The 130th Annual Meeting of APHA

Abstract #48335

M. E. Khan, PhD¹, Shampa Maria D'Costa, MA², and Moshiur Rahman². (1) Bangladesh Country Office, Population Council, Asia & Near East Region, House CES (B) 21, Road 118, Gulshan, Dhaka, Bangladesh, 8802-8821227, mekhan@pcdhaka.org, (2) House Number 21, Popualtion Council, Road #118, Gulshan, Dhaka, Bangladesh

In Bangladesh, oral contraceptive pills (OCP) contribute more than 50 percent of the contraceptive use. Available studies however, shows high discontinuation rate of pills. The BDHS shows that 31 percent of births are unwanted.

The paper based on 81 in-depth case studies, analyses contraceptive use dynamics and its determinants in Bangladesh with special attention to the use and discontinuation of OCP.

The study shows that birth interval is an important consideration for contraception. On average a woman in Bangladesh adopts and discontinue contraception 5 times, uses 3 contraceptive methods and adopts OCP 2.7 times. The main cause of discontinuation of pills was menstrual side effects. However, probing shows that the real cause was the tension in family and conjugal relationship triggered by these side effects. Considering the “cost” of unwanted pregnancy, many women were ready to bear the side effects but the hassle, which they faced in performing household chores, or conjugal relationship, forced them to discontinue the method. Slow decision-making process often delayed in switching to other contraceptive methods and thus exposed them to the risk of unwanted pregnancy. The informants reported many such unwanted pregnancies. Misconception that continuous use of pills cause infertility, pregnancy due to missing pills and poor counselling by the providers were other causes of frequent discontinuation of pills.

Learning Objectives:

• · Provides information on the decision making process of acceptance, continuation or discontinuation of contraception.
• · Provides insight why OCP are so frequently discontinued and possible remedies.

Keywords: Family Planning, Contraceptives

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Population Council
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.