“I have come to remove it because of heavy bleeding”: a mixed-methods study on early contraceptive implant removal and the underlying factors in eastern Uganda
Abstract Background Early contraceptive implant removal without intentions to conceive predisposes women to unintended pregnancies.. Some of the unintended pregnancies end in unsafe abortions which further increases the risk of maternal mortality and morbidity. Therefore, we assessed the proportion...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-04-01
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| Series: | Contraception and Reproductive Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40834-024-00279-7 |
| _version_ | 1827276914808586240 |
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| author | Janet Abiyo Rose Chalo Nabirye Brendah Nambozo David Mukunya Ritah Nantale Faith Oguttu Solomon Wani Milton W. Musaba Josephine Tumuhamye Joshua Epuitai |
| author_facet | Janet Abiyo Rose Chalo Nabirye Brendah Nambozo David Mukunya Ritah Nantale Faith Oguttu Solomon Wani Milton W. Musaba Josephine Tumuhamye Joshua Epuitai |
| author_sort | Janet Abiyo |
| collection | DOAJ |
| description | Abstract Background Early contraceptive implant removal without intentions to conceive predisposes women to unintended pregnancies.. Some of the unintended pregnancies end in unsafe abortions which further increases the risk of maternal mortality and morbidity. Therefore, we assessed the proportion of women who had early contraceptive implant removal. We also explored the reasons for early contraceptive implant removalamong women at Mbale Regional Referral Hospital in eastern Uganda. Methods We conducted a sequential explanatory mixed methods study at Mbale Regional Referral Hospital between November 2022 to December 2022. For quantitative data, we performed a secondary analysis on data extracted from the integrated family planning registers. We used systematic random sampling to select 600 clients’ serial numbers from the registers. The outcome variable was early contraceptive implant removal defined as removal of the implant by the woman before 18 months from the time of insertion. For qualitative data, we conducted 11 in-depth interviews among women who had come for contraceptive implant removal at the family planning clinic. We also conducted two key informant interviews with midwives working at the family planning unit. Quantitative data were analysed using Stata version 14.0 (Stata Corp LLC, College Station, Texas, USA) while qualitative data were analysed by thematic content analysis. Results In this study, 15% (91/600) of the women discontinued contraceptive implants within 12 months, 29% (175/600) within 18 months, 38% (230/600) within 24 months and 40% (240/600) within 36 months of insertion. Among the women who discontinued contraceptive implant use, only 6.7% (40/600) switched to another family planning method. Out of the 175 women who removed contraceptive implants early, side effects 61.1% (107/175) desire to conceive 53.1% ( 93/175),, and gender-based violence 8.6% (15/175) were the major reasons for removal. From the qualitative interviews, the major reasons for early contraceptive implant removal were side effects such as heavy menstrualbleeding. Conclusion A third of women discontinued contraceptive implant use within 18 months. Addressing concerns regarding side effects and male partner disapproval of modern contraceptives may improve continued use of implants. |
| first_indexed | 2024-04-24T07:10:59Z |
| format | Article |
| id | doaj.art-992ce2ed6b5f49d993681f7e0a468b91 |
| institution | Directory Open Access Journal |
| issn | 2055-7426 |
| language | English |
| last_indexed | 2024-04-24T07:10:59Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Contraception and Reproductive Medicine |
| spelling | doaj.art-992ce2ed6b5f49d993681f7e0a468b912024-04-21T11:33:13ZengBMCContraception and Reproductive Medicine2055-74262024-04-019111010.1186/s40834-024-00279-7“I have come to remove it because of heavy bleeding”: a mixed-methods study on early contraceptive implant removal and the underlying factors in eastern UgandaJanet Abiyo0Rose Chalo Nabirye1Brendah Nambozo2David Mukunya3Ritah Nantale4Faith Oguttu5Solomon Wani6Milton W. Musaba7Josephine Tumuhamye8Joshua Epuitai9Department of Nursing, Faculty of Health Sciences, Busitema UniversityDepartment of Nursing, Faculty of Health Sciences, Busitema UniversityDepartment of Community and Public Health, Faculty of Health Sciences, Busitema UniversityDepartment of Community and Public Health, Faculty of Health Sciences, Busitema UniversityDepartment of Community and Public Health, Faculty of