Women's Contraceptive Behavior Research Articles

Contraceptive behavior of women in India after induced abortion.

Putting an end to the silent pandemic of unsafe abortion is a major public health concern globally. Adoption of post-abortion contraception is documented as a significant contributor to reduce the number of unintended pregnancies and number of induced abortions. This study aimed at investigating the post abortion contraceptive behavior of Indian women exploring the determinants of post-abortion contraceptive uptake. Retrospective calendar data for 6,862 women aged 15-49 years from fifth round of National Family Health Survey (2019-2021) was used for the study. Multinomial logistic regression method was used to model the determinant factors to post-abortion contraceptive uptake. 72.6% women reported adopting no method of contraception after the abortion procedure. A total of 27.4% women adopted some method of contraception after abortion. 14% women preferred adopting short term modern methods. Women in early reproductive age group which is the most vulnerable group in experiencing unintended pregnancies are less likely to adopt any contraceptive method after abortion. Uptake of post abortion contraception is quite low in India. Effort should be taken in the direction of bringing awareness through provision of targeted contraceptive counselling after abortion.

Does Provider Bias Affect Choice of a Facility for Family Planning Services by Women in Urban Senegal?

Few studies to date have determined the effect of provider bias based on age, parity, and marital status on women's method and facility choice. Using data from women using modern methods in six cities of Senegal and a facility survey that included a facility audit and provider interviews, we undertake conditional logit analyses to determine whether women's choice of a family planning facility is associated with provider bias at the facility, controlling for other facility characteristics (e.g., size, sector, and number of methods available). We find that women bypass facilities where there is greater provider bias to attain their current family planning method. Women also bypass facilities of lower quality. This is the first study to demonstrate the effects of provider bias on women's contraceptive seeking behaviors and suggests the importance of training providers to reduce age and parity bias that affect access to a full range of methods and facilities for all women.

Wearable Devices and Intelligent Application in Women's Postpartum Repair for Smart Healthcare.

Wearable devices are more and more widely used in the field of smart healthcare. The purpose of this study was to explore the effect of contraceptive counseling and education on contraceptive behavior of women after induced abortion. The investigators will explain the situation of this topic to the respondents and select the respondents in strict accordance with the framework requirements of sampling design. All the data are from the induced abortion women in the first-, second-, and third-level hospitals, which reduces the selection bias of the respondents. It is found that the proportion of induced abortion among college students is the highest, reaching 66.03%. This study is helpful to reduce the incidence of unwanted pregnancy, induced abortion, and repeated abortion and improve the reproductive health of women.

COMPREHENSIVE TREATMENT AND REHABILITATION OF PELVIC FLOOR INSOLVENCY IN WOMEN WITH VARIOUS FORMS OF PROLAPSE

The article presents the results of the analysis of reproductive and contraceptive behavior of women with genital prolapse and UPBS who were treated in 3 maternity complex of Samarkand city for the period from 2012 to 2016. It was established that an optimized surgical method of treatment of vaginal wall prolapse with simultaneous transvaginal DSC The indications and criteria for selecting patients to perform this operation are presented, the efficiency of the proposed method of surgical treatment and contraception based on the study of the nearest and distant results is determined. The dynamics of the reproductive system organs condition and quality of life during a year after the operation are given in the article.

“Power of Mom”: A Mixed Methods Investigation of Mothers’ Influence on Women’s Contraceptive Attitudes and Behaviors

Unintended pregnancy is an individual and public health problem with significant social and economic consequences. The literature has established that parents, especially mothers, play an important role in shaping the contraceptive attitudes and behaviors of young women and could therefore affect the likelihood of their daughter experiencing an unintended pregnancy. However, research has yet to fully explore the nuances of how mothers influence their daughters with respect to contraception. We conducted a mixed methods study to explore the impact of mothers on women's contraceptive attitudes and behaviors. In-depth interviews were conducted with 86 women of reproductive age to identify potential patterns and explore the nature of mothers' influences. We then analyzed medical and prescription claims for a cohort of 9813 pairs of women (mother-daughter proxies) enrolled in Medicaid, to determine if such patterns of contraceptive use held in a larger sample. In-depth interviews reveal how and why mothers shape women's contraceptive attitudes and behaviors, particularly highlighting the nuances of communication, knowledge, and relationships. The statistical claims data supported such findings on a broader scale. For instance, across several types of contraceptives, including oral, injectable, and long-acting reversible contraceptives (LARCs), young women were significantly more likely to use a particular method if an older woman in the household (mother proxy) also used that method (AOR (95% CI) 1.99 (1.67-2.37), 2.06 (1.58-2.68) and 2.83 (1.64-4.88) respectively). This study fills a gap in the literature regarding the nuanced ways in which mothers influence women's contraceptive behavior. In turn, it supports the importance of familial context-especially the influence of mothers-in contraception decision-making and suggests that interventions aimed at improving access to and uptake of effective methods of contraception consider this context in their design and implementation.

