Experts highlight risks of contraceptive discontinuation for reasons other than pregnancy

EXPERTS have warned that contraceptive discontinuation for reasons other than the desire for pregnancy is associated with a high rate of unintended pregnancies leading to unsafe abortions, maternal morbidity and mortality.

In a new study, researchers had looked at the 2018 Nigeria Demographic and Health Surveys (NDHS) women’s dataset and found that 35.8 percent women discontinue using modern contraceptives with 45.8% (549) of the women doing so at risk of pregnancy.

According to the study, the commonest reasons for modern contraceptive discontinuation were the need to become pregnant (36.1%), followed by the need for a more effective method (19.1%), side effects/health concerns (14.1%), and becoming pregnant while using (13.4%).

In addition, the most modern method discontinued was Injectables (25.2%), followed by implants/Norplant (22.4%), lactation amenorrhea (16.4%), male condoms (15.7%), pills (12.8%), and IUD (6.0%). It was in the journal, Contraception and Reproductive Medicine.

The study said associated factors of modern contraceptive discontinuation among sexually active married women in Nigeria were: marital duration, visitation to a health facility in the last 12 months before the survey, education and region of residence.

Out of 3,353 sexually active married/in union women who had ever used a modern contraceptive five years before the survey and with complete reproductive histories and are not sterilised or declared infecund, 35.8% (1199) discontinued contraceptives and 64.2% (2,154) did not discontinue using a modern contraceptive.

The data revealed that women in the North-West and women in the South West have higher odds of modern contraceptive discontinuation than women in the North-Central. Also, the higher the educational level, the lower the modern contraceptive discontinuation.

The researchers, however, suggested that health care providers address the discontinuation of contraception through counselling, particularly among women who reside in the region of high prevalence of contraceptive discontinuation, short-term users as well as strengthen the use of contraception among those who are still at risk of becoming pregnant.

“Discontinuation of contraceptive use while women are still at risk of becoming pregnant without switching to any other contraceptive methods has adverse reproductive health consequences. It has adverse effects on family planning programmes as well as grave implications for demographic growth.

“This high rate of modern contraceptive discontinuation could cause Nigeria to lose the progress made in increasing contraceptive use over the past 20 years.

“Governments and stakeholders should also partner with private sectors to make health care accessible to women by bringing health facilities closer to them to improve facility visitation.”

Studies on maternal mortality have shown that about 44% of maternal deaths were prevented through the consistent use of contraceptives.