Early discontinuation of intrauterine device in Nepal – a retrospective study.
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Date
2012-07
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Abstract
Background: The Intrauterine Device (IUD) is the least popular method of contraception for family
planning in Nepal. In addition, discontinuation in the early days after insertion is very high and
information related to factors affecting early discontinuation is very limited.
Methods: A retrospective study was carried out over a 5-year period to determine the associated
factors for early discontinuation of the IUD. Insertion, consultation and removal records of IUD
users of Kshetrapati Family Welfare Centre, Kathmandu, were reviewed. Removal within 12 months
of insertion is defined as early discontinuation. The study participants were selected randomly.
Uni-variate and logistic regression analysis were used to analyse predictors of early discontinuation
of IUD.
Results: The results showed that one fifth of the 230 women using IUD discontinued within the
first year of insertion. Side-effects were the main reason for early discontinuation followed by
expulsion. Woman’s occupational status, husband’s occupational status, husband’s educational
status, experience of side-effects and follow-up practice were associated with early discontinuation
of IUD. Menstrual disorder and abnormal vaginal discharge were also associated with early
discontinuation.
Conclusion and recommendation: Risks of IUD discontinuation were found to be very high
during the early days of insertion and side-effects were identified as the major cause. So, proper
management of side-effects would be very important to reduce early discontinuation of IUD.
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Keywords
Intrauterine device, discontinuation, follow-up, side-effect, reproductive intention
Citation
WHO South-East Asia Journal of Public Health 2012; 1(3): 309-319.