Expectations for Sex without Birth Control among Young Men: Risk Factors from the USA National Survey of Reproductive and Contraceptive Knowledge

PurposeMale partner engagement in family planning can influence women's contraceptive behaviors and risk of unintended pregnancy. We identified factors associated with self-reported expectations for future contraceptive use among a nationally-representative sample of young men.Materials and MethodsThe National Survey of Reproductive and Contraceptive Knowledge asked unmarried, sexually active men (ages, 18–29 y), who were neither involved in nor trying for a pregnancy, about their likelihood of having sex without contraception in the following three months. Demographics, social factors, and contraceptive awareness and attitudes were examined for potential associations using weighted analyses.ResultsOf 903 men surveyed, nearly 600 were sexually active and expected to have sex in the following 3 months; nearly half (43%) reported at least some likelihood (23% slightly, 7% very, 13% extreme likely) that they would have sex without any contraception. Factors independently associated with sex without contraception included: not completing high school, not being in school full-time, not receiving sex education, limited awareness of contraceptive methods, multiple sexual partners, and friends with unintended pregnancies.ConclusionsDespite not wanting a pregnancy, many young men report they will have sex without contraception. While comprehensive sex education may increase contraceptive use, interpersonal and social factors also influence men's expected use of contraception.

Male partner reproductive coercion among women veterans

Male partner reproductive coercion is defined as male partners' attempts to promote pregnancy through interference with women's contraceptive behaviors and reproductive decision-making. Male partners may try to promote pregnancy through birth control sabotage such as taking away or destroying their partners' contraceptives, refusing to wear condoms, and/or verbally pressuring their partners to abstain from contraceptive use. Reproductive coercion is associated with an elevated risk for unintended pregnancy. Women who experience intimate partner violence, who are in racial/ethnic minorities, and who are of lower socioeconomic status are more likely to experience reproductive coercion. Women veterans who use Veterans Affairs for health care may be particularly vulnerable to reproductive coercion because they are disproportionally from racial/ethnic minority groups and experience high rates of intimate partner violence. We sought to examine the prevalence, correlates, and impact of reproductive coercion among women veterans who are served by the Veterans Affairs healthcare system. We analyzed data from a national telephone survey of women veterans aged 18-44 years, with no history of sterilization or hysterectomy, who had received care within the Veterans Affairs system in the previous 12 months. Participants who had sex with men in the last year were asked if they experienced male partner reproductive coercion. Adjusted logistic regression was used to examine the relationship between participant characteristics and male partner reproductive coercion and the relationship between reproductive coercion and the outcomes of contraceptive method used at last sex and pregnancy and unintended pregnancy in the last year. Among the 1241 women veterans in our study cohort, 11% reported experiencing male partner reproductive coercion in the past year. Black women, younger women, and single women were more likely to report reproductive coercion than their white, older, and married counterparts. Women who experienced military sexual trauma were also more likely to report reproductive coercion compared with women who did not report military sexual trauma. In adjusted analyses, compared with women who did not experience reproductive coercion, those who did were less likely at last sex to have used any method of contraception (76% vs 80%; adjusted odds ratio, 0.61; 95% confidence interval, 0.38-0.96), prescription contraception (43% vs 55%; adjusted odds ratio, 0.62; 95% confidence interval, 0.43-0.91), and their ideal method of contraception (35% vs 45%; adjusted odds ratio, 0.63; 95% confidence interval, 0.43-0.93). Those who reported coercion were more likely to have had a pregnancy in the last year (14% vs 10%; adjusted odds ratio, 2.07; 95% confidence interval, 1.17-3.64); there were no significant differences in unintended pregnancy by coercion status (6% vs 4%; adjusted odds ratio, 1.63; 95% confidence interval, 0.71-3.76). Eleven percent of women veterans in our sample experienced male partner reproductive coercion, which may impact their use of contraception and ability to prevent pregnancy.

