Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #103848

Shelly R. Koenemann, MPH¹, Debra Kalmuss, PhD¹, Carolyn L. Westhoff, MD, MSc², Linda F. Cushman, PhD¹, Tina Robilotto, MPH², Rebecca Podolsky, BA², and Deborah Horowitz, MPH². (1) Department of Population and Family Health, Mailman School of Public Health, Columbia University, 60 Haven Avenue, B-2, New York, NY 10032, 212-304-5633, shellykoenemann@ucsf.edu, (2) Department of Obstetrics and Gynecology and School of Public Health, Columbia University, 630 West 168th Street, PH 16-80, New York, NY 10032

Research on contraceptive discontinuation has overlooked a potential marker of risk; prior experiences with the method being initiated. This is particularly important for women starting oral contraceptives, who frequently have used the pill previously. In this paper, we examine the associations between the main reason for prior pill discontinuation and factors that may predict subsequent discontinuation.

The sample consists of 622 previous pill-users, a subset of women from a study of pill initiators recruited from family planning clinics in three university-based medical centers. 58% of the women reported that they had previously stopped the pill for logistical reasons, 19% for method side effects, and 24% no longer needed contraception.

Women who had previously stopped the pill for side effects had a shorter prior use interval and lower pill satisfaction. They were less likely to have been considering the pill when they came to the clinic that day and less likely to be very sure that they wanted to use the pill. They were more likely to report that a provider at the clinic had tried to convince them to use the pill and less likely to know how long they expected to use the pill this time.

These findings suggest that pill re-starters who have previously stopped because of side effects are at higher risk of subsequent discontinuation than those who had stopped because of no need for contraception or logistical reasons. Implications include the need to tailor contraceptive counseling messages to this group at high risk of pill discontinuation.

Learning Objectives: By the end of this session, participants will be able to

• Compare and contrast the differences in past pill experience and current perceptions of pill initiation among pill re-starters who previously stopped the pill for logistical reasons, side effects, or because they no longer needed contraception.
• Identify prior experiences with contraception as potential risk factors for subsequent discontinuation among method re-starters.
• Make inferences about the appropriateness and effectiveness of current contraceptive counseling methods for past pill users who previously discontinued the pill because of side effects.

Keywords: Contraception, Family Planning

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation