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Results for “Contraception Termination--determinants”

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At least 19 recordsLinked to original sources
PubMed1994

The use of contraceptive methods among women seeking a legal abortion.

In a simple random sample study of 404 women 20 to 29 years of age, 201 applying for abortion and 203 continuing their pregnancies, all were interviewed personally and requested to complete a questionnaire. The aim of the study was to analyse the use and experience of contraceptives among the abortion applicants in this age group, and to compare their experience with that of women in a matched control group. The most important reasons given for desisting in the use of contraceptives were the experience of side effects, worry about the side effects, and the "human failure" factor involved even with methods of contraception such as pills, which generally are regarded as safe. This study demonstrates that women living alone without any permanent relationship, having a strained economy or having previously had an abortion, need particular and detailed contraceptive advice plus continued close follow-up. To improve the continuation rate, precise contraception counselling focusing on both positive and adverse effects to reduce worry seems essential.

Abortion Applicants↗
PubMed1995

Return of fertility following discontinuation of Norplant-II subdermal implants. ICMR Task Force on Hormonal Contraception.

A total of 627 women who had discontinued the use of the Norplant-II implants for various reasons and were exposed to the risk of pregnancy were followed-up for two years for return of fertility. The cumulative conception rates in women who had discontinued due to planning pregnancy were 80.3 per 100 women at one year and 88.3 per 100 women at two years. The majority of women who did conceive (90 percent), had full-term normal live births; about 4 percent of women had spontaneous abortions, the remaining 6 percent decided on elective termination of pregnancy (ETP). The cumulative conception rates in women who discontinued due to bleeding irregularities and 'other reasons' were 64.5 and 55.8 per 100 women at one year and 77.9 and 75.1 per 100 women at two years, respectively. These rates were significantly lower as compared to those observed in women who discontinued due to planning pregnancy. A large proportion, about 40 percent, of women who conceived after discontinuation of the method due to bleeding irregularities and "other reasons," opted for ETP indicating that many women in these two groups did not desire another child and that such women need to be counselled for adopting another method of contraception. The spontaneous abortion rates observed in ex-users of Norplant-II implants (1.7 to 4.4% pregnancies) were comparable to the spontaneous abortion rates prior to Norplant-II implant use (3.6% pregnancies) indicating that ex-users of Norplant-II implants were not at a higher risk of spontaneous abortion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1997

Contraceptive continuation and its determinants in Benin.

To understand better the rates of continuation of different contraceptive methods, a study in 12 family planning centers in Cotonou and Porto Novo, the two largest cities in Benin, was conducted. From January 1 to December 31, 1993, 944 questionnaires completed by new women acceptors of one of three methods of contraception (oral contraceptive, injection, or IUD) were analyzed. For all methods of contraception, the average length of follow-up was 9.5 months. From the start of the analysis, 44.4% (n = 419) of the women were regularly followed, 49.5% (n = 467) were not regularly followed, and 6.1% (n = 58) reported discontinuation of the method. One year after beginning the use of contraception, the cumulative proportion of women at risk of becoming pregnant, for all the methods together, was 42.0% (38.6-45.4%). Age was associated with the probability of abandoning oral contraception (p = 0.01). Three months after the start, the cumulative proportion of drop-out women having chosen oral contraceptive was 37.2% (22.8-51.6%) of the less than 20-year-olds, 19.0% (14.3-23.7%) of the 20- to 30-year-olds, and 23.4% (15.6-31.2%) of the over 30-year-olds. In contrast, drop-out was not associated with age for women using injection (p = 0.96) or the IUD (p = 0.47). Our results indicate a relatively high and rapid rate of discontinuation for modern contraceptive methods, particularly for young women having chosen oral contraceptive. This finding should incite the family planning educators to give more emphasis to the counseling programs, especially during the first three months.

Adolescent↗
PubMed1997

Depot medroxyprogesterone acetate pioneers. A retrospective study at a North Carolina Health Department.

