Oral contraceptive discontinuation and its aftermath in 19 developing countries

Contraception. 2010 Jan;81(1):22-9. doi: 10.1016/j.contraception.2009.06.009.


Background: The purpose of the article was to document oral contraceptive (OC) discontinuation and switching in a large number of low- and middle-income countries, and to assess the effects of women's education and reason for use (spacing vs. limitation). An attempt was made to explain intercountry variations.

Study design: Calendar data from 19 Demographic and Health Surveys conducted between 1999 and 2005 were used. Data were analyzed by single- and multiple-decrement life tables and by Cox proportional hazard model.

Results: The probability of stopping OC use within 12 months for reasons that implied dissatisfaction with the method ranged from 15% in Indonesia to over 40% in Bolivia and Peru with a median value of 28%. On average, 35% switched to a modern method within 3 months and 16% to a less effective 'traditional' method. Both education and reason for use were strongly related to the probability of switching to a modern method. Discontinuation was lower and switching higher in countries judged to have strong family planning programs.

Conclusions: Both discontinuation of use and inadequate switching to alternative methods are major but neglected problems in the family planning services of many developing countries.

MeSH terms

  • Contraception / statistics & numerical data
  • Contraception / trends*
  • Contraception Behavior / statistics & numerical data
  • Contraception Behavior / trends*
  • Contraceptive Agents, Female / therapeutic use*
  • Developing Countries / statistics & numerical data*
  • Family Planning Services
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Surveys
  • Humans
  • Proportional Hazards Models
  • Withholding Treatment / statistics & numerical data*


  • Contraceptive Agents, Female