Contraceptive use among women through their later reproductive years: Findings from an Australian prospective cohort study

Egan, Nicholas; Forder, Peta; Coombe, Jacqueline

doi:10.1371/journal.pone.0255913

Cited by 15 publications

(33 citation statements)

References 56 publications

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“…The coital frequency also decreases with age. Moreover, older women are more knowledgeable about effective contraceptives and their reproductive goals 41 . Further research is needed to examine the reasons for insignificant relationships for 35–49-year age groups.…”

Section: Discussionmentioning

confidence: 99%

Exploring rise of pregnancy in Bangladesh resulting from contraceptive failure

Khan

Islam

2022

Sci Rep

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The objective of this study was to determine how changes in pre-pregnancy contraceptive methods used between 2011 and 2017/18 contributed to the changes in pregnancy resulting from contraceptive methods failure in Bangladesh. We used 2011 and 2017/18 Bangladesh Demographic and Health Survey data. Pre-pregnancy contraceptive methods failure was our outcome of interest, which was determined using women’s response about whether they became pregnant while using contraceptives before the most recent pregnancy. The year of the survey was the main explanatory variable. Descriptive statistics were used to describe the characteristics of the respondents. The difference in contraceptive methods failure across the socio-demographic characteristics was assessed by Chi-squared test. Multilevel poison regressions were used to determine the changes in the prevalence ratio of contraceptive methods failure across the survey years. Contraceptive methods failure rate increased between the surveys, from 22.8% in 2011 to 27.3% in 2017/18. Also, male condom use increased by 2.8%, while withdrawal/periodic abstinence and/or other methods decreased by 2.9%. The failure rates in these two categories of contraceptive methods increased substantially by 4.0% and 9.0%, respectively. Compared to the 2011 survey, the prevalence ratio (PR) of contraceptive methods failure was 20% (PR 1.2, 95% CI 1.1–1.3) high in the 2017/18 survey. This PR declined 13% (PR 1.1, 95% CI 1.04–1.2) once the model was adjusted for women’s and their partner’s characteristics along with the last contraceptives used. This study provides evidence of increasing rates of pregnancy due to contraceptive failure in Bangladesh. Given that this type of pregnancy is known to cause adverse pregnancy outcomes, including abortion, pregnancy complications, maternal and early child morbidity and mortality, policy and programs are needed to reduce its prevalence. Effective coordination between the contraception providers at the healthcare facilities and the households and a proactive role of family planning workers to make couples aware of the effective use of contraceptives are recommended.

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Section: Discussionmentioning

confidence: 99%

Exploring rise of pregnancy in Bangladesh resulting from contraceptive failure

Khan

Islam

2022

Sci Rep

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“…No studies have previously utilised these approaches for examining chronic disease among women of reproductive age. Given that contraceptive use and risk of an unintended pregnancy is dynamic across the reproductive life course [ 16 ], we excluded women not at risk of a future unintended pregnancy at each of the time points. Few studies have accounted for this in longitudinal research [ 51 ].…”

Section: Discussionmentioning

confidence: 99%

“…Chronic disease is on the rise among women of reproductive age in Australia (and increasing with successive generations) [ 14 ]. Further, contraceptive patterns differ markedly by age, with younger women reporting higher use of multiple (often less effective) methods than older women [ 15 , 16 ]. This underscores the need to examine contraceptive patterns that better reflect ‘actual’ contraceptive practices.…”

Section: Introductionmentioning

confidence: 99%

Patterns of contraceptive use among young Australian women with chronic disease: findings from a prospective cohort study

