Why are temporary methods of contraception not popular even among urban women? - A Qualitative study

Abstract

Introduction:  Tamil Nadu, has drastically brought down its birth rate (15) and Total fertility rate (1.7). This success could be attributed to increased female sterilization, while use of temporary contraceptives which is essential to avoid unwanted pregnancies and space births continuous to be very low. The main objective of this qualitative study is to understand why temporary methods of contraception are not popular even among urban women and reasons for poor acceptance and high discontinuation rates. Material and Methods: In-depth interviews and Focus group discussions were conducted with women adopting one or other methods of contraceptives and those not adopting any. Focus group discussion was also conducted with service providers of urban health Centre. Results: Inadequate knowledge, fear of side effects and lack of spousal support were reasons for poor adoption and high discontinuation rates of temporary contraceptives. Misconceptions about fertility and opting for abortion to space births are other reasons for not using contraceptives. Service providers recommend women with two or more children to adopt tubectomy and Copper-T for those who should space births, information of other temporary methods is not provided routinely. Service providers hesitate to promote Emergency oral contraceptive pills for fear of routine use by women. Women suggested that couple counselling and information sharing through social media will promote increased use of temporary methods of contraception. Conclusion: Couples should be educated about the various contraceptives available, its side effects, advantages, importance of birth spacing and risks of repeated abortions and given the option to choose. Proper screenings of cases, adoption of correct techniques, efficient couple counselling and a good follow up care will promote increased use of temporary methods of contraception.