Barriers to contraceptive use in adult women attending a tertiary referral hospital

Abstract

The purpose of this study was to recognise the barriers to unprotected intercourse in adult married women who were not keen for pregnancy. Focus Group discussion in groups of 8-10 women were held among women attending OPD of Obstetrics and Gynaecology Department of SCB Medical College, Cuttack. We interviewed 1840 adult married women out of which 1000 (54%) did not adopt any contraceptive measure. These women were included in Focus Group Discussion over a period of 6 months, aged between 18 to 45 years who were not desirous of pregnancy, to explore the possible reasons for unprotected intercourse. Women were grouped on the basis of the following characteristics: Age, Parity status, literacy, Place of residence-Rural/Urban, Religion and Socio-economic status (using Modified Kuppuswamy score). Women on an average gave 5 reasons for non-adherence to contraception. The reasons were further categorised at Personal, Interpersonal and Social levels. Common personal reasons cited were fear of complications or side-effects associated with contraception either established or self-perceived, and assumed low risk of pregnancy. The spectrum of barriers for unprotected intercourse are varied. Educational status of the woman as well as of the spouse plays a significant influence on a woman’s contraception usage, hence, in addition to a personalised counselling approach of the couple, shared decision making should be encouraged.