Knowledge, attitudes, and practices toward contraceptive use among Syrian women attending the Syrian family planning association clinics in Damascus and Rif Dimashq: a cross-sectional study

High fertility rates remain a significant public health concern, particularly in developing countries, where they are often associated with adverse maternal and child health outcomes. This study aimed to assess the prevalence and factors influencing contraceptive use among married women in Damascus and Rif Dimashq. A cross-sectional survey was conducted among married women of reproductive age (15–49 years) attending family planning centers in Damascus and Rif Dimashq. The study was carried out across four clinics from September to the end of November 2024. A total of 295 married women were interviewed using a structured questionnaire. Data were collected using a structured questionnaire collected on socio-demographics, family planning knowledge, attitudes, utilization, reproductive history, and contraceptive decision-making factors. Of the 295 participants, 67.8% reported current use of contraceptive methods, with oral contraceptive pills and intrauterine devices being the most frequently used. Knowledge levels varied, with the average participant recognizing approximately five different contraceptive methods. While awareness of pills and IUDs was high, knowledge of less common methods such as implants, patches, and female condoms remained limited. Contraceptive use was significantly associated with factors such as age, parity, education level, and the hometowns of both partners. Among non-users, the primary reasons cited were the desire to conceive, fear of side effects, and lack of spousal approval. Approximately one in five participants had experienced an unintended pregnancy, with a notable proportion occurring despite IUD use, indicating potential issues related to device quality or provider technique. Additionally, most women were unaware of or unprepared for emergency contraception options following unprotected sex. Among married women attending SFPA clinics in Damascus and Rif Dimashq, contraceptive use was relatively high and dominated by OCPs and IUDs. This finding was expected, as these clinics provide multiple services, including family planning, yet knowledge gaps and persistent barriers remained. Poor contraceptive knowledge was strongly associated with non-use, and awareness of emergency contraception was notably limited. The proportion of unintended pregnancies among IUD users also suggests possible gaps in counseling or service quality. Enhanced education and improved service delivery are needed to support informed contraceptive choices in this population.