Acceptability of Norplant-2 rods as a method of family planning

Abstract

The Norplant-2 rod system consists of two silastic rods in which levonogestrel has been incorporated with the polymer. The continuation rate at the end of five year was 62%. No accidental pregnancies occurred throughout the five years of use. The post-removal conception rate in women desiring pregnancy was 70.8% at the end of two years. The majority of acceptors were happy with the rods and 86.8% expressed the desire to have another set of implants inserted following removal of the first set. The study shows the Norplant-2 rod system to be a well accepted method of family planning.

PIP: Physicians from the National University Hospital, Singapore enrolled 100 women between December 1985-March 1986 in a 5 year study of the efficacy, acceptability, and reversibility of Norplant-2 rods. They examined them at 1, 3, 6, and 12 months and 2 times each year thereafter. All women returned. No one had an unintended pregnancy. The leading reason for removal was planning a pregnancy (24 of 38 removals). The 8 removals for menstrual problems occurred during the 1st 2 years. Of the 24 women, 6 changed their minds about having another child and used other family planning methods. 58.3% of the 24 women (77.7% of the 18 women who still wanted to conceive) were pregnant within 3 months after removal. At the end of 2 years, only 1 woman did not become pregnant (70.8% of 24 and 94.4% of 18) probably because she was experiencing subfertility since she was 44 years old. All 17 women gave birth vaginally to healthy full term infants. The physicians removed the rods from the 62 women who still had a Norplant-2 system at the end of 5 years. 87.1% (52) found the Norplant-2 system very favorable. No woman said it was not favorable. Further all 62 women were satisfied with all the information they received about the Norplant-2 system. 74.2% thought Norplant-2's ease of use/convenience was its best attribute and 24.2% said it was the low risk of pregnancy. Moreover 48.4% did not think negatively about Norplant-2. The least liked attribute was menstrual pattern changes (35.5%). 4 women complained about the removal procedure being painful, yet 3 requested a 2nd set of Norplant-2 rods. In fact, 86.8% of the women who intended to use contraception after removal chose Norplant-2 rods. Of the 9 women who did not plan to use contraception, 7 planned to conceive and 2 were widowed. In conclusion, Norplant-2 system is safe and efficient. Further it has an advantage over the Norplant-6 system--ease of insertion and removal.