title: Perceptions of nonsurgical permanent contraception among potential users, providers, and influencers in Wardha district and New Delhi, India: Exploratory research.
abstract: New permanent contraceptive methods are in development, including nonsurgical permanent contraception (NSPC).
  
  
  
  In the present study, perceptions of NSPC in India among married women, married men, mothers-in-law, providers, and health advocates in Eastern Maharashtra (Wardha district) and New Delhi were examined.
  
  
  
  We conducted semi-structured interviews with 40 married women and 20 mothers-in-law; surveys with 150 married men; and focus group discussions with obstetrics/gynecology providers and advocates. Transcripts were coded and analyzed using a grounded theory approach, where emerging themes are analyzed during the data collection period.
  
  
  
  The majority of female respondents expressed support of permanent contraception and interest in NSPC, stating the importance of avoiding surgery and minimizing recovery time. They expressed concerns about safety and efficacy; many felt that a confirmation test would be necessary regardless of the failure rate. Most male respondents were supportive of female permanent contraception (PC) and preferred NSPC to a surgical method, as long as it was safe and effective. Providers were interested in NSPC yet had specific concerns about safety, efficacy, cost, uptake, and government pressure. They also had concerns that a nonsurgical approach could undermine the inherent seriousness of choosing PC. Advocates were interested in NSPC but had concerns about safety and potential misuse in the Indian context.
  
  
  
  Although perceptions of NSPC were varied, all study populations indicated interest in NSPC. Concerns about safety, efficacy, appropriate patient counseling, and ethics emerged from the present study and should be considered as NSPC methods continue to be developed.
authors.affiliation: Adjunct Professor of Anthropology, Department of Anthropology, Portland State University, Portland, USA.
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Aengst
authors.affiliation: Acting Instructor and Senior Fellow, Department of Obstetrics and Gynecology, Division of Family Planning, University of Washington, Seattle, Washington, USA.
authors.forename: Elizabeth K
authors.initials: EK
authors.lastname: Harrington
authors.affiliation: Social Scientist, Department of Community Medicine, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India.
authors.forename: Pramod
authors.initials: P
authors.lastname: Bahulekar
authors.affiliation: Professor, Head of Department of Obstetrics and Gynaecology, Mahatma Gandhi Institute of Medical Sciences,Sevagram, Maharashtra, India.
authors.forename: Poonam
authors.initials: P
authors.lastname: Shivkumar
authors.affiliation: Professor, Reproductive and Developmental Sciences, Oregon National Primate Research Center; Leon Speroff Professor, Department of Obstetrics and Gynecology, Director of the Women's Health Research Unit, Center for Women's Health, Oregon Health and Science University, Portland, USA.
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Jensen
authors.affiliation: Director, Dr. Sushila Nayar School of Public Health; Director and Professor of Community Medicine, Secretary, Kasturba Health Society, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India.
authors.forename: B S
authors.initials: BS
authors.lastname: Garg
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003267:Contraception / Q000379:methods* / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D066296:Grounded Theory; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007194:India; D007407:Interviews as Topic; D008297:Male