# Contraceptive Side Effects, Method Dissatisfaction, and Early Discontinuation

> **NIH NIH F31** · UNIVERSITY OF WASHINGTON · 2020 · $39,174

## Abstract

PROJECT SUMMARY
Worldwide, unintended pregnancy and short pregnancy intervals contribute substantially to poor maternal
and child health outcomes. Global family planning (FP) initiatives remain focused on promoting access to
reproductive health services and uptake of modern methods of contraception, but efforts to understand why
women choose to discontinue use have not been prioritized. Early contraceptive discontinuation, within 12
months of initiation, has been termed the “leaking bucket” of contraceptive coverage and is a substantial
driver of high unmet need for FP. Evidence suggests quality of facility-based FP care, method type, and
experience of contraceptive side effects may contribute to early method discontinuation. Development of more
effective programs to improve women's experiences and effective long-term use of contraception for women
in need of FP will require deeper understanding of method dissatisfaction and discontinuation, relationships
between experience of side effects and subsequent discontinuation, and standardized metrics for evaluating
quality of service delivery. In this proposal, data from a prospective cohort study will be leveraged to evaluate
the relationships between contraceptive side effects, dissatisfaction, and contraceptive discontinuation in a
setting with high maternal mortality.
The proposed project will utilize data from 1,254 newly initiating or continuing modern FP in Kenyan maternal
and child health (MCH) clinics. Study data was captured through a novel mobile messaging platform, using
tailored short message system (SMS) surveys. Surveys measure FP use, concerns, side effects, and
satisfaction on a weekly basis. This prospective and dynamic approach to remotely collect data using the
mobile platform will provide unique insights into contraceptive use. We propose the following aims: 1) to
determine the relationship between quality of FP method counseling received at baseline and subsequent
risk of method discontinuation, adjusting for method type; 2) to measure the time of onset of bleeding side
effects (amenorrhea, spotting, heavier bleeding), and identify participant characteristics associated with
method continuation among women who experience bleeding side effects; and 3) to measure prevalence and
correlates of method dissatisfaction by 6 months, including method type, experience of side effects, age,
pregnancy intention, and relationship status. Pilot data from this study will be used to inform the design of
interventions to support method continuation for birth spacing and limiting, and improve maternal and child
health outcomes.

## Key facts

- **NIH application ID:** 10011569
- **Project number:** 5F31HD097841-02
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Claire Watt Rothschild
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $39,174
- **Award type:** 5
- **Project period:** 2019-09-16 → 2021-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10011569

## Citation

> US National Institutes of Health, RePORTER application 10011569, Contraceptive Side Effects, Method Dissatisfaction, and Early Discontinuation (5F31HD097841-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10011569. Licensed CC0.

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