Patient Perspectives on Contraceptive use in North India: A Case for Increased Contraceptive Counseling by Providers

Sneha Mittal^1,2 · Vineeta Gupta¹ · Namrata Saxena¹ · Kirti Lata¹

Vineeta Gupta vineetahims@yahoo.co.in 1 Department of Obstetrics and Gynaecology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India 2 Present Address: University of Tennessee Health Science Center College of Medicine, Memphis, TN, USA

Sneha Mittal is a Visiting Student; Vineeta Gupta is Professor and Head of Department; Namrata Saxena is Professor; Kirti Lata is a Junior Resident.

Background Given the underutilization of contraception in India, this study was undertaken to gauge cisgender female clients’ knowledge of, attitudes toward, and barriers to contraceptive usage in North India.

Methodology The present study was done at a tertiary care Institute in North India, where 209 structured interviews were conducted with cisgender female patients attending the outpatient department. One-way chi-square tests for independence, Kruskal–Wallis test, and Wilcoxon test were applied to quantitative data. Themes from qualitative questions were coded and analyzed.

Results Differences in awareness among contraceptives were found to be highly statistically significant (H (9) = 1022.3, p < 2.2 e−16). Friends or colleagues comprised the predominant information source for most contraceptive methods. Participants’ contraceptive usage was low, with 27.27% stating no prior use and 47.47% indicating occasional use (X2 (3, N = 198) = 66.121, p < 2.89 e−14). Lack of perceived need, concern for side effects, fear and desire for children were top reasons for non-use of contraceptive methods. Majority of the participants (79.45%) expressed comfort speaking with their spouse about contraception, 47.18% with a medical provider, 32.82% with friends, 15.38% with family, 2.05% with a health educator, and 3.59% with no one. Participants indicated little prior contraceptive counseling experience.

Conclusion Our study shows differential levels of awareness, usage, and barriers on contraceptive methods among participants. Results also suggest the importance of spouses and friends in clients’ contraceptive decision- making process and their limited counseling experience with health care providers.

Keywords : Contraception · Knowledge · Attitudes · Contraceptive usage · Barriers

Despite the expansion of modern contraceptive methods worldwide, estimates show that nearly 121 million unintended pregnancies, 48% of all pregnancies, occur every year [1]. In India, about 62 per 1000 of all pregnancies for women1 aged 15–49 from 2015 to 2019 were estimated to be unintended [1].

Conflict of interest Our study had no conflict of interest.

Ethical Approval Institutional ethical committee clearance was obtained for study. The study has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The authors hereby declare that the article is original; neither the article nor a part of it is under consideration for publication anywhere else and has not been previously published anywhere. We have declared all vested interests. We have meticulously followed the instructions. The article if published shall be the property of the journal.

Informed Consent Informed consent was obtained from all patients included in study.

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