This article examines the characteristics of the first group of depot medroxyprogesterone acetate (DMPA) acceptors after US Food and Drug Administration (FDA) approval of the method and evaluates their continuation rates and factors associated with discontinuation. This was a population based retrospective study based on 12 months of clinic data for 510 women who began using DMPA in 1993 at a large county health department. Cumulative 12 month life table rates were calculated for the entire group and were then stratified by selected characteristics. The 4, 8, and 12 month continuation rates were 67%, 46%, and 35%, respectively. More than half of these women discontinued because of bleeding and nonbleeding side effects (25% and 28%, respectively). Almost 20% of these women were considered discontinuers because they waited longer than 16 weeks to return for an injection. As measured in this study, continuation rates for this first group of DMPA acceptors were low. The next step is to determine if the characteristics and patterns of use of these "pioneer" acceptors are representative of more recent acceptors, and if lessons learned from this group will lead to higher continuation rates.

Adolescent↗
PubMed1998

Can intrauterine device removals for bleeding or pain be predicted at a one-month follow-up visit? A multivariate analysis.

From 4%-14% of intrauterine device (IUD) users have their IUD removed due to bleeding or pelvic pain in the first year of use. Past studies have analyzed whether baseline patient information can help predict such removals, but no previous analysis has examined whether information provided at the recommended 1-month follow-up visit could improve such predictions. Using data from an international multicenter randomized controlled trial, 89 women with removals for bleeding and pain after the 1-month visit were compared with 2536 continuing users. Logistic regression indicated several significant predictors of removal. Women reporting intermenstrual bleeding since last menses were nearly three times more likely to have removals for bleeding or pain (odds ratio [OR] 2.9; 95% confidence interval [CI] 1.4-5.9). Similarly, those complaining of excessive menstrual flow were 3.5 times more likely to have removals within 12 months (95% CI 1.4-9.2). Women reporting these menstrual problems during scheduled revisits may benefit from counseling and treatment with nonsteroidal anti-inflammatory drugs (NSAID).

Adolescent↗
PubMed1999

Analysis of client characteristics that may affect early discontinuation of the TCu-380A IUD.

The purpose of this study was to analyze the reasons for early discontinuation of the TCu-380A IUD in women participating in a large multicenter trial. The study relates specific characteristics of the women at the time of TCu-380A insertion with specific 1-year reasons for discontinuation. A secondary analysis was performed on data obtained from 2748 women from sites in Africa, Asia, and Latin America. By the end of the year, 321 discontinuations were observed. The gross cumulative 12-month life table rates of reasons for discontinuation were 13.3 for all reasons and 3.1, 4.5, and 4.3 for expulsion, removals for bleeding/pain, and personal reasons, respectively. Study site, age, and religion had a significant effect on early discontinuation. Women who had IUD insertions in the African centers had significantly higher expulsion rates than women from other centers. Women < 20 years old had significantly higher expulsion rates than older women. Muslim women had significantly higher rates of removal for bleeding and pain than women of other religions. This information may guide the counseling and follow-up process of women with such characteristics and result in a more satisfactory use and improved continuation rates of the TCu 380A.

Adolescent↗
PubMed1998

Levonorgestrel contraceptive implants in female patients 14 to 21 years old.

OBJECTIVE: To determine which factors are associated with duration of use of a levonorgestrel implant (Norplant) for contraception in adolescents and young adults. DESIGN: We retrospectively studied 144 young women (14 to 21 years of age) who chose a levonorgestrel contraceptive implant at Mayo Clinic Rochester between April 1990 and December 1993. MATERIAL AND METHODS: The following information was obtained at the time of insertion of the implant and from any follow-up visits: demographics, prior contraceptive experiences, frequency and management of complications, complications noted at removal of the implant, and subsequent contraceptive choice. The duration of use was examined. RESULTS: Of the 144 young women who underwent insertion of a Norplant system, 75 telephoned or made a medical appointment because of implant-related side effects. During the follow-up period, 64 patients had the Norplant system removed. The Kaplan-Meier estimate of the probability of the Norplant system remaining in place for at least 12 months was 83 % and for at least 24 months was 63 %. Duration of Norplant use was not found to differ with respect to age, prior contraceptive use, or timing of insertion, but it was significantly shorter among those with a prior pregnancy than in those who had never been pregnant. CONCLUSION: These findings suggest that a group of young women who are likely to continue use of a contraceptive implant (with or without treatment for side effects) are those who have never been pregnant.

