Contraceptive continuation and discontinuation in a general population sample of women

Even though very few women in the UK at risk of unplanned pregnancy do not use contraception, rates of unplanned pregnancy are high. Research on women undergoing abortion shows that in many cases their pregnancy was the result of them suddenly stopping their method of contraception, or switching to a less effective one. Their pregnancies might have been prevented had they been given the right information and advice they needed to continue protection. This study aims to assess the size of this problem, the reasons for it and how it might be addressed.

Contraceptive prevalence is high in the UK, yet up to a third of pregnancies are unplanned. It is likely that patterns of contraceptive use help to explain the high rates of unplanned pregnancy, yet few data are available to help understand the problem. Although studies have been carried out in other countries on the prevalence of, and reasons for, discontinuation and method change, no quantitative data are available for England.

The aim of the proposed study is to provide data which can be used in clinical practice and sexual health promotion to enhance contraceptive use. We will carry out a general population survey of women who are capable of conceiving to estimate the prevalence of discontinuation and the factors associated with it. We will then follow up the sample of women over an 18 month period to examine sequences of contraceptive use over time and factors asociated with them. Finally we will return to a small sample of repeat discontinuers and those who change to a less effective method, to carry out in-depth interviews examining their motivations and preferences, and their needs in terms of advice, information and support.