Use of family planning methods and attitudes of married women aged 15-49 in Konya Province

Authors

Abstract

Aim In this study, it was aimed to investigate the sociodemographic characteristics, fertility characteristics and attitudes towards family planning of women who applied to the Family Medicine Polyclinic.
Material and Methods This research; The study was conducted with 448 women between the ages of 15-49 years who applied to Konya Selcuk University Faculty of Medicine Family Medicine Polyclinic between 15 May 2022 and 15 July 2022. A questionnaire consisting of 18 questions was administeredapplied to the women in the family medicine outpatient clinic.
Results 30.8% of the women included in the study are were between the ages of 15-34 years. 93.3% of women used a family planning method. The most commonly used method was birth control pill (26.3%). Among the family planning methods used, the most satisfied method was condom (14.3%).
Discussion The short time between recurrent pregnancies and miscarriages are is the basis of maternal and child health problems. These problems stem from the fact that family planning use and education levels are not at the desired level. In order to overcome these problems, it is important to give priority to the education of women and to inform them about family planning methods.

Keywords

Introduction

The ability of people to have as many children as they want and whenever they want and to determine the size of their family is called family planning (FP). Today, FP is an integral part of general women’s health and safe motherhood programs. FP is an important health service that contributes positively to the health of mothers and babies by preventing both unwanted pregnancies and excessive fertility, thus playing a role in increasing the health level of the society [1, 2].
Preventing pregnancy for family planning is called contraception, and the methods used for this purpose are called contraceptive methods. Many people use contraception to plan the number of children at appropriate time intervals. Some people may seek contraception due to their illnesses and health problems. When using contraception due to health problems, choosing the appropriate contraception with the least side effects is also important [2].
It is essential for family physicians who provide multifaceted care services to individuals and families to have up-to-date information about the consultancy, effectiveness, reliability and side effects of these methods. It is thought that determining why women prefer the family planning method they use is important in terms of shedding
light on healthcare professionals in planning the service. It is thought that it is important to make this definition in order to disseminate the reasons for choosing effective methods and to prevent the reasons for choosing ineffective methods [3].
According to the 2018 Turkey Population Health Survey 2018 data, while the general fertility rate in Turkey is 2.3, the rate of using any family planning method is 70% [4]. Among the methods used,; withdrawal method the rate of withdrawal method is 20%, the male condom is 19%, IUD is 14%, and tubal ligation is 10% .
This research aims to investigate women’s sociodemographic characteristics, fertility characteristics and attitudes towards family planning.

Materials and Methods

The survey was administered using a face-to-face interview technique to a total of 448 female patients between the ages of 15-49 years who applied to Konya Selçuk University Faculty of Medicine Family Medicine Polyclinic between 15 May 2022 and 15 July 2022. The survey consists of 18 questions aiming to evaluate women’s sociodemographic information and their knowledge and attitudes towardsabout contraceptive methods. The data obtained were evaluated with the SPSS (Statistical Package for Social Sciences) for the Windows 22.0 program. Mean, standard deviation, median, minimum and maximum values were calculated. Chi-square test was used to compare qualitative data. Statistical significance was accepted as p<0.05. The research protocol was approved by the Selcuk University Faculty of Medicine Ethics Committee on 26.04.2022 (Decision No: 2022/211).

Results

Study Participants included in the research;
The distribution of some sociodemographic characteristics such as age groups, place of residence, educational status, smoking and alcohol use, and fertility characteristics are shown in Table 1. 30.8% of the participants are were between the ages of 15-34 years, and 69.2% are were aged 35 and over. 66.5% of the participants lived in the city center and 33.5% lived in a district or village;. 27.6% of these women were illiterate or primary school graduates, 29.5% were high school graduates, and 42.9% were undergraduate or master’s degree graduate graduates. It was observed that the rate of smoking among the participants was 37.9%, and the rate of alcohol use was 12.5%. The unintended pregnancy rate was found to be 21.9%, and the rate of curettage was found to be 17%. At the end of the research, it was determined that the average age of women was 40.00 ± 6.83, the marriage age was 23.00 ± 4.27, the number of living children was 2.00 ± 1.32 and the number of stillbirths was 2.00 ± 0.50.
It was determined that 93.3% of the women participating in the research used a family planning method and 87.5% had knowledge about family planning. 6.7% of the participants stated that they did not use any family planning method. It was determined that 83.7% of women using the FP method were satisfied with the birth control method they were using, 9.6% were dissatisfied, and 6.7% were undecided. 30.6% of the women stated that they became pregnant despite using any contraceptive method (CM) (Table 2).
The distribution of contraceptive methods used by women is shown in Figure 1.; Birth control pills were found to beaccounted for 26.3%, withdrawal method 17%, calendar monitoring 15.6%, IUD 11.2%, morning after pill 8.9%, condom 8.5%, permanent method use 5.8% (Figure. 1). The contraceptive methods used by women according to their age groups were examined. 53.6% of women aged 15-34 years using contraceptive methods were useding an effective family planning method, and 36.1% of women aged 35 years and over were useding an effective family planning method. FP methods used by women were evaluated according to their age ranges. The most frequently used contraceptive method was the birth control pill, both among those aged 15-34 years (35.9%) and those aged 35 years and over (24.8%). The second most frequently used contraceptive method between the ages of 15-34 was the withdrawal method, which has limited effect, with a rate of 21.9%. The second most frequently used contraceptive method among those aged 35 years and over was calendar tracking, which also has a limited effect, with a rate of 17.9%.
As stated in Table 34, when considering the distribution of FP use and women’s educational status, is examined; it was observed that all illiterate women, 80% of primary school graduates, 96.7% of secondary school graduates, 89.4% of high school graduates, 98.9% of undergraduate graduates, and all master’s degree graduate graduates used any contraceptive method. A statistically significant difference was detected between these groups (p = 0.00).
The distribution of effective FP method use according to women’s educational status was investigated (Table 3). None of the illiterate women were useding an effective FP method. 60% of women with primary school degrees, 73.3% of women with secondary school degrees, 59.1% of women with high school degrees, 72.7% of women with bachelor’s degrees, and all women with master’s degrees were useding an effective FP method. A statistically significant difference was detected between these groups (p = 0.00).
In our study, 88.5% of women without children, 88.9% of women with 1 child, and 96.9% of women with 2 children were useding the FP method. All women with 3 children, 87.1% of women with 4 children, and all women with 5 children were useding an the FP method. A statistically significant difference was detected between the increase in the number of children and the use of FP (p = 0.002).

