Farwa Rizvi, Ghazia Irfan


Background: High rates of contraceptive discontinuation for reasons other than the desire for
pregnancy are a public health concern because of their association with negative reproductive health
outcomes. The objective of this study was to determine reasons for discontinuation of contraceptive
methods among couples with different family size and educational status. Methods: This crosssectional study was carried out at the Obstetrics/Gynaecology Out-Patient Department of Pakistan
Institute of Medical Sciences, Islamabad from April–September 2012. Patients (241) were selected by
consecutive sampling after informed written consent and acquiring approval of Ethical Committee. The
survey interview tool was a semi-structured questionnaire. Results: Majority (68%) of women
belonged to urban, and the rest were from rural areas. Mean age of these women was 29.43±5.384 year.
Reasons for discontinuation of contraceptives included fear of injectable contraceptives (2.9%),
contraceptive failure/pregnancy (7.46%), desire to become pregnant (63.48%), husband away at job
(2.49%), health concerns/side effects (16.18%), affordability (0.83%), inconvenient to use (1.24%),
acceptability (0.83%) and accessibility/lack of information (4.56%). Association of different reasons of
discontinuation (chi square test) with the family size (actual number of children) was significant
(p=0.019) but was not significant with husband’s or wife’s educational status (p=0.33 and 0.285
respectively). Conclusions: Keeping in mind the complex socioeconomic conditions in our country,
Family planning programmers and stake holders need to identify women who strongly want to avoid a
pregnancy and finding ways to help the couples successfully initiate and maintain appropriate
contraceptive use.
Keywords: Contraceptives, discontinuation, side effects

Full Text:



Blanc A, Curtis S, Croft T. Monitoring contraceptive

continuation: links to fertility outcomes and quality of care. Stud

Fam Plann 2002;33(2):127–40.

Shah I, Comparative Analysis of Contraceptive Method Choice,

in Demographic and Health Surveys World Conference,

Proceedings, Volume I, IRD/Macro International, Columbia,

Maryland 1991.

Khan MA. Side effects and oral contraceptive discontinuation in

rural Bangladesh. Contraception 2001;64(3):161–7.

Tolley E, Loza S, Kafafi L, Cummings S. The impact of

menstrual side effects on contraceptive discontinuations: findings

from a longitudinal study in Cairo Egypt. International Fam

Plann Perspectives 2005;31(1):15–23.

Population Reference Bureau. Family planning saves lives.

Washington, DC: Population Reference Bureau; 1998.

Choe MK, Luther NY, Pandey A, Sahu D, Chand J. Identifying

children with high mortality risk. National Family Health Survey

Bulletin 1999;12.

Central Bureau of Statistics (CBS), Ministry of Health (MoH)

and ORC Macro, Kenya Demographic and Health Survey, 2003,

Calverton, MD, USA: CBS, MOH and ORC Macro; 2004.

Bradley SEK, Schwandt HM, Khan S. Levels, Trends, and

Reasons for Contraceptive Discontinuation; DHS Analytical

Studies 20. Calverton, Maryland, USA: ICF Macro; 2009.

United Nations (UN). A/CONF.171/13: Report of the

International Conference on Population and Development 1994.

Available at:


Westoff, CF. New estimates of unmet need and the demand for

family planning. DHS Comparative Reports 2006. No. 14.

Calverton, Maryland: Macro International Inc; 2006.

Sedgh G, Hussain R, Bankole A, Singh S. Women with an unmet

need for contraception in developing countries and their reasons

for not using a method. Occasional Report No. 37, New York:

Guttmacher Institute; 2007.

Westoff CF, Cross AR. The stall in the fertility transition in

Kenya. DHS Analytical Studies No. 9. Calverton, Maryland:

ORC Macro; 2006.

Lutalo T, Kidugavu M, Wawer MJ, Serwadda D, Zabin LS, Gray

RH. Trends and determinants of contraceptive use in Rakai

District, Uganda, 1995–98. Stud Fam Plann 2000;31(3):217–27.

Fakhr El-Islam M, Malasi TH, Abu-Dagga SI. Oral

contraceptives, socio cultural beliefs and psychiatric symptoms.

Soc Sci Med 1988;27:941–5.

Esseghairi, K., Hinde, P.R., McDonald, J.W. and Meddeb,

S. (1991) IUD and pill use dynamics in Tunisia and

Morocco. In, Proceedings of the Demographic and Health

Survey World Conference, August 507, 1991, Washington

DC. Demographic and Health Survey World

Conference Columbia, USA, Institute for Resource Development

/ Macro International; 1991.p. 2119–34.

Ahmed G, Liner EC, Williamson NE, and Schellstede WP.

Characteristics of condom use and associated problems:

Experience in Bangladesh. Contraception 1990;42:523–33.

Ali M, Cleland J. Determinants of contraceptive discontinuation

in six developing countries. J Biosoc Sci 1999;31:343–60.

Steele F, Diamond I. Contraceptive switching in Bangladesh.

Stud Fam Plann 1999;30:315–28.

Moreno L. Differences by residence and education in

contraceptive failure rates in developing countries. Int Fam Plann

Perspect 1993;19(2):54–60, 71.

Riley AP, Stewart MK, Chakraborty J. Program- and methodrelated determinants of first DMPA use duration in rural

Bangladesh. Stud Fam Plann 1994;25:255–67.

Curtis SL, and Blanc A. Determinants of contraceptive failure,

switching, and discontinuation: An analysis of DHS

contraceptive histories. DHS Analytical reports 6. Calverton,

Maryland: Macro International Inc; 1997.


  • There are currently no refbacks.

Contact Number: +92-992-382571

email: [jamc] [@] []