et al. 2022

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Background Given chronic disease is increasing among young women and unintended pregnancies among these women are associated with poor maternal and fetal outcomes, these women would benefit from effective preconception care. However, there is a lack of understanding of how these women use or don’t use contraception to inform such interventions. This study examined patterns of contraceptive use among an Australian cohort of young women and investigated the influence of chronic disease on contraceptive use over time. Methods Using data from 15,244 young women from the Australian Longitudinal Study on Women’s Health (born 1989–1995), latent transition analysis was performed to identify distinct contraceptive patterns among women who were at risk of an unintended pregnancy. Multinomial mixed-effect models were used to evaluate the relationship between contraceptive combinations and chronic disease. Results Contraceptive use for women with cardiac and autoinflammatory diseases differed to women without chronic disease over the observation period. Compared to women without chronic disease using the pill, women with cardiac disease had double the odds of using ‘other’ contraception and condoms (OR = 2.20, 95% CI 1.34, 3.59) and a modest increase in the odds of using the combined oral contraceptive pill and condoms (OR = 1.39, 95% CI 1.03, 1.89). Compared to women without chronic disease who used the pill, women with autoinflammatory disease had increased odds of using LARC and condoms (OR = 1.58, 95% CI 1.04, 2.41), using ‘other’ contraception and condoms (OR = 1.69, 95% CI 1.11, 2.57), and using the combined oral contraceptive pill and condoms (OR = 1.38, 95% CI 1.09, 1.75). No differences in contraceptive patterns over the observation period were found for women with asthma or diabetes when compared to women without chronic disease. Conclusion The findings identified a need for effective contraceptive counselling as part of routine chronic disease care and improved communication between health care providers and women with chronic disease to improve young women’s contraceptive knowledge and agency in contraceptive choice, particularly for those with cardiac or autoinflammatory conditions. This may be the key to reducing high-risk unintended pregnancies among this vulnerable population.

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“…We were able to examine a comprehensive set of contraceptive methods (including prescription and non-prescription methods) and applied complex statistical modelling to accurately identify contraception use (including contraceptive combinations). We also considered the dynamic nature of contraceptive use and unintended pregnancy risk across the reproductive lifecourse in our analysis [19, 23]. Given 5,046 women were not at risk of an unintended pregnancy for at least one of the time points, this should be standard practice for future longitudinal contraceptive research.…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, method choice was complex amongst this group, with these women more likely to engage in permanent contraception or alternatively, low efficacy methods and no contraception. In this cohort, sterilisation was driven by partner vasectomy [19]. For women of older reproductive age with AICs who have completed their families or do not wish to have children, this finding is promising given that partner vasectomy is a more straight forward procedure with fewer risks than female sterilisation [27, 28].…”

Section: Discussionmentioning

confidence: 99%

Patterns of contraceptive use through later reproductive years: a prospective cohort study of Australian women with chronic disease

Egan

Forder

Bateson

et al. 2022

Preprint

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BackgroundPregnancies among women with chronic disease are associated with poor maternal and fetal outcomes. There is a need to understand how women use or don’t use contraception across their reproductive years to better inform the development of preconception care strategies to reduce high risk unintended pregnancies, including among women of older reproductive age. However, there is a lack of high-quality longitudinal evidence to inform such strategies. We examined patterns of contraceptive use among a population-based cohort of reproductive aged women and investigated how chronic disease influenced contraceptive use over time.Methods and FindingsContraceptive patterns from 8,030 women of reproductive age from the Australian Longitudinal Study on Women’s Health (1973-78 cohort), who were at potential risk of an unintended pregnancy were identified using latent transition analysis. Multinomial mixed-effect logistic regression models were used to evaluate the relationship between contraceptive combinations and chronic disease. Contraception non-use increased between 2006 and 2018 but was similar between women with and without chronic disease (13.6% vs. 12.7% among women aged 40-45 years in 2018). When specific contraceptive use patterns were examined over time, differences were found for women with autoinflammatory diseases only. These women had increased odds of using condom and natural methods (OR=1.20, 95% CI=1.00, 1.44), and sterilisation and other methods (OR=1.61, 95% CI=1.08, 2.39) or no contraception (OR=1.32, 95% CI=1.04, 1.66), compared to women without chronic disease using short-acting methods and condoms.ConclusionPotential gaps in the provision of appropriate contraceptive access and care exist for women with chronic disease, particularly for women diagnosed with autoinflammatory conditions. Development of national guidelines as well as a clear coordinated contraceptive strategy that begins in adolescence and is regularly reviewed during care management through their main reproductive years and into perimenopause is required to increase support for, and agency among, women with chronic disease.

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Contraceptive use among women through their later reproductive years: Findings from an Australian prospective cohort study

Cited by 15 publications

References 56 publications

Exploring rise of pregnancy in Bangladesh resulting from contraceptive failure

Exploring rise of pregnancy in Bangladesh resulting from contraceptive failure

Patterns of contraceptive use among young Australian women with chronic disease: findings from a prospective cohort study

Patterns of contraceptive use through later reproductive years: a prospective cohort study of Australian women with chronic disease

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