Contraceptive discontinuation and unintended pregnancy: An imperfect relationship

Type Conference Paper - Intention and Contraception The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA
Title Contraceptive discontinuation and unintended pregnancy: An imperfect relationship
Author(s)
Publication (Day/Month/Year) 2006
URL https://guttmacher.org/pubs/journals/3705811.pdf
Abstract
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.

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