Health Sciences, Busitema UniversityDepartment of Community and Public Health, Faculty of Health Sciences, Busitema UniversityDepartment of Community and Public Health, Faculty of Health Sciences, Busitema UniversityDepartment of Obstetrics and Gynaecology, Faculty of Health Sciences, Busitema UniversityMakerere University Hospital, Makerere University KampalaDepartment of Nursing, Faculty of Health Sciences, Busitema UniversityAbstract Background Early contraceptive implant removal without intentions to conceive predisposes women to unintended pregnancies.. Some of the unintended pregnancies end in unsafe abortions which further increases the risk of maternal mortality and morbidity. Therefore, we assessed the proportion of women who had early contraceptive implant removal. We also explored the reasons for early contraceptive implant removalamong women at Mbale Regional Referral Hospital in eastern Uganda. Methods We conducted a sequential explanatory mixed methods study at Mbale Regional Referral Hospital between November 2022 to December 2022. For quantitative data, we performed a secondary analysis on data extracted from the integrated family planning registers. We used systematic random sampling to select 600 clients’ serial numbers from the registers. The outcome variable was early contraceptive implant removal defined as removal of the implant by the woman before 18 months from the time of insertion. For qualitative data, we conducted 11 in-depth interviews among women who had come for contraceptive implant removal at the family planning clinic. We also conducted two key informant interviews with midwives working at the family planning unit. Quantitative data were analysed using Stata version 14.0 (Stata Corp LLC, College Station, Texas, USA) while qualitative data were analysed by thematic content analysis. Results In this study, 15% (91/600) of the women discontinued contraceptive implants within 12 months, 29% (175/600) within 18 months, 38% (230/600) within 24 months and 40% (240/600) within 36 months of insertion. Among the women who discontinued contraceptive implant use, only 6.7% (40/600) switched to another family planning method. Out of the 175 women who removed contraceptive implants early, side effects 61.1% (107/175) desire to conceive 53.1% ( 93/175),, and gender-based violence 8.6% (15/175) were the major reasons for removal. From the qualitative interviews, the major reasons for early contraceptive implant removal were side effects such as heavy menstrualbleeding. Conclusion A third of women discontinued contraceptive implant use within 18 months. Addressing concerns regarding side effects and male partner disapproval of modern contraceptives may improve continued use of implants.https://doi.org/10.1186/s40834-024-00279-7Contraceptive implantsEarly implant removalLong-acting contraceptives (LARCs)Mixed methodsUgandaFamily planning |
| spellingShingle | Janet Abiyo Rose Chalo Nabirye Brendah Nambozo David Mukunya Ritah Nantale Faith Oguttu Solomon Wani Milton W. Musaba Josephine Tumuhamye Joshua Epuitai “I have come to remove it because of heavy bleeding”: a mixed-methods study on early contraceptive implant removal and the underlying factors in eastern Uganda Contraception and Reproductive Medicine Contraceptive implants Early implant removal Long-acting contraceptives (LARCs) Mixed methods Uganda Family planning |
| title | “I have come to remove it because of heavy bleeding”: a mixed-methods study on early contraceptive implant removal and the underlying factors in eastern Uganda |
| title_full | “I have come to remove it because of heavy bleeding”: a mixed-methods study on early contraceptive implant removal and the underlying factors in eastern Uganda |
| title_fullStr | “I have come to remove it because of heavy bleeding”: a mixed-methods study on early contraceptive implant removal and the underlying factors in eastern Uganda |
| title_full_unstemmed | “I have come to remove it because of heavy bleeding”: a mixed-methods study on early contraceptive implant removal and the underlying factors in eastern Uganda |
| title_short | “I have come to remove it because of heavy bleeding”: a mixed-methods study on early contraceptive implant removal and the underlying factors in eastern Uganda |
| title_sort | i have come to remove it because of heavy bleeding a mixed methods study on early contraceptive implant removal and the underlying factors in eastern uganda |
| topic | Contraceptive implants Early implant removal Long-acting contraceptives (LARCs) Mixed methods Uganda Family planning |
| url | https://doi.org/10.1186/s40834-024-00279-7 |
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