Contraceptive discontinuation refers to when a person starts contraceptive use and then stops it for any reason while still being at risk for unintended pregnancy. Contraceptive discontinuation may lead to unintended pregnancies, thereby reducing the impact of family planning programs.
There are several reasons users discontinue contraception. Frequently cited reasons are method related concerns and side effects such as amenorrhea, prolonged or heavy bleeding, and other changes in menstruation. Myths and misconceptions also contribute towards discontinuation as well as a poor service environment. The service environment includes availability of commodities, service quality inclusive of providers behavior and attitudes, and referral mechanisms in place.
Social and behavior change (SBC) plays a crucial role in preventing contraceptive discontinuation. SBC interventions can help optimize the quality of counseling by providers, enabling clients to choose methods that will enable voluntary continuation. With optimal counseling, clients are well aware of the side effects of their preferred method and see these side effects as normal if they occur. Interventions focused on provider behavior can also improve provider attitudes and strengthen referral mechanisms.
In this Trending Topic, we share resources and tools which would help readers understand the drivers of contraceptive discontinuation, and how SBC interventions can be effectively used to prevent discontinuation. If you have materials on discontinuation you would like to share with us, please upload the items, or contact us at firstname.lastname@example.org.
For Additional Reading
- Danna, K., Angel, A., Kuznicki, J., Lemoine, L., Lerma, K., & Kalamar, A. (2021). Leveraging the client-provider interaction to address contraceptive discontinuation: A scoping review of the evidence that links them. Global Health: Science and Practice, 9(4), 948-963. https://doi.org/10.9745/GHSP-D-21-00235.
- Tin, K.N., Maung, T.M. & Win, T. (2020). Factors that affect the discontinuation of family planning methods in Myanmar: analysis of the 2015–16 Myanmar Demographic and Health Survey. Contraception and Reproductive Medicine 5,20. https://doi.org/10.1186/s40834-020-00126-5.
- Schwandt, H., Boulware, A., Corey, J., Herrerra, A., Hudler, E., Imbabazi, C., King, I., Linus, J., Manzi, I., Merrit, M., Mezier, L., Miller, A., Morris, H., Musemakweli, D., Musekura, U., Mutuyimana, D., Ntakarutimana, C., Patel, N., Scanteianu, A., … Feinberg, S. (2021). Family planning providers and contraceptive users in Rwanda employ strategies to prevent discontinuation. BMC Women’s Health21,361 (2021). https://doi.org/10.1186/s12905-021-01503-1.