Avoiding unwanted births among Balinese women: The role of long-term contraceptives

INTRODUCTION: Some women express a clear desire to stop childbearing, yet go on to have more children in ensuing years. Determining which factors enable these women to accomplish their intentions could improve how family planning services are offered, particularly in resource-poor settings. METHODS: This longitudinal study was conducted in rural Bali, Indonesia, focussing on the 665 married women who declared their desire to stop child-bearing. Four years later, these women were re-surveyed. We used logistic regression to identify which factors seemed most predictive of their ability to avoid having additional births. RESULTS: Almost 30% of women who wanted no more children had a birth during the four-year study period. Only 68% of women who used no contraception at baseline avoided births, compared to 72% among women using a short-term method and 81% of those using a long-term method (p<.01). Women at highest risk for an unwanted birth were younger, had fewer children and did not use a long-term contraceptive method. Use of a short-term method, distance from the nearest health facility, educational level, and age at marriage were not significant. CONCLUSIONS: Our findings suggest that long-term contraceptive methods could benefit women who are not usually offered these methods, such as younger women and those with fewer children who desire to stop childbearing. Making a range of effective and appropriate methods available and affordable to all women has several advantages, such as increasing client satisfaction, promoting women's reproductive rights and preventing unwanted births.