < .05) was negatively associated with receiving postpartum counseling about IUDs and implants and a family income of $10,000 to $19,000 (OR, 2.21; p < .01) was positively associated. Approximately 20% of women receiving prenatal counseling and 10% receiving postpartum counseling on IUDs and implants were discouraged from using them. The most common reason providers restricted use of these methods was inaccurate medical advice. ConclusionsPrenatal and postpartum counseling, particularly about IUDs and implants, was infrequent and varied by sociodemographics. Providers should implement evidence-based prenatal and postpartum contraceptive counseling to ensure women can make informed choices and access their preferred method of postpartum contraception.

Kadınların Kontraseptif Yöntem Tercihleri ve Yöntem Kullanırken Gebe Kalma Durumlarının Değerlendirilmesi

Objectives : The objective of this study was to investigate the contraception methods used by the patients admitted to the department of Obstetrics and Gynaecology at Ankara Ataturk Training and Research Hospital. The study was performed in a group of patients who were using contraceptive methods and the aim was to identify patients` contraceptive method preferences, the pregnancy rates in the period they were using contraceptives and to determine whether there where any differences between different methods based on how often pregnancies occurred while using contraception. Materials and Methods : In our cross-sectional study that was carried out among a group of patients that visited the Department of Obstetrics and Gynaecology at Ankara Ataturk Training and Research Hospital and were on contraception, data were collected by requesting patients complete questionnaires during face-to-face interviews. The study examined patients` sociodemographic information, contraceptive method preferences, pregnancy rates while using contraception and whether they had information about methods. Results : The average age of the 209 patients who participated in our study was 36,90±9,005. 30.62% of respondents had experienced 4 or more pregnancies. 41,15% of the participants were primary school graduates 78,95% of which were unemployed. When we investigated the methods used we noticed RIA was the most preferred method by 30,62% and traditional methods were used by 34% who used multiple birth control methods. 29,67% of the respondents said they conceived while using birth control methods and 46,71% of those experienced pregnancy while using traditional methods. When they were asked whether they were informed about contraceptive methods 93,27% said they were informed and 61,72% of those thought the information they had was sufficient. Conclusion : Family planning allows people to attain their desired number of children and timing of their births. This affects the mother and baby's health positively. Accurate and adequate information is important while choosing a contraception method. In our study; pregnancies experienced while using birth control was higher in numbers when traditional methods were used. On the other hand; insufficient information about modern methods had led to problems. It is important to provide individuals with sufficient and accurate information.

Understanding low uptake of contraceptives in resource-limited settings: a mixed-methods study in rural Burundi

BackgroundFamily planning can reduce deaths, improve health, and facilitate economic development in resource-limited settings. Yet, modern contraceptive methods are often underused. This mixed-methods study, conducted in rural Burundi, sought to explain low uptake of contraceptives by identifying utilization barriers. Results may inform development of family planning interventions in Burundi and elsewhere.MethodsWe investigated uptake of contraceptives among women of reproductive age in two rural districts of Burundi, using an explanatory sequential, mixed-methods research design. We first assessed availability and utilization rates of modern contraceptives through a facility-based survey in 39 health clinics. Barriers to uptake of contraceptives were then explored through qualitative interviews (N = 10) and focus groups (N = 7).ResultsContraceptives were generally available in the 39 clinics studied, yet uptake of family planning averaged only 2.96%. Greater uptake was positively associated with the number of health professionals engaged and trained in family planning service provision, and with the number of different types of contraceptives available. Four uptake barriers were identified: (1) lack of providers to administer contraception, (2) lack of fit between available and preferred contraceptive methods, (3) a climate of fear surrounding contraceptive use, and (4) provider refusal to offer family planning services.ConclusionsWhere resources are scarce, availability of modern contraceptives alone will likely not ensure uptake. Interventions addressing multiple uptake barriers simultaneously have the greatest chance of success. In rural Burundi, examples are community distribution of contraceptive methods, public information campaigns, improved training for health professionals and community health workers, and strengthening of the health infrastructure.

Provider-controlled or user-dependent contraceptive methods: Levels and pattern among married women of reproductive age in China, 1988–2006

ObjectivesTo explore levels and patterns in contraceptive use since the introduction of informed choice in reproductive health services in China since 1994, and to assess the implications of reproductive health service needs among married women of reproductive age in China. Material and methodsData from Chinese nationwide surveys of family planning and reproductive health undertaken in 1988, 1997, 2001, and 2006 were analyzed to assess levels and trends in patterns of contraceptive use among married women by age, residence, and number of children. Contraceptive methods were classified into two categories: provider-controlled and user-dependent methods. ResultsThe provider-controlled pattern for contraceptive use was predominant regardless of whether women were free to choose their own contraceptives. Older, rural women, and those with more than one child preferred provider-controlled contraceptive methods; this trend has changed little after 1997. In contrast, the user-controlled methods were preferred by young, urban women, strikingly with no or only one child, and geographically in more affluent areas in north or southwest China. ConclusionA preference for user-dependent methods is noted in the urban areas but inclination towards provider-controlled contraceptive methods is still prevalent in rural areas in China.

Awareness and Acceptance of Contraception in Postpartum Women in Our Tertiary Hospital in Central India

ABSTRACT Introduction Contraception is an important intervention to reduce unwanted pregnancy and promote healthy and better living among women. As the population continues to rise, there will be overcrowding, a limiting of resources, and the quality of life will decline. India, as the first country in the world, initiated the National Family Planning program in the year 1951 with the objective of “reducing the birth rate to the extent necessary to stabilize the population at a level consistent with requirement of national economy.” Objectives (1) To study awareness, acceptance, and preferred method of contraception among postpartum women. (2) To identify the reasons for rejection of contraceptive methods. (3) To contribute to the development of knowledge in the area of family planning. Materials and methods The study is a community-based cross-sectional observational study. The study was conducted among postpartum women in reproductive age group who delivered in our hospital in the Department of Obstetrics and Gynecology of Netaji Subhash Chandra Bose Medical College &amp; Hospital, Jabalpur, Madhya Pradesh, India. A total of 480 married women were interviewed in the local language using a pretested questionnaire. Their level of awareness, acceptance, and reason for acceptance/refusal was assessed. Results A total of 65.2% of women were aware of at least one method of contraception; 73.9% women were using a contraceptive at the time of study; 34.8% women were unaware of any health care facility providing contraceptives in the vicinity. Maximum number of women preferred intrauterine contraceptive device (IUCD; 38.8%) as their first choice. Knowledge and practice of emergency contraceptive was very low. Main reason for nonacceptance of contraceptive was lack of knowledge and fear of side effects. Health professionals were the main source of knowledge. Conclusion There is till date lack of awareness of contraception in some postpartum women. Regular counseling is a must to all pregnant women from every health care center in a village to superspeciality centers in cities. Information should be provided about various methods of contraception and patient should be able to choose a method of her choice. How to cite this article Sahu B, Tiwari P, Uikey V, Badkur P. Awareness and Acceptance of Contraception in Postpartum Women in Our Tertiary Hospital in Central India. J South Asian Feder Obst Gynae 2017;9(4):327-330.

Contraceptive Use Among Women Living with HIV and AIDS Receiving Care at Secondary and Tertiary Health Care Facilities in Ibadan, Nigeria

Contraceptive use is a form of family planning and it is one practice among the most important health decisions that many people make and this does not exclude women living with HIV/AIDS. Lack of adequate information on available contraceptive methods and restriction of choices are the major constraints for contraceptive users to obtain a method that suits their need. Consequently, this study was designed to assess contraceptive use among women living with HIV and AIDS receiving care at secondary and tertiary health care facilities in Ibadan, Nigeria. A cross-sectional study using systematic sampling technique was conducted to select 350 consenting women among HIV positive women receiving care in two health facilities in Ibadan, Nigeria. A pre-tested interviewer administered questionnaire was used to obtain information on respondent’s socio-demographic characteristics, contraceptive usage and level of satisfaction of modern contraceptive method. Data were analyzed using SPSS version 22. Chi-square statistic was used to test associations between categorical variables at a level of statistical significance of 5%. The mean age of respondents was 37.0±8.5 years and about 87.0% were currently married. The current prevalence of contraceptive was 67.7%. Condom was the most currently preferred contraceptive method (54.0%), followed by injectable (12.2%) and oral pills (11.0%). About 83.1% was satisfied with their current method of contraception. The most cited reason by those who were not satisfied with their current contraceptive method irregular menses (30.0%). The factors that were significantly associated with contraceptive use were maternal age, marital status, type of marriage, level of education and parity decision (P < 0.05). High level of contraceptive uptake and satisfaction was observed in this study. However, irregular menses was a common complaint of those who were not satisfied with their current method. Family planning programme should be incorporated as a component part of care for women living with HIV and AIDS.

Systematic Review: Contraceptive Knowledge and Use in Saudi Arabia

Introduction: Contraceptive use was remaining as paramount importance to women’s health. In the kingdom of Saudi Arabia (KSA), it was found that up to 62.8% of fertile married Saudi women do not use contraceptive methods. While, the women who are using contraceptive methods, they do not have adequate knowledge. The purpose of the systematic review in the current study is to retrieve all researches that related to contraceptive method in KSA. Methods: two questions were used to guide the review were: (1) What are the women’s knowledge and use of contraceptive methods in SA, (2) Does the contraceptive counseling conducted in KSA? Five electronic databases were used to find studies. The search started from 26th of April 2015 until 5th of May 2015. Then, it was repeated in the first of April 2017 until May 2017. Certain criteria were used to minimize the studies which were; full text article, included the married women from 18-49 years, English articles and within 2000 to 2017 years. Result: twenty-one of studies were found and met the search criteria in this review. Several Saudi studies have reported that most women have heard contraceptives but still had inadequate knowledge about benefits and side effects. The studies reported that the main sources of women’s contraceptive knowledge (53.7%) were friends and family members. Two studies found that nurses have very limited roles in contraceptive and family planning education. It is disappointing that none of the women mentioned receiving contraceptive education or information by nurses. Fifteen studies have conclude that women had used contraceptives. The most commonly used contraceptive in SA is the oral pill, IUDs and fertility awareness. Other contraceptive methods such as lactational amenorrhea, withdrawal, injections, spermicidal and tubal ligation are also noted to be used by women. all of the studies agreed that effective counseling and education were needed to improve women’s knowledge and enable them to use their preferred contraceptive method properly Conclusion: nurses have very limited roles in contraceptive and family planning education.

Contraceptive User’s Profile

Objective: To obtain informations regarding the profile of contraceptive users in Raden Saleh Clinic, Jakarta.&#x0D; &#x0D; Method: A cross-sectional study was conducted in June 2012, at Raden Saleh Clinic, Jakarta. The study population was the patient who came to Raden Saleh Clinic from 2008 until 2011.&#x0D; &#x0D; Results: The mean age of the contraception users was 34.06 and the mean of their husband’s age was 38.91 years old. Most of the patients were graduated from senior high school (43.2%) and university (37.9%). More than half of the patients (55.2%) were not working&#x0D; and more than a half of their husband (53.2%) were private employee. Almost all (92.6%) of the patient were married. Most of the patient (38.8%) came with no prior contraception. After consultation, all patients had chosen their preferred contraceptive methods, namely IUD (61.4%), injectable contraception (20.9%), pill (13.7%),&#x0D; sterilization (3.4%), and implant (0.6%).&#x0D; &#x0D; Conclusion: Family planning reduces maternal mortality and the best method is different for each patient because of the difference in their own condition and the consideration of the cost and benefit.&#x0D; &#x0D; [Indones J Obstet Gynecol 2013; 1-4:179-82]&#x0D; &#x0D; Keywords: contraception, contraceptive users profile

Contraceptive method preferences and provision after termination of pregnancy: a population-based analysis of women obtaining care with the British Pregnancy Advisory Service.