Adolescent↗
PubMed1998

Factors influencing continuation of IUD use in south India: evidence from a multivariate analysis.

This paper studies the correlates of IUD continuation, particularly in relation to quality of service provided in Karnataka, South India, by using a discrete-time logit model. Provision of follow-up services had a moderate influence on continuation, and medical check-up at insertion influenced the experience of side effects. But these effects were trivial in comparison with the overriding influence of motivational variables and of reported side effects. The IUD is retained for a limited duration in rural India where it is used mainly as a spacing device by lowly motivated young women who discontinue the method at the slightest feeling of discomfort or abnormality. If the IUD were recommended to older women for limiting childbearing by emphasizing its reversibility, it would enhance the method's popularity and improve the levels of contraceptive use among younger women.

Adult↗
PubMedDate not supplied

The determinants of IUD discontinuation in China: a discrete-time competing risk model analysis.

This research examines the social, demographic, and family-planning-program factors that influence the occurrence of IUD discontinuation among Chinese women, using a sample of 14,639 IUD use segments from the 1988 Chinese National Survey of Fertility and Contraceptive Prevalence. A discrete-time competing-risk event history method is employed to identify the determinants of IUD discontinuation by five kinds of reasons: contraceptive failure, expulsion, switching method, side-effects and other nonmethod-related reasons. The predictors of IUD discontinuation suggest that a number of mechanisms are in operation. Some of the determinants may reflect the effects of the family planning program; some may illustrate women's physiological and biological reactions to IUD's; some may be related to women's previous history of contraceptive use; and still others may indicate social characteristics of women that lead them to have their IUD's removed.

Adult↗
PubMed1994

Education and counseling for Norplant users.

Because Norplant provides effective contraception for 5 years, it is an excellent choice for many women. However, it has side effects that have prompted early removal in a significant number of women. Nurses who educate and counsel women about Norplant before insertion and provide support and management of side effects afterward can increase user satisfaction and long-term continuation.

Contraception↗
PubMedDate not supplied

Birth control discontinuance as a diffusion process.

This paper applies the diffusion of innovations model to the study of the birth control discontinuance of first-time users in the Dominican Republic. Two sets of factors are examined: social characteristics of the adopters are used to test Rogers's and Shoemaker's contention that discontinuers have more traditional values than continuers; and the adoption decision process is analyzed to identify the relationship of communication factors to discontinuance. Although number of children and experience of method problems were the major determinants of discontinuance, unfavorable information from friends and other birth control users was a significant factor. Rumor was found to have little effect on a women's decision to continue or discontinue.

Adult↗
PubMed1996

The introduction of a new contraceptive; two years experience with Norplant.

OBJECTIVE: To determine the uptake, acceptability and continuation rates of a new contraceptive implant, Norplant. DESIGN: Review of case notes of all acceptors during the two years following the introduction of the implant. SETTING: A large family planning clinic in Edinburgh. SUBJECTS: All women choosing Norplant. RESULTS: 508 women chose Norplant, many as an alternative to sterilisation or because they had experienced problems with other methods of contraception. 9% of women were lost to follow-up. Of the remainder continuation rates were 84% at one year and 80% after 18 months of use. 43% of women gave bleeding problems as the reason for removal. However the combination of weight gain, mood swings, depression and headache was frequently reported as unwanted side effects by women seeking removal. No major problems were experienced with either insertion or removal of Norplant. CONCLUSIONS: Norplant is an effective method of contraception which many women find attractive. The incidence of erratic bleeding is high but many women tolerate this problem because the method is easy to use and lasts five years. Careful counselling is essential for high continuation rates.

