Contraception use and attitudes of women and health care providers

Abstract

Introduction: Very few women use modern methods of contraception in Serbia and the number of abortions is still high. The aim of this research was to analyze factors affecting non-use of contraception in women as well as the attitudes of health care providers in order to influence them and therefore lower the number of abortions and preserve the reproductive health of women. Methods: We surveyed 600 women from Northern Serbia, aged 20-44 who were gynecologically healthy with no desire to conceive and give birth at that moment. We also surveyed health care providers 50 gynecologists (aged 30-65), 70 general practitioners (aged 25-55) and 100 nurses (aged 20-54). Both groups completed separate questionnaires constructed for this research, one for women and one for health care providers, and two standardized psychological questionnaires: The locus of control test and Planning and Future Orientation test. Results and discussion: Women used the method of withdrawal most often (70.5%). The same method was used by 46.5% of health care providers. Health care providers use a condom most commonly 57.7%, while 53.5% women do so. Effective methods combined oral contraception (COC) and the intrauterine device (IUD) were used more by gynecologists (28% and 27.5%) than women (19.2%, 13.3%), but even they used it insufficiently. Only one half of women see a gynecologist for counseling about contraception. Gynecologists recommend effective methods of contraception most often but not even they use them to a satisfactory extent. Women and their partners often consider these methods harmful to health hence they do not use them sufficiently. A greater number of health care providers (61.4%) than women (43.3%) have a positive attitude toward effective methods of contraception. Prerequisites for better use of contraception are internal locus of control and orientation to future and planning. There are differences regarding the use and method of contraception with regard to marital status and age. Conclusion: In order to increase the use of effective contraception and, therefore, to decrease the number of abortions, a systematic action is needed, with the emphasis on education and dissemination of knowledge about the benefits of modern contraception among women, their partners and health care providers.