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A qualitative exploration of contraceptive practice and decision making of Malaysian women who had induced abortion: a case study

Tong WT, Low WY, Wong YL, Choong SP, Jegasothy R

Asia Pac J Public Health, 2014 Sep;26(5):536-45.
PMID: 24368749 DOI: 10.1177/1010539513514434

This study explores contraceptive practice and decision making of women who have experienced abortion in Malaysia. In-depth interviews were carried out with 31 women who had abortions. Women in this study did adopt some method of modern contraception prior their abortion episodes. However, challenges to use a method consistently were experiences and fear of side effects, contraceptive failure, partner's influence, lack of confidence, and cost. The decision to adopt contraception was theirs but the types of contraceptive methods to adopt were influenced by their spouses/partners. The women wanted to use modern contraception but were faced with challenges that hampered its use. More proactive contraceptive promotion is needed to educate people on the array of contraceptive methods available and made accessible to them, to correct misconceptions on safety of modern contraception, to increase men's involvement in contraceptive choices, and to encourage consistent contraceptive use to prevent unintended pregnancies.

Matched MeSH terms: Contraception Behavior/statistics & numerical data*
Fulltext Contraceptive use among women with chronic medical conditions and factors associated with its non-use in Malaysia

Manaf RA, Ismail IZ, Latiff LA

Glob J Health Sci, 2012 Sep;4(5):91-9.
PMID: 22980381 DOI: 10.5539/gjhs.v4n5p91

INTRODUCTION: Women with chronic medical conditions are at higher risk of adverse pregnancy outcomes, which may be minimized through optimal preconception care and appropriate contraceptive use. This study aimed to describe contraceptive use among women with chronic medical conditions and factors associated with its non-use.
METHODS: This study used cross-sectional data from a family planning survey among women with chronic medical conditions conducted in three health facilities in a southern state of Malaysia. A total of 450 married women in reproductive age (18-50 year) with intact uterus, and do not plan to conceive were analysed for contraceptive use. Both univariate and multivariate analysis was conducted to identify factors associated with contraceptive non-use among the study participants.
RESULTS: A total of 312 (69.3%) of the study participants did not use contraceptive. Contraceptive non-use was highest among the diabetics (71.2%), connective tissue disease patients (68.6%) and hypertensive patients (65.3%). Only 26.3% of women with heart disease did not use contraceptive. In the multivariate analysis, contraceptive non-use was significantly more common among women who received their medical treatment in the health clinics as compared to those who received treatment in the hospital (adjusted odds ratio [OR]=1.75, 95% confidence interval [CI]: 1.09, 2.79), being in older age group of 41-50 year (adjusted OR=2.31, 95% CI: 1.19, 4.48), having children (adjusted OR=4.57, 95% CI: 1.66, 12.57) and having lower education (adjusted OR=2.87, 95% CI: 1.43, 5.77).
CONCLUSION: About two-third of women with chronic medical conditions who needed contraceptive did not use them despite the higher risk of pregnancy related complications. The high unmet need warrant an effective health promotion programme to encourage the uptake of contraceptives especially targeting women of older age group, low education and those who received their medical treatment at health clinics.
Study site: Outpatient clinic, three hospitals; 8 health clinics, Malaysia

Matched MeSH terms: Contraception Behavior/statistics & numerical data*
Fulltext Prescription contraception use: a cross-sectional population study of psychosocial determinants

Molloy GJ, Sweeney LA, Byrne M, Hughes CM, Ingham R, Morgan K, et al.

