title: Determinants of early implant discontinuation among low-income women.
abstract: The determinants of contraceptive implant discontinuation within six months of insertion were examined among 786 low-income women attending family planning clinics in three U.S. cities. The six-month cumulative life-table discontinuation rate was 7.6%. Menstrual side effects were the most common reasons given for early implant removal, although women who discontinued use were no more likely than those who continued with the method to report menstrual irregularities. Women who opted for early removal were more likely than those who continued with the method to experience headaches, hair loss, weight gain and arm infection. Logistic regression analysis indicates that dissatisfaction with prior contraceptive methods, a partner who wants a child within the next two years, perceived pressure from health care providers to choose the implant, exposure to negative media coverage and the number of implant side effects significantly predict early implant discontinuation. Women's social and demographic characteristics, Medicaid status and motivation to avoid an unplanned pregnancy were not significantly related to early removal.
authors.affiliation: Center for Population and Family Health, Columbia University School of Public Health, New York, USA.
authors.forename: D
authors.initials: D
authors.lastname: Kalmuss
authors.forename: A R
authors.initials: AR
authors.lastname: Davidson
authors.forename: L F
authors.initials: LF
authors.lastname: Cushman
authors.forename: S
authors.initials: S
authors.lastname: Heartwell
authors.forename: M
authors.initials: M
authors.lastname: Rulin
mesh_terms: D000328:Adult; D003271:Contraceptive Agents, Female / Q000009:adverse effects; D005260:Female; D006801:Humans; D016912:Levonorgestrel / Q000009:adverse effects; D016015:Logistic Models; D008484:Medicaid; D008599:Menstruation Disturbances / Q000139:chemically induced; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D010352:Patient Dropouts; D017060:Patient Satisfaction; D011203:Poverty; D011247:Pregnancy; D011275:Pregnancy, Unwanted; D014481:United States
chemical_list: D003271:Contraceptive Agents, Female; D016912:Levonorgestrel