Abstract
Objective
To determine the influence of “structured contraception counseling” on Indian women’s selection of contraceptive methods.
Methods
Women (≥18 and ≤40 years) requesting contraception were enrolled at 36 sites. “Structured contraception counseling” was provided by a health care professional on the available contraceptive methods. Questionnaires on the women’s pre- and post-counseling contraceptive choice, her perceptions, and the reasons behind her post-counseling decision were filled.
Results
Significant reductions were observed in the proportion of women who were indecisive (n = 260; 31.5 % pre-counseling vs. n = 30; 3.6 %, post-counseling [P < 0.001]) and women opting for non-hormonal method (24.6 % pre-counseling vs. 6.8 % post-counseling, [P < 0.001]). Of all the women counseled (n = 825), 89.6 % (739/825) of women chose a hormonal contraceptive method. There were significant difference (P < 0.001) in the women’s choice of contraceptive in the pre- and post-counseling sessions, respectively (combined oral contraceptive: 30.8 vs. 40.7 %; vaginal ring: 1.8 vs. 14.1 %; progestogen only pills: 1.6 vs. 7.9 %; injectable-depot medroxyprogesterone acetate: 5.9 vs. 13.6 %; levonorgestrel-intrauterine system: 3.8 vs. 13.3 %).
Conclusions
Structured contraception counseling using standardized protocol and aids resulted in a significant increase in the selection of modern contraceptive methods. Post-counseling majority of women opted for hormonal methods with an increase in selection of pills and newer alternatives.
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Acknowledgments
Family Welfare Committee, Federation of Obstetrics and Gynecological Societies of India (FOGSI) and the participating study investigators (Dr. Anita Soni, Dr. Arnab Basak, Dr. Atul Ganatra, Dr. Atul Munshi, Dr. Avan Dadina, Dr. Fahmida Banu, Dr. Gayatri Deshpande, Dr. Geeta Balsarkar, Dr. Jaiashree Gajraj, Dr. Kiran Desai, Dr. M. Krishna Kumari, Dr. Mala Arora, Dr. Mitra Saxena, Dr. Pallaniappan, Dr. Parag Biniwale, Dr. Poonam Gupta, Dr. Priti Vyas, Dr. Priyadarshini, Dr. Pushpa Jaiswal, Dr. Ratnaboli Chakravorty, Dr. Rekha Kurian, Dr. Rupam Arora, Dr. Rupashree Bhoyar, Dr. S. R. Pal, Dr. Sarmistha Patra, Dr. Saswati Sanyal Choudhury, Dr. Sonal Kotdawala, Dr. Sreekrishna Rao, Dr., Sukumar Barik, Dr. Sunita Chandra, Dr. Susheela Rani, Dr. Uma Ram, Dr. Uma Sheshagiri Dr. Vijay Lakshmi R). Editorial assistance was provided by Dr Varun Sharma of GVK Biosciences Pvt. Limited.
Compliance with ethical requirements and Conflict of interest
The study was initiated after getting approval of the study from Institutional Review Board (IRB)/Independent Ethics Committee (IEC), in compliance with local laws. Ethical principles that have their origin in the world medical association declaration of Helsinki, and all applicable local laws, rules, and regulations relating to the conduct of the study were followed. Informed consent was obtained from all patients for being included in the study. Since the study was observational in design, local regulatory authorities were notified about the study.
Dr. Nozer Sheriar, Dr. Ritu Joshi, and Dr. Bhaskar Pal were investigators in this study and have received investigator's grant from MSD. Dr. Basab Mukherjee nothing to declare. Dr. Ashish Birla and Dr. Subrat K Ray are employees of Organon India Pvt. Limited.
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Sheriar, N., Joshi, R., Mukherjee, B. et al. Impact of Structured Counseling on the Selection of Hormonal Contraceptive Methods: Results of a Multi-Centric, Observational Study in India. J Obstet Gynecol India 64, 241–250 (2014). https://doi.org/10.1007/s13224-014-0560-1
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DOI: https://doi.org/10.1007/s13224-014-0560-1