Long-acting, reversible and permanent methods of contraception: insight into women's choice of method

Abstract

Background: This study aims to explore the views of women concerning their choice of long-acting method of contraception. Method: Two-hundred and eighty-six women who had either been sterilised or fitted with an etonorgestrel (ETN) implant or the levonorgestrel intrauterine system (LNG IUS) were invited to take part. A response rate of 54% was achieved. Women from all three groups reported positive and negative experiences with their chosen method. Results: Women frequently choose sterilisation specifically because it is irreversible, does not involve hormonal treatment, and they do not wish to retain choice of future fertility. Women incorrectly regard sterilisation as more reliable than any reversible method. Regret after sterilisation was common, even if this was preceded by full counselling. Even among patients of practices with a special interest in family planning, long-acting methods, although available, were not widely known about. Conclusion: This study suggests that women chose sterilisation for one of three main reasons: to avoid the possible side-effects of hormones; to avoid continually having to make decisions regarding child-bearing; and/or a lack of information regarding reversible methods. Sterilisation is often chosen by women specifically because of its irreversibility. This may explain why long-acting reversible methods have remained relatively unpopular.