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APHA Scientific Session and Event Listing

Recorded presentation

Sian L. Curtis, PhD¹, Emily M. Evens, MPH², and William Sambisa, PhD². (1) MEASURE Evaluation, Carolina Population Center, UNC-Chapel Hill, 123 West Franklin Street, CB# 8120 University Square East, Chapel Hill, NC, NC 27516-3997, (919) 966-1737, sian_curtis@unc.edu, (2) Carolina Population Center, UNC-Chapel Hill, CB# 8120, University Square, 123 West Franklin Street, Chapel Hill, NC 27516-2524

This paper expands evidence on the relationship between the discontinuation of contraception and pregnancy intentions. Contraceptive discontinuation is a common event both domestically and internationally and is associated with negative reproductive health outcomes such as unintended pregnancy and induced abortion. Discontinuation is the result of a complex interplay between the motivation to avoid pregnancy and the acceptability of available contraceptive methods and does not appear to be readily amenable to existing programmatic interventions. The decision to continue or discontinue contraception involves trade-offs, the weighing of advantages and disadvantages, and the consideration of current circumstances and fertility desires. Understanding these dynamics will help to rethink the design of interventions to assist couples to achieve their reproductive goals in contexts of moderate to high contraceptive use where the majority of unintended pregnancy is associated with contraceptive discontinuation or failure.

The fact that not all women who discontinue contraceptives for reasons other than the desire for pregnancy go on to report their pregnancies as unintended suggests that underlying variation in motivation to avoid pregnancy plays a role in the discontinuation process. This study examines the extent to which women report pregnancies following discontinuation as unintended and the associated determinants. Random effects models will be used to model the latent characteristics of individual motivation to avoid pregnancy. Data for this study come from Demographic and Health Surveys conducted in Bangladesh, Dominican Republic, Kazakhstan, Kenya, the Philippines, and Zimbabwe.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Identify the major reasons why women discontinue contraception and the consequences of discontinuation in developing countries.
• Articulate the relationship between contraceptive discontinuation and pregnancy intentions.

Keywords: Contraception, International Reproductive Health

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation