Jain Aparna, Reichenbach Laura, Ehsan Iqbal, Rob Ubaidur
Evidence Project, Population Council, Washington, DC, USA.
Evidence Project, Population Council, Dhaka, Bangladesh.
Open Access J Contracept. 2017 Jul 10;8:45-52. doi: 10.2147/OAJC.S140214. eCollection 2017.
In a country like Bangladesh that has made great progress in contraceptive use with one of the lowest levels of fertility and highest levels of contraceptive use, understanding what factors influence women's decisions to discontinue a contraceptive method and not switch to a new method is critical in designing interventions and programs that will help enable Bangladesh to reach its FP2020 goals. Research on side effects has focused on physical manifestations like headaches, moodiness, abdominal pain, and menstrual irregularities. While physical effects alone may stop women from continuing a contraceptive method, less is known about how side effects influence women's daily activities and lives. The purpose of this study is to understand the ways that side effects affect Bangladeshi women's participation in different social settings.
Thirty-five in-depth interviews with married women who recently discontinued or switched to a different contraceptive method were conducted in Sylhet and Khulna Divisions. Interviews explored reasons for discontinuation including experience of side effects and impact of side effects on women's lives.
Key themes emerged including that side effects are not only experienced physically but are barriers to women's participation in many aspects of their lives. The spheres of life that most commonly appeared to be influenced by side effects include religion, household, and sexual intimacy irrespective of method used or residence.
Family planning providers need to be aware of these additional consequences associated with contraceptive side effects to provide tailored counseling that recognizes these issues and helps women to mitigate them. For Bangladesh to achieve its FP2020 goals, understanding the broader context in which family planning decisions are made vis-à-vis side effects is critical to design programs and interventions that meet all the needs of women beyond just their fertility intentions.
在像孟加拉国这样在避孕措施使用方面取得了巨大进展，生育率处于极低水平且避孕措施使用率极高的国家，了解哪些因素会影响女性停止使用一种避孕方法且不更换为新方法的决定，对于设计有助于孟加拉国实现其2020年计划生育目标的干预措施和项目至关重要。关于副作用的研究主要集中在诸如头痛、情绪波动、腹痛和月经不调等身体表现上。虽然仅身体影响可能会使女性停止继续使用某种避孕方法，但对于副作用如何影响女性的日常活动和生活却知之甚少。本研究的目的是了解副作用影响孟加拉国女性参与不同社会环境的方式。
在锡尔赫特和库尔纳专区对35名最近停止使用或更换为不同避孕方法的已婚女性进行了深入访谈。访谈探讨了停止使用的原因，包括副作用经历以及副作用对女性生活的影响。
出现了一些关键主题，包括副作用不仅在身体上有所体验，而且是女性参与生活许多方面的障碍。最常受副作用影响的生活领域包括宗教、家庭和性亲密关系，无论使用何种避孕方法或居住地点如何。
计划生育服务提供者需要意识到与避孕副作用相关的这些额外后果，以便提供能够认识到这些问题并帮助女性减轻这些问题的针对性咨询。对于孟加拉国实现其2020年计划生育目标而言，了解在副作用方面做出计划生育决策的更广泛背景对于设计满足女性所有需求（而不仅仅是她们生育意愿）的项目和干预措施至关重要。
