What differentiates method stoppers from switchers? Contraceptive discontinuation and switching among Honduran women.

CONTEXT Contraceptive discontinuation contributes to unplanned pregnancy and unwanted births, as well as increased maternal, neonatal and infant morbidity and mortality. Information on differences between women who stop using contraceptives and those who switch to another method would be useful for programs aimed at preventing unplanned pregnancies and their consequences. METHODS Data come from two rounds of interviews with women aged 15-44 (800 interviewed at baseline and 671 reinterviewed one year later) who were new or continuing users of injectable or oral contraceptives or an IUD. Bivariate analysis examined associations between attitudes and behaviors of women who discontinued their baseline method and side effects they experienced. Multivariate logistic regression assessed differences between women who switched methods immediately or within one month of discontinuation and those who stopped contraceptive use for one month or more. RESULTS Of the 671 women who were reinterviewed, 41% (273) discontinued use of their baseline contraceptive method within the one-year follow-up; of those, 43% (117) switched to a new method, and 57% (156) stopped for one month or more. Seeking help with side effects from a health worker, urban residence, talking to a partner about the decision to discontinue, and new and recent method adoption were associated with increased odds of switching methods (odds ratios, 2.0-3.5). CONCLUSION Access to high-quality family planning services and encouraging discussion with partners and families before stopping contraceptive use is important for women who experience side effects from contraceptive methods and are at risk of discontinuation.