BMJ Open, 2015 Aug 12;5(8):e007794.
PMID: 26270944 DOI: 10.1136/bmjopen-2015-007794

OBJECTIVE: Many forms of contraception are available on prescription only for example, the oral contraceptive pill (OCP) and long-acting reversible contraceptives (LARCs). In this analysis we aim to identify key determinants of prescription contraceptive use.
DESIGN: Cross-sectional population survey. Data on sociodemographic indices, concerns about the OCP and perceived barriers to access were collected.
SETTING: Data set constructed from a representative population-based telephone survey of community dwelling adults in the Republic of Ireland (RoI)
PARTICIPANTS: 1515 women aged between 18 and 45 years
MAIN OUTCOME MEASURE: Self-reported user of the OCP or LARCs (intrauterine contraception, contraceptive injections or subdermal contraceptive implants) in the previous 12 months.
RESULTS: For at least some of the previous year, 35% had used the OCP and 14% had used LARCs, while 3% had used two or more of these methods. OCP users were significantly younger, more likely to be unmarried and had higher income than non-users. Overall, 68% agreed with the statement 'that taking a break from long-term use of the contraceptive pill is a good idea' and 37% agreed with the statement that 'the OCP has dangerous side effects' and this was the strongest predictor variable of non-use of the OCP. Intrauterine contraception users were significantly older, more likely to be married and had lower income than non-users. Injections or subdermal contraceptive implant users were significantly younger, less likely to be married, had lower income and were less likely to agree that taking a break from long-term use of the pill is a good idea than non-users.
CONCLUSIONS: Prescription contraceptive use is sociodemographically patterned, with LARCs in particular being associated with lower incomes in the RoI. Concerns about the safety of the OCP remain prevalent and are important and modifiable determinants of contraceptive-related behaviour.

Matched MeSH terms: Contraception Behavior/statistics & numerical data*
Fulltext Factors associated with crisis pregnancies in Ireland: findings from three nationally representative sexual health surveys

Bourke A, Kelleher C, Boduszek D, Morgan K

Reprod Health, 2015;12:14.
PMID: 25884222 DOI: 10.1186/s12978-015-0005-z

Findings on the demographic and sexual health characteristics associated with the experience of a crisis pregnancy are important to inform the public health policy of a country, including Ireland. Studies from other jurisdictions have suggested that certain demographic groups are at risk for unintended pregnancies and the disparity between the groups has been growing in recent years. Ireland is a country which experienced much economic and societal change in the first decade of the 21(st) century; changes which are likely to have affected demographic variables pertaining to sexual health. The current study had two aims: to investigate changes in the socioeconomic characteristics associated with crisis pregnancies over a seven year period [2003 to 2010], and to investigate the recent [2010] socioeconomic risk factors associated with crisis pregnancies in Ireland.

Matched MeSH terms: Contraception Behavior/statistics & numerical data*
Fulltext Access and knowledge of contraceptives and unmet need for family planning in Pakistan

Asif MF, Ali M, Abbas HG, Ishfaq T, Ali S, Abid G, et al.

BMC Womens Health, 2024 Dec 21;24(1):651.
PMID: 39709374 DOI: 10.1186/s12905-024-03495-0

BACKGROUND: Family planning facilities provide an extensive choice of assistance that is beneficial for women and the society. It may limit the fatality risk for mothers and babies by reducing the rate of pregnancies and abortions. The Government of Pakistan has been continuously trying to persuade the people about the importance of family planning. The accomplishment of these programs depends upon various aspects associated with the knowledge, availability, and access to contraceptives. This paper has investigated the effect of knowledge and access to contraceptives on the unmet need for family planning (UMNFP) among married women of reproductive age (MWRA) in Pakistan.
METHOD: The comprehensive dataset of the Pakistan Demographic and Health Survey 2017-18 has been used to investigate the effect of knowledge and access to contraceptives on UMNFP among MWRA in Pakistan by applying Multivariable Logistic regression.
RESULTS: The prevelance of UMNFP is higher among MWRA of 25 to 34 years than other age groups. The likelihood of UMNFP decreases with increase in education above the primary level. The prevalence of UMNFP is found higher among women who belong to the poorer wealth quintile than the women of the poorest wealth quintile. The odds of UMNFP are considerably low among women belonging to the richer and richest wealth quintile, compared to the women of the poorest wealth quintile. Women's participation in decision making for not using contraceptives is a significant factor to reduce UMNFP. The odds of UMNFP are higher among those women who have no knowledge and lack of access to contraceptives compared to those who have knowledge and access to contraceptives.
CONCLUSIONS: Both knowledge and access to contraceptives are important factors to determine UMNFP. The government should initiate programs to disseminate knowledge as well as provision of contraceptives for effective family planning.

