What differentiates method switchers from discontinuers? An examination of characteristics between women who switched contraceptive methods and women who discontinued all methods

Contraceptive discontinuation is an important public health concern, especially when women at risk of an unwanted pregnancy do not effectively switch to another method. This study examines the differences between women who reinitiate contraceptive use immediately after a discontinuation (i.e. switch methods) and women who discontinue use and do not immediately begin another method (i.e. experience an episode of non-use). We aim to characterize method switchers in contrast to discontinuers/non-switchers and to use the comparisons to identify programmatic implications. The data for the analysis come from a panel study conducted in 2006 and 2007 with 671 women aged 15-44 in four areas of Honduras. A bivariate analysis shows that women who switched to another method after discontinuation are significantly different than women who did not switch (by demographic characteristics, fertility desires, perception of service quality, method characteristics, experience with side effects, communication with others, and main reason for method discontinuation). A multivariate logistic regression with these indicators shows that living in an urban area, being a new method user, seeking help from a clinic or health worker when experiencing side effects, and discussing the decision to stop using the method with a partner, increase the likelihood of switching methods. In contrast, experiencing amenorrhea as a side effect is significantly related to a decreased likelihood of switching methods. One recommendation is that family planning practitioners encourage women to speak with a health worker when experiencing side effects with a method, particularly women adopting methods with amenorrhea as a possible side effect.