Factors influencing the return to fertility after contraceptive discontinuation among contraceptive ever-users in the Accra Metropolitan Area, Ghana
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Date
2015-11-09
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Abstract
Although more women in Ghana are opting for more reliable modern methods of family planning- trends in contraceptive use for married women (15-49 years) show an increase from 5% in 1988 to 17% in 2008 (GSS/GHS/ORC Macro 2009), the family planning acceptor rates in Ghana have fallen from 33.8% in 2008 to 31.1% in 2009 to as low as 23.5% in 2010 (GHS, 2010). Fear of adverse effects on subsequent fertility following reversible contraceptive use is an important concern for a number of women. Women explain that the fear of delayed return to fertility and even in some cases “infertility” after contraceptive use prevents them from using a long-acting method or taking up a family planning method, even after a service provider has been consulted.
This study aimed to assess the factors influencing return to fertility as measured by the time to pregnancy after discontinuing contraception. The influences of the factors were assessed before and after adjustment for the individual and lifestyle characteristics.
A Cox regression analysis was performed to estimate the influence of background and lifestyle characteristics on return to fertility among the women in this study. The probability to conceive after discontinuing a contraceptive method does not differ with respect to age, number of children, body mass index, history of gynecological disease, alcohol intake, secondary smoking, type of contraceptive and the duration of contraceptive usage.
As such, the issue of fear of side effects’ particularly future infertility, which can lead to contraceptive discontinuation should be a key point addressed during counseling for contraceptive use. Service providers should be educated and updated on the relationship between different socio-economic, demographic and lifestyle factors and return to fertility, such that they can provide adequate information to clients.
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A thesis submitted to the Department of Population, Family & Reproductive Health,
College of Health Sciences, School of Public Health, in partial fulfillment of the requirements for the degree of Master of Public Health in Population, Family and Reproductive Health, 2015