Matched MeSH terms: Contraception Behavior/statistics & numerical data
Fulltext Migrant Women's Access to Sexual and Reproductive Health Services in Malaysia: A Qualitative Study

Loganathan T, Chan ZX, de Smalen AW, Pocock NS

Int J Environ Res Public Health, 2020 07 26;17(15).
PMID: 32722563 DOI: 10.3390/ijerph17155376

Providing sexual and reproductive health (SRH) services to migrant workers is key to fulfilling sustainable developmental goals. This study aims to explore key informants' views on the provision of SRH services for migrant women in Malaysia, exploring the provision of SRH education, contraception, abortion, antenatal and delivery, as well as the management of gender-based violence. In-depth interviews of 44 stakeholders were conducted from July 2018 to July 2019. Data were thematically analysed. Migrant workers that fall pregnant are unable to work legally and are subject to deportation. Despite this, we found that insufficient SRH information and contraceptive access are provided, as these are seen to encourage promiscuity. Pregnancy, rather than sexually transmitted infection prevention, is a core concern among migrant women, the latter of which is not adequately addressed by private providers. Abortions are often seen as the only option for pregnant migrants. Unsafe abortions occur which are linked to financial constraints and cultural disapproval, despite surgical abortions being legal in Malaysia. Pregnant migrants often delay care-seeking, and this may explain poor obstetric outcomes. Although health facilities for gender-based violence are available, non-citizen women face additional barriers in terms of discrimination and scrutiny by authorities. Migrant women face extremely limited options for SRH services in Malaysia and these should be expanded.

Matched MeSH terms: Contraception Behavior/statistics & numerical data*
Fulltext Consistent condom use and its predictors among female sexual Partners of People who Inject Drugs in Klang Valley, Malaysia

Abdul Manaf R, Dickson N, Lovell S, Ibrahim F

BMC Public Health, 2019 Nov 07;19(1):1473.
PMID: 31699061 DOI: 10.1186/s12889-019-7855-1

BACKGROUND: Men who inject drugs (MWIDs) comprise the highest percentage of diagnosed HIV cases in Malaysia. Their female partners risk being infected through unprotected sexual contact. This paper reports the prevalence of consistent condom use and its predictors among the wives and regular sexual partners of MWIDs in Klang Valley, Malaysia.
METHODS: A cross-sectional study using a self-administered questionnaire was conducted among the wives and regular sexual partners of MWIDs in the study location; 221 women were recruited through respondent-driven sampling. Data were analysed descriptively for the prevalence of consistent condom use, HIV status and HIV risk-related behaviour. Subsequently, simple and multiple logistic regressions were undertaken to identify the predictors of consistent condom use.
RESULTS: The prevalence of consistent condom use among respondents was 19.5%. Slightly more than half (52.5%) of respondents had never used condoms with their partner. Fourteen women (6.3%) reported being HIV positive. While 7.7% had HIV-positive partners, 45.7% were unaware of their partner's HIV status. Consistent condom use was significantly higher among single women (AOR = 4.95; 95% CI: 2.45, 9.99), women who lived in urban areas (AOR = 2.97; 95% CI: 1.30, 6.78), HIV-positive women (AOR = 3.45; 95% CI: 1.13, 10.5) and women involved in sex work (AOR = 3.55, 95% CI: 1.45, 8.67).
CONCLUSIONS: Inconsistent condom use among the majority of female sexual partners of MWIDs underscores the heightened risk faced by these women and calls for alternative prevention methods that women are able to control.

Matched MeSH terms: Contraception Behavior/statistics & numerical data*