Factors influencing college women's contraceptive behavior: An application of the integrative model of behavioral prediction

ABSTRACTObjective: This study investigated variables within the Integrative Model of Behavioral Prediction (IMBP) as well as differences across socioeconomic status (SES) levels within the context of inconsistent contraceptive use among college women. Participants: A nonprobability sample of 515 female college students completed an Internet-based survey between November 2014 and February 2015. Methods: Respondents were asked about their contraception use, knowledge and information sources, demographic information, and IMBP factors, including attitudes, norms, and perceived behavioral control (PBC). Results: While overall attitudes, norms, PBC, and intentions for contraceptive use were high, only 46.8% of women used contraception consistently. Data also revealed only moderate levels of knowledge about contraception. While there were no differences across SES levels for attitudes, PBC, norms or knowledge, SES levels did differ in sources used to acquire contraceptive information. Conclusions: This study highlights the need to consider where college women acquire contraceptive information which is associated with SES.

Utilisation of maternal health services and its predictors in slum population

Introduction: The particularly sorry plight of disadvantaged slum population with ample scope of further research into such areas as vulnerability to health risk and access to treatment, reduced economical choice and social support besides natural disasters and emotional stress of displacement. Material & Methods: An observational (cross-sectional) study was designed on a pre designed and pre tested questionnaire to understand women's fertility and contraceptive behavior and to study Socio behavioral Determinants of Utilization of MCH services. Results: The prevalence of

State Abortion Context and U.S. Women's Contraceptive Choices, 1995–2010

The number of women in the United States exposed to restrictive abortion policies has increased substantially over the past decade. It is not well understood whether and how women adjust their contraceptive behavior when faced with restrictive abortion contexts. Data from 14,523 women aged 15-44 were drawn from the 1995 and 2010 cycles of the National Survey of Family Growth. A difference-in-differences approach was employed to examine the relationship between state-level changes in women's access to abortion and their contraceptive choices. Multinomial logistic regression analysis was used to determine the relative risk of using highly effective or less effective methods rather than no method for women exposed to varying levels of restrictive abortion contexts. Women who lived in a state where abortion access was low were more likely than women living in a state with greater access to use highly effective contraceptives rather than no method (relative risk ratio, 1.4). Similarly, women in states characterized by high abortion hostility (i.e., states with four or more types of restrictive policies in place) were more likely to use highly effective methods than were women in states with less hostility (1.3). The transition to a more restrictive abortion context was not associated with women's contraceptive behavior, perhaps because states that introduced restrictive abortion legislation between 1995 and 2010 already had significant limitations in place. To prevent unwanted pregnancies, it is important to ensure access to highly effective contraceptive methods when access to abortions is limited.

Bridging user and provider perspectives: Family planning access and utilization in rural Mozambique

ObjectivesTo examine how the contraceptive behavior of women in rural southern Mozambique is shaped by their individual and household characteristics; community characteristics; access to family planning services; and characteristics of health facilities. MethodsQuantitative and qualitative data were collected mostly between January 20 and December 15, 2011, in rural areas of four districts in Gaza Province, Mozambique. The data included: a retrospective household-based survey of women of reproductive age (the analytical sample consisted of 1554 non-pregnant women in marital union); qualitative interviews with a subsample of surveyed women; a survey of communities where the women resided (n=56); and a survey of all health facilities in the study area (n=56). Binomial and multinomial logistic models were fitted to predict current use of modern contraceptive methods. Statistical analyses were complemented by insights from qualitative data. ResultsPositive associations were detected between contraceptive use and education, household wealth, and perceived HIV infection status. Distance to the clinic was negatively associated with contraceptive use. These effects were additive, with some varying by type of contraceptive method. Examination of qualitative data highlighted frequent cognitive dissonance between service providers and users. ConclusionA simultaneous consideration of user-level and provider-level perspectives on contraceptive use improves our understanding of contraceptive dynamics and can usefully inform policy.

Race and Reproductive Coercion: A Qualitative Assessment

BackgroundUnintended pregnancy is common and disproportionately occurs among low-income and African-American (AA) women. Male partners may influence women's risk of unintended pregnancy through reproductive coercion, although studies have not assessed whether racial differences in reproductive coercion impact AA women's disparate risk for unintended pregnancy. We sought to describe women's experiences with pregnancy-promoting behaviors by male partners and explore differences in such experiences by race. MethodsSemistructured interviews were conducted with low-income, AA and White women aged 18 to 45 years recruited from reproductive health clinics in Western Pennsylvania to explore contextual factors that shape women's contraceptive behaviors. Narratives were analyzed using content analysis and the constant comparison method. FindingsAmong the 66 participants (36 AA and 30 White), 25 (38%) described experiences with male partner reproductive coercion. Narratives provided accounts of contraceptive sabotage, verbal pressure to promote pregnancy and specific pregnancy outcomes, and potential motives behind these behaviors. AA women in the sample reported experiences of reproductive coercion more often than White women (53% and 20%, respectively). AA women were also more likely than White women to attribute a current or prior pregnancy to reproductive coercion. AA women identified relationship transiency and impending incarceration as potential motivations for men to secure a connection with a female partner via pregnancy. ConclusionsOur findings suggest that reproductive coercion may be a factor contributing to disparities in unintended pregnancy. More research, including population-level studies, is needed to determine the impact of reproductive coercion on unintended pregnancy and to understand the social and structural factors associated with pregnancy-promoting behaviors.

Knowledge, Attitude, and Practice about Emergency Contraception among Health Staff in Bushehr State, South of Iran

Emergency Contraception (EC) is used within a few days of unprotected sex to prevent an unintended pregnancy. About one quarter of pregnancies in south of Iran are unintended. EC is important option that women can use after unprotected sex or contraceptive failure for preventing of unplanned pregnancies and adverse maternal and perinatal health outcomes. Health staff have influence on women’s contraceptive behavior and their knowledge and attitudes about EC can affect women’s contraceptive behaviors. Data are lacking about the knowledge, attitude and practice of hormonal EC method among health staff in Bushehr state, south of Iran. A cross-sectional study using self administered questionnaire was conducted. A sample of 170 health staff were surveyed. The mean age of respondents was 30.6±5.1. Overall 6.5% of participants had poor knowledge, 25.2% moderate knowledge, 68.3% good knowledge about EC. Half of participants had positive and half had negative attitude towards the EC method. Midwives and family health workers were more knowledgeable (p<0.05) and more frequently counseled women about EC than general practitioners (GPs) (p<0.001). The most cited reason for EC prescriptions were rupture condom and none use of contraception. Our findings showed despite of majority of health staff had good knowledge about EC, their knowledge about the indications for prescription of EC and its side effects was inadequate. The educational efforts for health staff should be focused more on the specific aspects of EC method. GPs also should be more involved in family planning program.

Ambivalence, communication and past use: Understanding what influences women's intentions to use contraceptives

Unintended pregnancy among women in the 18–30 age group is a public health concern. The Extended Parallel Process Model (EPPM) provides a framework for exploring how women's perceptions of threat, efficacy, and fear influence intentions to use contraceptives. Past use and communication with best friends and partners were also considered. A telephone survey of 18–30-year-old women (N = 599) was completed. After univariate and bivariate analyses were conducted, the variables were entered into a hierarchal, multi-variate linear regression with three steps consistent with the EPPM to predict behavioral intention. The first step included the demographic variables of relationship status and income. The constructs for the EPPM were entered into step 2. Step 3 contained the fear measure. The model for the third step was significant, F(10,471) = 36.40, p < 0.001 and the variance explained by this complete model was 0.42. Results suggest that perceived severity of the consequences of an unintended pregnancy (p < 0.01), communication with friends (p < 0.01) and last sexual partner (p < 0.05), relationship status (p < 0.01), and past use (p < 0.001) were associated with women's intentions to use contraceptives. A woman's perception of the severity was related to her intention to use contraceptives. Half of the women (50.3%) reported ambivalence about the severity of an unintended pregnancy. In our study, talking with their last sexual partner had a positive effect on intentions to use contraceptives, while talking with friends influenced intentions in a negative direction. These results reconfirm the need for public health practitioners and health care providers to consider level of ambivalence toward unintended pregnancy, communication with partner, and relationship status when trying to improve women's contraceptive behaviors. Implications for effective communication interventions are discussed.

Effectiveness of a theory-based postpartum sexual health education program on women's contraceptive use: a randomized controlled trial

Background The aim of this study was to evaluate the effectiveness of a refined theory-based Interactive Postpartum Sexual Health Education Program to enhance postpartum women's effective contraceptive behavior. Study Design Participants ( N=250) were randomized to three groups. Experimental Group A received our intervention program via strategies that matched participants' learning preparedness, as determined by the transtheoretical model. Experimental Group B received only a pamphlet. The control group received routine education. Only Group A received health education. Data were collected at baseline, 3 days, 2 months and 3 months postpartum. Results Women who received theory-based postpartum sexual health education program had significantly greater contraceptive self-efficacy and were more likely to choose more effective contraceptive methods at 2 months postpartum than women in the routine teaching and interactive pamphlet-only groups. Conclusion Our theory-based Interactive Postpartum Sexual Health Education Program enhanced postpartum women's contraceptive self-efficacy and effective contraceptive behavior.

How Do Family Planning Workers' Visits Affect Women's Contraceptive Behavior in Bangladesh?