To examine contraceptive choices among women seeking termination of pregnancy (TOP) and the provision of the chosen methods. Population-based study. British Pregnancy Advisory Service (BPAS) clinics in England and Wales. Between 1 January 2011 and 31 December 2014, 211215 women had a TOP at BPAS, were offered contraceptive counselling, and were eligible to obtain contraception at no cost. We examined electronic records from BPAS and assessed the proportions of women who accepted contraceptive counselling and chose a contraceptive method, as well as the distributions of methods chosen, analysed by provider and by TOP type. We calculated the proportions receiving their chosen method and the methods chosen by women using no method at conception. We used logistic regression to examine the factors associated with choice of an intrauterine contraceptive (IUC) or implant. Post-TOP contraceptive method choice. Receipt of chosen method post-TOP. Eighty-five percent of women accepted contraceptive counselling and 51% chose to obtain a method from BPAS rather than from a GP or contraception and sexual health clinic post-TOP. [correction added on 25 November 2016 after first online publication: 51% has been inserted in the preceding sentence.] Among those who wanted to receive contraception from BPAS, 51% chose an IUC or implant and 19% chose oral contraceptives. Ninety-one percent of women who obtained contraception from BPAS received their chosen method. Women were more likely to choose an IUC or implant if they obtained contraception from BPAS, had a surgical TOP, were parous, young, white, or had one or more previous TOPs. The standards set for patient-centred TOP care should emphasise the need for a full range of contraceptive options to be offered and provided post-TOP. Uptake targets for long-acting reversible methods do not reflect women's post-TOP contraceptive preferences.

Women's Contraceptive Preference-Use Mismatch

Family planning research has not adequately addressed women's preferences for different contraceptive methods and whether women's contraceptive experiences match their preferences. Data were drawn from the Women's Healthcare Experiences and Preferences Study, an Internet survey of 1,078 women aged 18-55 randomly sampled from a national probability panel. Survey items assessed women's preferences for contraceptive methods, match between methods preferred and used, and perceived reasons for mismatch. We estimated predictors of contraceptive preference with multinomial logistic regression models. Among women at risk for pregnancy who responded with their preferred method (n = 363), hormonal methods (non-LARC [long-acting reversible contraception]) were the most preferred method (34%), followed by no method (23%) and LARC (18%). Sociodemographic differences in contraception method preferences were noted (p-values <0.05), generally with minority, married, and older women having higher rates of preferring less effective methods, compared to their counterparts. Thirty-six percent of women reported preference-use mismatch, with the majority preferring more effective methods than those they were using. Rates of match between preferred and usual methods were highest for LARC (76%), hormonal (non-LARC) (65%), and no method (65%). The most common reasons for mismatch were cost/insurance (41%), lack of perceived/actual need (34%), and method-specific preference concerns (19%). While preference for effective contraception was common among this sample of women, we found substantial mismatch between preferred and usual methods, notably among women of lower socioeconomic status and women using less effective methods. Findings may have implications for patient-centered contraceptive interventions.

Young Women's Contraceptive Decision Making: Do Preferences for Contraceptive Attributes Align with Method Choice?

Understanding how women's preferences for certain attributes of contraceptive methods relate to their method choice can inform the content of contraceptive counseling. Data from 715 women aged 18-29 who had ever used contraceptives were drawn from the 2009 National Survey of Reproductive and Contraceptive Knowledge. Chi-square tests and multivariable logistic regression analyses were used to examine how women's preferences for specific contraceptive attributes were related to their social and demographic characteristics and their current contraceptive choice. The majority of women considered it extremely important for a method to be very effective at preventing pregnancy (79%) and to be effective at preventing HIV and STDs (67%); fewer than one-quarter felt similarly about a method's being hormone-free (22%). Women who felt it was quite or extremely important for a method to be very effective at preventing pregnancy were not more likely to use the most effective methods than were women who considered this attribute not at all or only slightly important. Women who considered it quite or extremely important for a method to be hormone-free were less likely than others to use hormonal methods (odds ratio, 0.4), and women who considered STD protection quite or extremely important had elevated odds of relying on condoms alone, rather than on an effective contraceptive method alone (3.6). Most women desire a very effective method for pregnancy prevention, but it is unclear how this translates to their contraceptive use. The associations between women's preferred contraceptive attributes and method choice warrant further attention.

