| Abstract: | Many women in developing countries would rather risk an unwanted pregnancy than put up with the side effects of efficient contraceptive methods. 40-70% of Third World users abandon use of oral contraceptives and the IUD within 2 years because of side effects. An additional 25-33% of women do not use contraceptives at all because of a fear of side effects. In part, this reflects the tendency of pharmaceutical firms and health staff to avoid discussing the side effects of modern contraceptives with Third World women, out of concern this will keep them away from family planning clinics. Without proper information, women become suspicious they are being manipulated or interpret unrelated symptoms as due to contraception. Another reason for low rates of acceptance of modern contraceptive methods is the failure of family planning programs to match the contraceptive prescribed to the needs of the acceptor. Women who want a number of children, for example, should not be given a method such as the IUD or injectables that may interfere with future fertility. In a village in Bangladesh, the birth rate actually went up after the pill was introduced because it interfered with lactation and was abandoned by 80% of initial acceptors. Ironically, there is evidence that efficient methods turn out to be less efficient in preventing births than their traditional counterparts such as the widely acceptable coitus interruptus method. |
