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What Do Women Use When They Stop Using the Pill?

William F. Pratt and Christine A. Bachrach
Family Planning Perspectives
Vol. 19, No. 6 (Nov. - Dec., 1987), pp. 257-266
Published by: Guttmacher Institute
DOI: 10.2307/2135106
Stable URL: http://www.jstor.org/stable/2135106
Page Count: 10
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What Do Women Use When They Stop Using the Pill?
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Abstract

Current use of oral contraceptives among currently married women aged 15-44 declined from 25 percent to 13 percent between 1973 and 1982, while ever-use increased from 60 percent to 80 percent. By 1982, the pill appeared to be used mainly to delay first pregnancies, secondarily to space subsequent conceptions, and only rarely as a means of ending childbearing. Most women who had stopped using the pill by 1982 had done so on their own initiative: Only about one-third had been advised by a doctor to discontinue use. Virtually all former users gave some physical problem connected with pill use as a reason for quitting the method. At the time they quit, former users had been taking the pill for an average of 3.2 years. The decline in current use of the pill during the 1970s coincided with a marked increase in contraceptive sterilization, but was not the result of a direct switching from the pill to sterilization by individual women. Only 21 percent of women who quit the pill chose sterilization as their next method. The majority-60 percent-switched to nonpermanent methods, the condom being the most popular in all age-groups; the proportions selecting the condom as their next method ranged from 20 percent of 15-19-year-olds to 12 percent of 30-44-year-olds. Nineteen percent of former pill users did not adopt any method after discontinuing the pill. Just over half of the women who quit using the pill adopted a new method without any break in contraceptive practice. Nearly 20 percent of former pill users had some break in use but apparently were not exposed to the risk of unintended pregnancy at the time they stopped taking the pill. The remaining women-27 percent of former pill users-apparently were exposed to risk but went unprotected for some time after they quit using the pill. By 1982, the proportion of former pill users who were relying on sterilization had risen to 30 percent, while the proportion using nonsurgical methods had fallen to 29 percent. Forty percent of former pill users were using no method at the survey date, but the large majority of them were not exposed to the risk of unintended pregnancy. Continuity of method use and the effectiveness of the next method chosen had important effects on the risk of unintended pregnancy following pill discontinuation. Among white married women who discontinued pill use in 1979 or later, the proportion who subsequently had an unintended pregnancy ranged from six percent of those whose next method was the IUD or sterilization to 23 percent of those who switched to methods such as periodic abstinence or withdrawal. Ten percent of women who adopted their next method in the same month or next month after quitting the pill had an unintended pregnancy, compared with 26 percent of those who had a break in method use and were exposed to risk. The proportions who obtained abortions after discontinuing the pill followed a similar pattern.

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