In Bangladesh, family planning workers’ visits reduce the costs of contraception and may increase the demand. If visits increase demand or if workers are targeting their visits, past visits by family planning workers should have a positive and significant effect on later probabilities of adopting contraceptive methods. Longitudinal data show that past visits are not significant in hazard models for adoption of contraceptive methods, whereas visits in the current round are significant. Therefore family planning workers’ visits affect women’s contraceptive behavior by decreasing the costs of contraception. Results of contraceptive discontinuation hazard models further support this hypothesis.

Family Planning Access Increases Contraceptive Practice, Even Among Women Who do not Intend to Use a Method

This article examines the influence of the family planning supply environment on the contraceptive behavior of women. Data were drawn from both the 1992 Morocco Demographic and Health Survey and the 1995 Morocco Panel Survey. A total of 910 women were interviewed in the aspects of fertility desires current use of contraceptives and intention to use a method in the future. These women were within 30 km of at least one facility that offered family planning services. Median distance to a provider in rural areas was 7 km; in urban areas less than 1 km. Overall rural facilities had fewer stocks of contraceptive methods fewer staff members trained to provide family planning and a lower level of infrastructure than in the urban facilities. Findings of the multivariate analysis indicated that of the supply-side variables the number of nurses number of trained staff members and the level of method availability at the nearest clinic were associated with the intention of contraceptive usage. Furthermore women who aspire to control their fertility tend to be successful in finding alternative sources of services and supplies even when aspects of the local supply environments do not fully satisfy their needs.

Household organization, women's autonomy, and contraceptive behavior in southern Ethiopia.

The Southern Nations, Nationalities, and People's Region of Ethiopia (SNNPR) is home to 11 million people constituting more than 45 language and ethnic groups, most of whom live in extremely poor rural communities. Data for currently married, fecund women aged 15-49 from demographic surveys conducted in the SNNPR in 1990 and 1997 are used to investigate contraceptive knowledge and communication, and the use and future need for family planning services in this population. This study focuses on how these processes are affected by household organization and women's status, and on their implications for population policies and programs. Considerations of the implications of these results for understanding the fertility transition of a highly diverse African population under severe stress are presented. Although household extension and polygamy characterize one-third of the women sampled, they do not affect the women's contraceptive behavior. Women's literacy and autonomy are, by far, the most significant forces in the movement toward lower fertility in the region.

The Impact of Multimedia Family Planning Promotion on the Contraceptive Behavior of Women in Tanzania

This study examined effects of mass media campaigns promoting family planning (FP) on contraceptive use in Tanzania. Nationally representative data were obtained from a 1994 KAP Survey and a 1991-92 Demographic and Health Survey. Tanzania integrated FP into maternal and child health services in 1988. It adopted 1992 IEC policy a national communication program and social marketing of condoms in 1992. The FP Communication Project operated during 1991-94 and educated men and women about the health benefits of modern contraception. The multimedia campaign relied on radio spots in 1993 and 1994 a radio serial drama during 1993-94 a Green Star logo posters leaflets newspapers and audiocassettes. Other campaigns by five other organizations or programs were complementary. Analysis reveals that womens exposure to mass media sources of FP messages was associated with increased contraceptive use especially modern methods. Women exposed to FP messages were more likely than other women to discuss FP with their spouses and to visit health facilities. These effects remained after controls for residence education age marital status parity approval of FP partners views on FP and radio ownership. Most women who recalled mass media messages were not already using or had not ever used contraceptives. The impact was greater when women were exposed to multiple sources. Messages reached about 55% of reproductive-age women.

Factors affecting contraceptive use and behavior in Kocaeli, Turkey.

This study aimed to investigate contraceptive use and its determinants in Kocaeli, Turkey. A questionnaire was applied to 922 randomly selected sexually active women of reproductive age, in order to extract information concerning contraceptive use and sociodemographic factors affecting behavior and contraceptive use. Knowledge of at least one method was nearly universal. Intrauterine devices and withdrawal were the most commonly used methods. Illiterate women and housewives had less knowledge about some modern methods. The number of children (p < 0.001), nuclear type family (p < 0.05), and approval of family planning (p < 0.001) were the factors most predictive of contraceptive use. Husbands were involved in family planning via discussing family size (79.4%) and method (85.5%) 38.2% of males participated actively by using withdrawal or condom. Increasing the literacy of both male and female partners significantly increased both contraceptive use and the participation of husbands in family planning descision making. In conclusion, increasing the education level of couples and the status of women would result in increased contraceptive use in the future. Since the contraceptive behavior of women is influenced by their husbands' attitudes, family planning programs should be focused on the needs of both partners.