The objective of this study was to evaluate possible factors associated with discontinuing use of TCu 380A IUDs due to personal reasons among 2748 users. Overall, a total of 88 subjects discontinued using the TCu 380A IUD within 12 months postinsertion for personal reasons. The most common reasons were planned pregnancy (32%) and husband or family opinion against IUD use (26%). The gross cumulative 12-month life table discontinuation rate for all personal reasons was 4.0 per 100 women. Having no education and/or living in a rural area were the sociodemographic characteristics associated with an increased risk of discontinuation for personal reasons. Effective and regular counseling about IUD use, especially among illiterate women, may help prevent IUD discontinuations related to personal reasons.
PIP: The objectives were to examine the rates and timing of IUD discontinuation for personal reasons, and to analyze the users' discontinuation characteristics. Data were used from randomized clinical trials with a total of 2748 TCu 380A users, healthy and sexually active women, between 18 and 40 years of age; and comparing the performance of the TCu 380A3 with that of various other IUDs conducted by Family Health International, from 1985 to 1989, in family planning clinics located in Cameroon, Chile, Egypt, El Salvador, Malaysia, Mexico (2 centers), Nigeria, Pakistan, Peru, Philippines (3 centers), Sri Lanka (2 centers), Thailand, Turkey, and Venezuela. The last pregnancy ended at least 40 days before IUD insertion. Participants were asked to return for follow-up visits at 1, 3, 6, and 12 months after insertion. Subjects discontinuing IUD use for personal reasons were more likely to be married or in a consensual union and to have fewer years of education; to reside in rural areas; to have had fewer children and to want additional children; and less likely to have been previous IUD users than were women who discontinued IUD use for medical reasons or who were lost to follow-up or continued IUD use after the 12-month follow-up visit. At 12 months of use, the discontinuation rate for personal reasons was 4.0/100 women, compared to 5.8/100 women for medical reasons, and 3.7/100 women for pregnancy and expulsion. 31.8% of the 88 cases discontinuing for personal reasons had a planned pregnancy; and the husband's objection or family influence against IUD use contributed to 26.1% of the IUD removals for personal reasons. 18.2% no longer needed contraception and 13.6% wished to switch methods. Dissatisfaction with the method, moving to another country, and unspecified reasons together were responsible for 10.3% of the discontinuations for personal reasons. Other variables which were not statistically significant constituted: age, parity, additional children wanted, previous contraceptive method used, and months after last pregnancy.