Acceptance of Contraceptive Methods Among Postpartum Women in a Tertiary Care Center.

In India, a large proportion of women with an unmet need for contraception are within their first year after childbirth. Therefore, concentrating efforts to educate postpartum women on the importance of attending contraceptive clinics could have a proportionally bigger impact on increasing postpartum contraception usage. Hundred and seventy-eight (178) women were followed up to determine the proportion of postpartum women who attended the family planning clinics for contraceptive counseling. The reason for non-attendance, choice and effectiveness of contraceptive method selected was determined. Out of 178 postpartum women who were followed up, only 12 (6.8%) attended the contraceptive clinic. IUD, POPs and Inj-DMPA are the preferred contraceptive methods selected by postpartum women. Hundred percent of the postpartum women who attended contraceptive selected a contraceptive method as compared to only 44% of the postpartum women who did not attend a contraceptive clinic. Only 29.2% of these postpartum women selected highly effective contraceptive methods as compared to 83.3% by the postpartum women who attended family planning clinics. The common reasons cited for not attending contraceptive clinic was found to be time constraint (43.9%) followed by 'stay far away' (39%), followed by 'already have information' (9.7%). Family planning service that is scheduled to be delivered at the 6-week postpartum is rarely attended. The common reason cited by postpartum women for poor attendance in these family planning clinics was time constraint.

Characteristics and contributory factors for injectable contraceptive usage among women in Kumasi, Ghana.

BackgroundPreferred methods of contraception vary from country to country. Family Planning services have been available on a large scale in Ghana since the 1980’s and their use has contributed to gradual decline in the total fertility rate from 6.4 in 1988 to 4.2 in 2014. Since their introduction in Ghana in the early 1990’s, Injectable contraceptives have seen increasing patronage and are currently the most preferred method of contraception. We set out to identify possible factors contributing to the preference for injectable contraceptives among women in Ghana.MethodsWe conducted a descriptive cross-sectional survey of women accessing contraceptive services at the Family Planning Unit of the Komfo Anokye Teaching Hospital in Kumasi, Ghana. Women who reported for the second dose of their injections were eligible to be selected for participation in the study. Informed consent was obtained from eligible participants. Data was collected using a structured questionnaire in January and February 2011. Data captured included age, marital status, highest level of education completed, religion, ethnicity and employment status, previous contraceptive use, sources of contraceptive information and reasons for choosing injectable contraceptives. Quantitative data was entered into a Microsoft Access Database and analysed using Epi Info Version 7.1.4. Qualitative data was analysed thematically.ResultsA total of 247 respondents participated in the study. One hundred and seventy three (70.0 %) were using Depot Medroxyprogesterone Acetate and 74 (30.0 %) were using NorethisteroneEnanthate/Estradiol Valerate. The mean age for women on Depot Medroxyprogesterone Acetate was higher than those on NorethisteroneEnanthate/Estradiol Valerate (p < 0.001). The effectiveness of method, recommendation from other users, low incidence of forgetfulness and the relatively longer intervals for administration were the commonest reasons for the use of injectables among respondents. The majority of users, 225 (91.1 %), were satisfied with the method and will recommend it to other potential users. Only 10.8 % of the 68 respondents reporting undesirable effects of the injectables intend to change the method.ConclusionA high level of satisfaction exists among current users of injectables in Ghana and is influenced by a variety of factors. Strategies to increase the uptake of injectables can go a long way to increase the contraceptive prevalence rate and reduce the unmet need for Family Planning in Ghana.

