Assessment of contraceptive morbidity: Associated factors, and its role in further contraceptive utilization – An analytical cross-sectional study from the field practice area of a medical college in Sikkim, India

<h2>ABSTRACT</h2><h3>BACKGROUND</h3> The term "Contraceptive Morbidity" was coined by the WHO to describe conditions resulting from the use of contraceptive methods such as menstrual irregularities, weight gain, disturbances of appetite, headache, lower abdominal pain, acne, mood swings, decreased libido, dermatitis, uterine perforation etc. The study aimed to examine the role of such contraceptive morbidity in further contraceptive use and to identify the factors associated with contraceptive morbidity. <h3>MATERIALS AND METHODS</h3> The present study is a community-based cross-sectional observational epidemiological study conducted over 1 year from July 2022 to July 2023. The study included 410 female partners of eligible couples who were "ever users" of contraceptives. A pre-designed and pre-tested questionnaire was the study tool. Probability proportional to size sampling was applied to distribute the sample into urban and rural areas. Participants were selected using systematic random sampling. With the help of ASHAs (Accredited Social Health Activists), these individuals were located and data was collected through house-to-house visits. <h3>RESULT</h3> The prevalence of contraceptive morbidity was found to be higher among 31-35 years old, Hindu, unemployed women, from Other Backward Class (OBC), belonging to middle socioeconomic status and lower educational level and having irregular menstrual cycle, and having 1-2 children. Women who received counselling were less likely to report experiencing contraceptive morbidity. On chi-square analysis statistically significant associations were found between age, educational level, occupation, socioeconomic status, reproductive history, and counselling with contraceptive morbidity. 30% of participants switched their contraceptive method, and 32% discontinued the method due to contraceptive morbidity. Among those who discontinued, 72% experienced unintended pregnancies, with 52% resulting in live births <h3>CONCLUSION</h3> The discontinuation of contraceptive methods as a result of contraceptive morbidities contributes largely to the unmet need of contraception among women. The findings underscore the importance of improving contraceptive counseling and follow-up care to address contraceptive morbidities and thus reduce the unmet need for contraception among women.