Adolescent↗
PubMed1996

Patient satisfaction with a levonorgestrel-releasing contraceptive implant. Reasons for and patterns of removal.

OBJECTIVE: To investigate the experience of the users of a levonorgestrel-releasing contraceptive implant (Nor-plant) and reasons for early removal. STUDY DESIGN: Two hundred fifty-one women who had Norplant placed through the Ohio State University Department of Obstetrics and Gynecology were sent a questionnaire that included general demographic questions and questions regarding preplacement education; reasons for choosing Norplant; problems experienced due to Norplant; reasons for removal, if applicable; and overall satisfaction. RESULTS: One hundred eleven questionnaires (44%) were completed and analyzed. Twenty-four (21.6%) of patients had Norplant removed, 32 (28.8%) planned on early removal, and 55 (49.5%) desired continued use. Ninety-eight percent of women who planned continued use of Norplant had received reading material as part of their preplacement counseling and 95% felt adequately counseled. This is significantly higher than women who had Norplant removed or planned on early removal. Convenience, problems with other contraceptive methods and effectiveness were the most important reasons why patients chose Norplant. Menstrual changes were the most common side effect, experienced by 80% of all women in the study. Weight gain, headache, mood changes, mastalgia and acne were also frequently reported. Women who had Norplant removed were significantly more likely to have experienced dizziness when compared to women desiring continued use. Women planning early removal were also more likely to have experienced dizziness in addition to acne, headache, hair loss and other side effects. Menstrual irregularities, followed by mood changes and headaches, were the most important side effects associated with early Norplant removal. Overall, 68% of users were at least somewhat satisfied with Norplant. CONCLUSION: Norplant contraception was a satisfactory form of birth control for the majority of patients in the study despite the frequent occurrence of side effects. Reading material regarding benefits and side effects of Norplant is an important aspect of patient counseling and may improve long-term use of Norplant.

Adolescent↗
PubMed1997

Acceptance, efficacy, and side effects of Norplant implants in four counties in north China.

This report attempts to present a comprehensive analysis of the acceptability, side effects, and efficacy of Norplant as used in rural areas, based on a field experiment conducted in four counties in Hebei and Shandong Provinces, China. The initial acceptance of Norplant was relatively high but waned after the first year in three of the four counties. Compared with clinical trials, the current study shows a lower prevalence but similar patterns of side effects. The pregnancy rate during the first two years of use is similar to that found in large-scale clinical trials conducted in China, but discontinuation due to other reasons is lower. A three-level logistic regression analysis shows significant variation in the probability of discontinuation due to side effects across counties. It also indicates an increase in the conditional probability of discontinuation with the duration of use. Whereas introducing Norplant and achieving a very low failure rate and high continuation rate in rural areas is feasible under diverse socioeconomic conditions, the results vary significantly across different areas. Particular attention should be paid to the local factors that may affect results.

Adult↗
PubMed1999

Determinants of contraceptive discontinuation in six developing countries.

This analysis investigates the determinants of contraceptive discontinuation in six developing countries, using data from Phase I surveys of the DHS programme. Cumulative probabilities of discontinuation at 24 months for reasons other than the desire for another child were examined. By this time, typically about 40% of couples have stopped use and most are subsequently at risk of an unwanted conception. Discontinuation of IUD use was found to be less common than for other methods, partly perhaps because cessation of use requires a deliberate decision to have the device removed. The most important results are negative ones. Neither the schooling of couples nor their type of residence exerted appreciable influence on discontinuation. The policy and programme implications are discussed. Prior use of a method, fertility preferences and the related demographic factors of age and family size emerged as pervasive predictors of discontinuation.

Adolescent↗