Discussion

According to the results of this study, 93.3% of women use any FP method. According to the results of the 2018 Turkey Demographic and Health Survey (TDHS) 2018, 70% of women aged 15-49 years in Turkey use any of the family planning methods [4]. According to our study results, the rate of women using any family planning method is higher compared to the 2018 TDHS 2018 results. However, it is an undesirable result is that 17% of these women used limited effect methods such as withdrawal method and 15.6% used the calendar method. In a A study conducted at Hacettepe University in 2013, it was determined that married couples were the most likely to use the the method most used by married couples was withdrawal method, with a rate of 63.8% [1]. What is noteworthy in this study is that although 99.7% of the participants stated that they had information about an effective birth control method, the most frequently used method was still the withdrawal method.
As seen in Table 3, Wwomen using FP in our study most frequently preferred effective modern methods (65.1%). The rate of those who prefer traditional methods with limited effect is 34.9%. In Oour study, it was determined that the birth control method most frequently used by women was the birth control pill, with a rate of 26.3%. Afterwards, it was observed that the most frequently used FP method was the withdrawal method with a rate of 17%. According to the 2018 TDHS 2018 results, the most commonly used FP method in Turkey is the withdrawal method, which is a traditional method with a rate of 20% . Similar to the 2018 TDHS 2018 results, Öztaş et al. in 2015, it was observed that the most frequently used FP method by women was the withdrawal method with a rate of 26.4% [5]. In the study conducted by Karabulutlu and Ersöz in 2017, it was determined that the FP method most frequently used by women of childbearing age was IUD with a rate of 28.8% [6].
The use of Using family planning methods and reproductive behaviors are affected by the educational status of individuals [7]. In our research, it was determined that there was a statistically significant relationship between the increase in women’s education levels and the use of FP (p = 0.000). It has been observed that as the education level of women increases, the use of FP also increases. Similarly, in the study of by Öztaş et al., it was determined that as the education level of women increased, their knowledge and use of family planning increased [5].
It has been observed that as the education level increases, women’s use of FP increases as well as their use of an effective FP method. It was determined that there was a statistically significant relationship between the increase in women’s education levels and the preferred FP method being an effective method (p = 0.000). Many studies have shown that the success rates of traditional methods are much lower than modern methods [8, 9]. Similar to our study, a study by Aydoğdu and Akça in 2018 showed that there was a statistically significant relationship between educational status and effective FP use. It has been observed that as the education level of women increases, the preference for an effective FP method also increases (p<0.05) (10). This suggests that increasing women’s education levels may affect their attitudes, behaviors and choice of method selection regarding family planning methods.
In our study, a statistically significant relationship was found between the increase in the number of children and the use of FP (p=0.000). It was determined that as the number of children increased, the use of FP also increased. In a study conducted by Altıparmak and Adıgüzel in 2006, similar to our research, as the number of living children increases, the rate of using the FP method also increases [11].
Similar to our study, in other studies conducted in our country, the first priority is to obtain information from healthcare professionals [4, 6]. Our study is important as it shows that most women receiveget information about FP primarily from healthcare personnel. Obtaining Getting information from health professionals can increase women’s access to accurate and reliable information about family planning. According to the 2018 TDHS 2018, 52% of women using modern methods obtain the method they use from the public sector [4]. Women should be encouraged to obtain such information from health professionals and health institutions.
There are many factors that affect the use of the FP method. These may include be the reliability of the method, misuse of the method and false beliefs about the method, expectations of the society, and the attitude of the individual and the family [1, 2, 3]. In order to provide FP factors services effectively, it is necessary to determine the usage status of FP methods, the state of influence and the attitude towards FP.

Tables

Table 1. Distribution of some sociodemographic characteristics and fertility characteristics of the participants

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Table 2. Participants’ knowledge and attitudes towardsabout FP and CM

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Table 3. Comparison of FP use and effective FP method use according to women’s educational status

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Conclusion

In our country, the basis of maternal and child health problems are based the short interval between repeated pregnancies and miscarriages. The basis of these problems lies in the fact that individuals’ FP use and education levels are not at the desired levels. Therefore, in solving these problems, it is important to prioritize the education of women and to inform women of childbearing age about FP methods. Again, since the high frequency of use of limited effective methods such as withdrawal method and calendar tracking in our country may increase the frequency of unwanted pregnancies and lead to maternal and child deaths and diseases, family planning education programs should be organized. The use of modern family planning methods should be increased. A more educational and effective approach to educating women about various methods of contraception will enable every woman, regardless of educational attainment, marital status or age, to make the right choice for themselves and their partners in using a method that will work effectively.

Data Availability

The data supporting the findings of this article are available from the corresponding author upon reasonable request, due to privacy and ethical restrictions. The corresponding author has committed to share the de-identified data with qualified researchers after confirmation of the necessary ethical or institutional approvals. Requests for data access should be directed to bmp.eqco@gmail.com

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Scientific Responsibility Statement

The authors declare that they are responsible for the article’s scientific content including study design, data collection, analysis and interpretation, writing, some of the main line, or all of the preparation and scientific review of the contents and approval of the final version of the article.

Animal and Human Rights Statement

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Funding

None

Conflict of Interest

None of the authors received any type of financial support that could be considered potential conflict of interest regarding the manuscript or its submission.

Ethics Declarations

This study was approved by the Ethics Committee of Selcuk University Faculty of Medicine Ethics Committee (Date: 2022-04-26, No: 2022/211)

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