Unintentional Discontinuation of Injectable Contraceptives Can Be Prevented

USAID-supported research from Family Health International, the University of Cape Town, and the Walter Sisulu University in South Africa shows that being late for a re-injection can lead to unintentional discontinuation of injectable contraceptives. Results of the study also suggest that family planning providers can take certain steps to help clients who do not wish to stop using the method.

The study included more than 1,000 users of injectable contraceptives who were receiving a re-injection at one of 10 family planning clinics in two South African provinces. Approximately half of the women were late for their injections. Nearly a third were late by two weeks or less.

Current recommendations from the World Health Organization state that a woman may receive a re-injection without the need to rule out pregnancy even if she is up to two weeks late for her appointment. However, a woman who returns to the clinic after this two-week "grace period" may be at risk of an unintended pregnancy. In this case, the World Health Organization recommends that a woman should not receive another injection until pregnancy is ruled out.

Nevertheless, a substantial portion of women who returned to the South African clinics within the grace period were denied a re-injection. Many were not given an alternative contraceptive method or were told to return to the clinic only after they had begun menstruating.

Providers should counsel the users of injectable contraceptives about the timing of their next injection and the consequences of being more than two weeks late. They should also be careful not to deny a woman a re-injection if she returns to the clinic within the recommended grace period, and they should provide effective contraceptive alternatives to a woman who cannot have another injection until pregnancy is ruled out.

Read more (PDF, 255 KB) about this study, published in International Family Planning Perspectives.

Source
Baumgartner JN, Morroni C, Mlobeli RD, et al. Timeliness of contraceptive reinjections in South Africa and its relation to unintentional discontinuation. Int Fam Plan Perspect 2007;33(2):66-74.