Patterns of contraceptive usage at family planning clinics in Ilorin, Nigeria

This study was carried out to evaluate the pattern of contraceptive usage in family planning clinics of public hospitals within Ilorin metropolis, Nigeria. It was a retrospective study carried out between January 2010 and December 2012 involving a total of 10,002 contraceptive users attended family planning clinics in the centers within this period. Over a half of the clients (56.6%) were within the age bracket of 30-39 years, and 1.4% were less than 20 years. Majority (79.8%) of the users had two or more children while 0.9% were nulliparas. The most preferred contraceptive method was the hormonal injectable (59.5%); the percentage of users of oral contraceptive pills was 9.6% and utilization of the male condoms was 6.9%. The user rate for intrauterine contraceptive device was 17.3% while it was 6.6% for hormonal implant. Surgical sterilization was utilized by 0.1%. The commonest source of information was from healthcare personnel accounting for 41.9% followed by the mass media (21.6%). There was a low level of acceptance amongst teenagers; the level of acceptance of surgical sterilization methods was also low. There is need to improve on information dissemination regarding contraceptive use, via the internet and social media for teenagers who tend to be more internet-savvy. The number and age of clients were statistically significant factors for patterns of contraceptive usage at various family planning clinics in Ilorin metropolis.Bangladesh Med J. 2015 Sep; 44 (3): 140-145

Barriers to Postpartum Contraception in Texas and Pregnancy Within 2 Years of Delivery.

To assess pregnancies that could have been averted through improved access to contraceptive methods in the 2 years after delivery. In this cohort study, we interviewed 403 postpartum women in a hospital in Austin, Texas, who wanted to delay childbearing for at least 2 years. Follow-up interviews were completed at 3, 6, 9, 12, 18, and 24 months after delivery; retention at 24 months was 83%. At each interview, participants reported their pregnancy status and contraceptive method. At the 3- and 6-month interviews, participants were also asked about their preferred contraceptive method 3 months in the future. We identified types of barriers among women unable to access their preferred method and used Cox models to analyze the risk of pregnancy from 6 to 24 months after delivery. Among women interviewed 6 months postpartum (n=377), two thirds had experienced a barrier to accessing their preferred method of contraception. By 24 months postpartum, 89 women had reported a pregnancy; 71 were unintended. Between 6 and 24 months postpartum, 77 of 377 women became pregnant (20.4%), with 56 (14.9%) lost to follow-up. Women who encountered a barrier to obtaining their preferred method were more likely to become pregnant less than 24 months after delivery. They had a cumulative risk of pregnancy of 34% (95% confidence interval [CI] 0.25-0.43) as compared with 12% (95% CI 0.05-0.18) for women with no barrier. All but three of the women reporting an unintended pregnancy had earlier expressed interest in using long-acting reversible contraception or a permanent method. In this study, most unintended pregnancies less than 24 months after delivery could have been prevented or postponed had women been able to access their desired long-acting and permanent methods.

Multinomial Logistic Regression for Modeling Contraceptive Use Among Women of Reproductive Age in Kenya

Contraceptive use is viewed as a safe and affordable way to halt rapid population growth and reduce maternal and infant mortality. Its use in Kenya remains a challenge despite the existence of family planning programmes initiated by the government and other stakeholders aimed at reducing fertility rate and increasing contraceptive use. This study aimed at modeling contraceptive use in Kenya among women of reproductive age using Multinomial logistic regression technique. A household based cross-sectional study was conducted between November 2008 and March 2009 by Kenya National Bureau of Statistics on women of reproductive age to determine the country’s Contraceptive Prevalence Rate and Total Fertility Rate among other indicators, whose results informed my data source. Multinomial logistic regression analysis was done in R version 3.2.1. statistical package. Modern method was the most preferred contraceptive method, of which Injectable, female sterilization and pills were the common types. Descriptive Analysis showed richest women aged between 30-34 years used modern contraceptives, while poorer women aged 35-39 years preferred traditional method. Multinomial Logistic Regression Analysis found marital status, Wealth category, Education level, place of Residence and the number of children a woman had as significant factors while age, religion and access to a health facility were insignificant. Simulation study showed that MLR parameters estimates converged to their true values while their standard errors reduced as sample size increased. Kolmogorov-Smirnov statistic of the MLR parameter estimates decreased while the P-value increased as the sample size increased and remained statistically insignificant. Marital status, Wealth category, Education level, place of Residence and the number of children a woman had could determine the contraceptive method a woman would choose, while age, religion and access to a health facility had no influence on the decision of choosing folkloric, traditional or modern method of contraception. MLR parameter estimates are consistent and normally distributed.