Skip to main content
American Journal of Public Health logoLink to American Journal of Public Health
. 1997 Sep;87(9):1532–1534. doi: 10.2105/ajph.87.9.1532

Injectable contraceptive discontinuation and subsequent unintended pregnancy among low-income women.

A R Davidson 1, D Kalmuss 1, L F Cushman 1, D Romero 1, S Heartwell 1, M Rulin 1
PMCID: PMC1380984  PMID: 9314810

Abstract

OBJECTIVES: This study investigated rates of discontinuation of the recently introduced injectable contraceptive depot medroxyprogesterone acetate (DMPA) and postdiscontinuation rates of unprotected intercourse and unintended pregnancy. METHODS: A sample of 402 low-income, urban, minority women were interviewed when they initiated DMPA use and 12 months later. RESULTS: The 12-month life-table discontinuation rate was 58%, with half of the discontinuers stopping after only one injection. Menstrual changes and other side effects were the most frequently cited reasons for discontinuation. Approximately half of the discontinuers at risk for unintended pregnancy either did not make the transition to another contraceptive or used contraception only sporadically. The cumulative unintended pregnancy rate by 9 months postdiscontinuation was 20%. CONCLUSIONS: DMPA initiators were at substantial risk for unintended pregnancy because most quickly discontinued use and did not make the transition to consistent use of another contraceptive.

Full text

PDF
1532

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Berenson A. B., Wiemann C. M. Use of levonorgestrel implants versus oral contraceptives in adolescence: a case-control study. Am J Obstet Gynecol. 1995 Apr;172(4 Pt 1):1128–1137. doi: 10.1016/0002-9378(95)91471-4. [DOI] [PubMed] [Google Scholar]
  2. Kalmuss D., Davidson A. R., Cushman L. F., Heartwell S., Rulin M. Determinants of early implant discontinuation among low-income women. Fam Plann Perspect. 1996 Nov-Dec;28(6):256–260. [PubMed] [Google Scholar]
  3. Oakley D., Sereika S., Bogue E. L. Oral contraceptive pill use after an initial visit to a family planning clinic. Fam Plann Perspect. 1991 Jul-Aug;23(4):150–154. [PubMed] [Google Scholar]
  4. Polaneczky M., Guarnaccia M., Alon J., Wiley J. Early experience with the contraceptive use of depot medroxyprogesterone acetate in an inner-city clinic population. Fam Plann Perspect. 1996 Jul-Aug;28(4):174–178. [PubMed] [Google Scholar]
  5. Sangi-Haghpeykar H., Poindexter A. N., 3rd, Bateman L., Ditmore J. R. Experiences of injectable contraceptive users in an urban setting. Obstet Gynecol. 1996 Aug;88(2):227–233. doi: 10.1016/0029-7844(96)00194-9. [DOI] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES