Ceylon: continuing practice of contraception by acceptors of oral contraceptives and intrauterine devices in a field programme.

A follow-up study of oral-contraceptive and intrauterine-device acceptors in the early years of the Ceylon family planning programme was undertaken to determine the effect of a 1968 policy decision to cut the per cycle price of oral contraceptives by half and to allow nonclinical prescription and distribution of the pills by trained field midwives under medical supervision. While pill acceptance increased, study findings suggest that continuation did not. On balance, the intrauterine device proved much more effective than oral contraceptives in preventing unplanned pregnancies, reflecting the higher continuation rates of IUD acceptors. Although the availability of both methods clearly contributed to expansion of the programme, the demographic and administrative implications of initial choice of method, and the finding that pregnancy rates for pill users are not lower than for IUD wearers, suggest the need for more realistic counselling by clinic and field staff at the time of choice.