“If I use family planning, I may have trouble getting pregnant next time I want to”: A multicountry survey-based exploration of perceived contraceptive-induced fertility impairment and its relationship to contraceptive behaviors

Bell, Suzanne O.; Karp, Celia; Gemmill, Alison

doi:10.1016/j.conx.2023.100093

Cited by 3 publications

(2 citation statements)

References 24 publications

(43 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Fears that long-term use will lead to infertility may be less concerning for women who wish to end childbearing, but few quantitative studies have explicitly explored whether the in uence of fears related to contraceptive induced infertility vary by age or parity level. A recent multi-country study by Bell and colleagues found some evidence of greater perceptions of contraceptive-induced fertility impairment among women with fewer children in several geographies, but patterns by age were less consistent (23).…”

Section: Introductionmentioning

confidence: 99%

Variation in the influence of concerns about contraceptive-induced fertility impairment on hormonal contraceptive use by parity and residence; evidence from PMA Ethiopia 2020 cross- sectional survey

Zimmerman

Karp

Shiferaw

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

Background Fear of contraceptive-induced fertility impairment is a major deterrent to contraceptive use, however, few studies have explored whether and how this fear varies by life course or residence. Objectives We use cross-sectional nationally representative data from the 2020 PMA Ethiopia survey to describe patterns of concerns about contraceptive-induced infertility, assess the relationship between these concerns and current contraceptive use and assess whether these relationships vary by parity and residence. Methods We use descriptive statistics among a sample of 7,491 women, age 15-49, to assess agreement with the statement “If I use family planning, I may have trouble getting pregnant next time I want to”, a proxy for concerns about contraceptive-induced fertility impairment. We use multilevel hierarchical models to assess how agreement is associated with the use of a hormonal method of contraception among 3,882 sexually active, fecund women who wish to prevent pregnancy. We include interaction terms for parity and residence. Results About six in ten women disagreed (42.3%) or strongly disagreed (20.7%) with the statement. Relative to women who strongly disagreed, women who disagreed and women who agreed had significantly lower odds of using a hormonal method of contraception (aOR: 0.65, 95% CI: 0.44-0.97 and 0.46, 95% CI: 0.46, 95% CI: 0.30-0.70). This effect was strongest among high parity women (aOR: 0.54, 95% CI: 0.30-0.95). Greater agreement with the statement at the community-level use was associated with a reduction in the odds of using hormonal contraception, but only among rural women. Discussion While the majority of women in Ethiopia either disagree or strongly disagree that use of hormonal contraception may influence fertility, efforts to address this concern, particularly amongst high-parity women and in rural communities, through the provision of comprehensive counseling and through community education or other mass media campaigns are necessary. Incorporation of comprehensive counseling, particularly as a part of postpartum care, is an opportunity to address concerns about contraceptive-induced infertility.

show abstract

Section: Introductionmentioning

confidence: 99%

Variation in the influence of concerns about contraceptive-induced fertility impairment on hormonal contraceptive use by parity and residence; evidence from PMA Ethiopia 2020 cross- sectional survey

Zimmerman

Karp

Shiferaw

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…In many regions of the world, especially where pressure to bear children is significant ( Dyer 2007 ; Hollos et al 2009 ), these barriers are pervasive and expressed by both men and women ( Bornstein et al 2020 ; Sedlander et al 2018 ). Historically, these concerns have been dismissed as “misperceptions,” but emerging evidence indicates that such beliefs may in fact be rooted in personal experience or observations of others’ slower-than-expected returns of fecundity following contraceptive discontinuation ( Bell et al 2023 ).…”

Section: Introductionmentioning

confidence: 99%

The Relationship Between Contraceptive Method Use and Return of Fecundity Among Women Attempting Pregnancy in Low- and Middle-Income Countries

et al. 2023

Self Cite

View full text Add to dashboard Cite

One of the most common barriers to using effective family planning methods is the belief that hormonal contraceptives and contraceptive devices have adverse effects on future fertility. Recent evidence from high-income settings suggests that some hormonal contraceptive methods are associated with delays in return of fecundity, yet it is unclear if these findings generalize to low- and middle-income populations, especially in regions where the injectable is widely used and pressure to bear children is significant. Using reproductive calendar data pooled across 47 Demographic and Health Surveys, we find that the unadjusted 12-month probability of pregnancy for women attempting pregnancy after discontinuing traditional methods, condoms, the pill, and the IUD ranged from 86% to 91%. The 12-month probability was lowest among those who discontinued injectables and implants, with approximately 1 out of 5 women not becoming pregnant within one year after discontinuation. Results from multivariable analysis showed that compared with users of either periodic abstinence or withdrawal, users of the pill, IUD, injectable, and implant had lower fecundability following discontinuation, with the largest reductions occurring among women who used injectables and implants. These findings indicate that women's concerns about potential short-term reductions in fecundity following contraceptive use are not unfounded.

show abstract

Concern that contraception affects future fertility: How common is this concern among young people and does it stop them from using contraception?

Watson,

Yarger,

Sedlander

et al. 2023

Contraception: X

View full text Add to dashboard Cite

“If I use family planning, I may have trouble getting pregnant next time I want to”: A multicountry survey-based exploration of perceived contraceptive-induced fertility impairment and its relationship to contraceptive behaviors

Cited by 3 publications

References 24 publications

Variation in the influence of concerns about contraceptive-induced fertility impairment on hormonal contraceptive use by parity and residence; evidence from PMA Ethiopia 2020 cross- sectional survey

Variation in the influence of concerns about contraceptive-induced fertility impairment on hormonal contraceptive use by parity and residence; evidence from PMA Ethiopia 2020 cross- sectional survey

The Relationship Between Contraceptive Method Use and Return of Fecundity Among Women Attempting Pregnancy in Low- and Middle-Income Countries

Concern that contraception affects future fertility: How common is this concern among young people and does it stop them from using contraception?

Contact Info

Product

Resources

About