In 1991, shortly after Norplant became available in the United States, 678 women who had received the implant from 17 providers in Texas were surveyed. Forty-five percent of these women were under 21 years old. The majority (56%) had tried the implant because they were dissatisfied with their previous contraceptive method. Forty-four percent of the sample indicated that the implant was one of the first contraceptive methods they had used and that they had only recently decided to prevent unplanned pregnancy. The average number of children per woman was 1.2, and one-third of the sample had had at least one abortion. While 37% of the women said they wanted no more children, 63% said they were using the implant as a spacing method. The reasons for choosing the implant and concerns about it varied according to the user's age, educational level and race or ethnic group.
PIP: Researchers analyzed 1991 data on 678 12-45 year old women attending either a university-based family planning clinic, 8 Planned Parenthood clinics, or the private practice or health maintenance organization clinic of 8 physicians in southeast Texas to determine the characteristics of these women who accepted Norplant shortly after its approval in the US and their overall attitude towards Norplant. Most acceptors were 25 years old (64.1%) and not married (67.4%). In fact, 45% were 21 years old which was higher than expected. Norplant was 1 of the first contraceptives used by 44% of the women. Further, these women had only recently chosen to prevent unplanned pregnancy. The mean family size was 1.2. 35 of the women did not want any more children. The remaining 67% used Norplant to space births. 32.5% of the women had experienced at least 1 abortion, which was significantly higher than the national adjusted rate. The leading reasons for choosing Norplant included dissatisfaction with previous methods (55.5%), its convenience (38.7%), and confidence in its effectiveness (20.8%). 44% of the women were not concerned about Norplant. The main concerns of the other women were pain during insertion (21.9%), menstrual changes (17.9%), and hormonal effects (16.2%). Further, 11.8% were worried about Norplant's effect on future pregnancies. Most women (61.1%) had previously used oral contraceptives (OCs). 5.3% had used no method in the last 3 months. 42.2% had used condoms either alone or with a spermicide. Yet, 48% of them would now either stop using them or use them sometimes. They constituted 40% of the unmarried women. This resulted in an increased risk of acquiring a sexually transmitted disease or HIV among 25% of the sample. Medicaid patients paid nothing for Norplant or its insertion. Patients who received Norplant via the physician training program paid nothing for Norplant but did for its insertion. Some clinic patients made required copayments of $9-$100. Private practice patients paid $500-$750 for Norplant and its insertion.