The dynamics of contraceptive use in Peru

Abstract

In 1986, the Demographic and Health Surveys project administered the first six-year calendar history of events that included women's contraceptive use and their reasons for discontinuation in experimental surveys in Peru and the Dominican Republic. In this report the experimental survey from Peru is examined to demonstrate how the calendar data can be used to calculate multiple increment-decrement life table rates of contraceptive discontinuation--including contraceptive failure, method switching, and abandonment of use--and of resumption of method use following discontinuation. These analyses reveal that nearly half of all Peruvian women who begin to use a method will stop using it within one year; 29 percent of women discontinue method use for nonpregnancy-related reasons within one year of initiating use. Women who switch methods do so frequently, and many will return to a method used previously, or move on to a third method. Women who become pregnant after abandoning contraceptive use have similar contraceptive-use patterns to women who experience a contraceptive failure.

PIP: An analysis of calendar data from January 1981 to interview date in 1986 (Demographic and Health Survey) on 1065 ever married Peruvian women who had ever used a contraceptive was used to show how researcher can use these data to calculate multiple increment-decrement life table rates of contraceptive discontinuation and renewed method use after discontinuation. 46.4% of women discontinued a method within 1 year. 29% discontinued a method for nonpregnancy related reasons within 1 year of use. Women who stopped using a method were more likely to switch directly to another method than not use any method. The risk of unplanned pregnancy was therefore low for these women. Women who discontinued use of a method but not switch directly to another method likely ceased having sexual intercourse, while others either ran out of supplies, were dissatisfied with the method, or could not find acceptable alternative methods. Regardless of the reason for not switching to another method after discontinuation, these women were at an increased risk of unplanned pregnancy. Women who discontinued a method and did not directly switch to another method were just as likely to return to the abandoned method as they were to switch to another method, but were likely to become pregnant before they returned to the abandoned method or switched to another method. Contraceptive use patterns of such pregnant women matched those of women whose contraceptives failed. Both groups of women tended to return to the method that failed. The considerable amount of method switching in a population may demonstrate either that women profit from a wide range of contraceptive choices or they cannot easily obtain and are not satisfied with currently available contraceptives. Since Peru had one of the weakest family planning programs in Latin America during the 1980s, the latter 2 reasons were most likely the case.