Determinants of Intrauterine Contraceptive Device Discontinuation Among Indian Women

Abstract

Objective To determine intrauterine contraceptive device (IUCD) discontinuation rate and its causes and related factors among women attending the OPD/family planning clinic in Mahila Chikitasalaya, SMS Medical College, Jaipur from January 2012 to December 2012. Methods 387 women who had an intrauterine device (IUD) inserted during the last 1-5 years were interviewed during their visits to the OPD/family planning clinic. Sociodemographic characteristics for all women were described using frequency distribution. Life tables were used to describe the proportion of women who discontinued IUD at various time intervals. The main outcome measure was IUD discontinuation. Results The incidence of IUD discontinuation in the first year following insertion was 16.79 %. Approximately 31 % of the study sample continued using their devices after 5 years. The average duration of IUD use was 36 months. Of the 387 women, 56 % discontinued IUD use because of a desire to conceive, 27.7 % because of side effects, 15.36 % because of opposition from the woman's family, and 1.5 % because they were sexually inactive. The most common side effects reported as the reasons for discontinuation were bleeding, infection, and pain. Discontinuation was inversely related to the age at insertion, the number of living children, and the sex of children. Previous contraceptive users were significantly less likely to discontinue IUD use. Conclusions The crude cumulative rate of IUD discontinuation was 16.79 % during the first year, suggesting a need to tackle the problem of discontinuation through effective educational strategies and counseling techniques. Desire to have a male child still predominates among Indian families. The average duration of IUD use in majority of the females was about 36 months (45 %), thereby fulfilling its objective of spacing between children as laid down by the WHO (2 years spacing between pregnancies). About 31 % of the women continued using IUCD even after 5 years. It is crucial to correct misconceptions and identify the lack of correct and complete information both among the providers and the acceptors, to improve the effectiveness of family planning programs.

<p>Perception And Use Of Intrauterine Contraceptive Devices (IUCD) Among Married Women Of Reproductive Age In Bhaktapur, Nepal</p>

“…Among 12 previous users of IUCD in our study, 58.3% stopped using IUCD to get pregnant. The proportion of women stopping IUCD was similar to a 2012 study in Jaipur, India,16 where 55.13% stopped IUCD use because of their desire to conceive. More than one-third (34.0%) in 2011 discontinued IUCD for the same reason in Pakistan,17 while 12.2% also wanted a child in another study in Nepal 18.…”

A prospective interventional study of intra-caesarean copper intrauterine contraceptive devices insertion in a teaching hospital in a rural medical college in Telangana, India

“…11 The discontinuation in the first 12 months of use was mostly due to side effects like irregular bleeding, menorrhagia, infection and pain. 15.36% had copper IUCD removed because of family opposition in a study by Sharma M et al 15 The main reason for acceptance was awareness about its reversibility (73.62%) and safety and effectiveness of PPIUCD (69.96%) as in a study by Urmila et al 14 Reasons for non-acceptance was refusal by partner/family members (72.75%) and fear of complications (70.05%) as in a study by Ashutosh et al 16 Absence of uterine perforation and low incidence of infection are strong indicators of safety of PPIUCD. 14 With effectiveness greater than 99% and being one of LARC methods, copper IUCD is the most effective reversible contraceptive with highest continuation rates.…”

Evaluation of postpartum intrauterine contraceptive devices (IUCD) insertion: 5 years study

“…5 In the present study the major reasons for non-acceptance of CU-T are preference to another contraceptive and family opposition, similar result was found in study conducted by Sharma Megha et al , family opposition remains second most common cause whereas side effects of CU-T from previous use becomes the first major reason. 6 According to the study conducted in India to explore the reasons for non-acceptance of PPIUCD, the most common reasons are nonawareness of contraceptive methods, misbelieves about copper-t, male child preference. 7 The acceptance rate was more in the young age groups 18-25 years (33.8%) and 26-30 years (30.1%) in present study, and according to study conducted by Kafiye Eroglua et al , the maximum number of patients i.e.…”