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Contraceptive discontinuation and switching in urban Istanbul region in Turkey
Author(s) -
Kurutas Sebahat,
Sato Ryoko,
HuberKrum Sarah,
Baykal Simay Sevval,
Rohr Julia,
Karadon Duygu,
Kaur Navdep,
Okcuoğlu Bahar Ayca,
Esmer Yılmaz,
Canning David,
Shah Iqbal
Publication year - 2021
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.13577
Subject(s) - discontinuation , medicine , unintended pregnancy , developed country , obstetrics , family planning , pediatrics , demography , national survey of family growth , population , research methodology , environmental health , sociology
Abstract Objective To evaluate rates of contraceptive discontinuation and method switching and examine their determinants in Istanbul, Turkey, because discontinuation of modern contraception leading to unintended pregnancy is a public health concern. Methods We conducted a cross‐sectional household survey between March and June 2018 among 4224 married women of reproductive age (16–44 years). Information on contraceptive use and discontinuation for the 31 months preceding the survey was recorded in a monthly calendar. Using single and multiple decrement life‐table methods, we calculated the overall discontinuation and the cause‐specific discontinuation rates. Results The 12‐month overall discontinuation rate was 12.32%. Intrauterine devices had the lowest discontinuation rate (7.12%). The most common reasons for discontinuation were the desire to become pregnant (6.56%) and method failure (2.76%). One in three episodes of discontinuation was not followed by method switching (32.16%). Age, education, and the method type were predictive of contraceptive discontinuation. Conclusion To reduce method failure, women should be provided with information about method effectiveness, correct use of methods, and what to do if they anticipate their method failed (e.g., emergency contraception). Programs should focus on improving knowledge about discontinuation and method failure. Contraceptive counseling should also emphasize timely switching to an effective method after discontinuation.