Study on the factors associated with contraceptive discontinuations in Bangkok

Detailed information was collected from 666 cohorts of pill, injectable-DMPA and IUD acceptors at 14 Bangkok Metropolis Health Clinics (MHCs). The contraceptive status at 12-month follow-up home interview showed that 47% of pill acceptors, 39% of DMPA acceptors and 55% of IUD acceptors were still using the same contraceptive method and receiving them from the original source. The women who initially adopted the pill could seek the oral contraceptive from other sources with a higher significant percentage (14%) than was found in the DMPA and IUD group. The DMPA group revealed the lowest percent of using same method and same source but higher rate of clinic switch (15%), including method and clinic switch (18%), than the pill and IUD acceptors. The women who adopted the pill had stopped using any contraceptive method with the highest percentage (31%). The main reason for method switch among the three contraceptive acceptors was disagreeable health effects; 50% for pill acceptors, 75% for DMPA acceptors and 49% for IUD acceptors. Another important reason for IUD switch was a 32% expulsion of IUD. Those who switched clinic gave the three important reasons of distance inconvenience, opening hour inconvenience and disagreeable health effects. Service-related factors are likely to play a less important role in determining discontinuation of the pill and DMPA, while the reasons on doctors objecting to removing the IUD appear to be the major service-related factor in discontinuation of IUD (19%). The decision to stop using any contraceptive appeared to be related to dissatisfaction with the method and side effects was the primary reason and the secondary reason was that they wanted another child. The majority of the contraceptive discontinuers were in need of family planning (FP) (93%) and this group of women actually needs to be motivated for family planning.