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Condoms, rather than intrauterine devices, were the most commonly cited method of contraception among women attending an outpatient gynecology clinic in Beijing, China.
Contraceptive use in China has steadily increased since the 1-child policy was introduced in the late 1970s, with all-method prevalence at 86.9% in 2002 . Although usage is high, the most popular contraceptive methods vary by region and age group [1,2], with recent studies indicating that such differences in usage may be attributable to lack of availability and information about specific methods [1–3]. The aim of the present study was to assess contraceptive practices among women of reproductive age visiting an obstetrics and gynecology clinic in Beijing, China.
Women were recruited from the Outpatient Gynecology Clinic at Peking University First Hospital, Beijing, China, between May 15 and July 25, 2008. All women attending the clinic were asked to complete a self-administered questionnaire regarding contraceptive knowledge and current contraception behavior. To ensure accuracy, the questionnaire was created in English, translated into Mandarin Chinese, and back-translated. The study protocol and all research instruments were reviewed and approved by the Institutional Review Boards of both the Chinese and the US institutions.
In total, 733 women were invited to participate, of whom 571 (77.9%) completed the questionnaire and were included in the analysis. Most respondents were married (82.5%) and of Han ethnicity (92.8%). The age of participants ranged from 18 to 66 years (mean 33.2 ± 8.3 years), and the majority had undergone at least some college education (62.7%). In total, 16.3% of women lived in households with a monthly income of more than US $732—with more than half of households (54.5%) earning between US $293 and US $732 per month, and 27.1% earning less than US $293 per month. Overall, 11.1% of participants had never used birth control methods, and 27.6% reported no current use. Although 12.6% of the women were older than 44 years, menopausal status was not assessed; therefore, the percentage of women of reproductive age not currently using contraception may have been overestimated. Table 1 shows participant characteristics, and contraception use is shown in Table 2.
Whereas intrauterine devices (IUDs) were the predominant form of contraception in many previous studies in China , condoms were the most commonly used method (62.7%) in the present study—with IUDs reported as the current/most recent form of contraception by only 16.7%. These findings are supported by a recent study in which condoms were the most commonly used contraceptive method for women attending a family-planning clinic in Shanghai . In total, 21.1% of women reported currently using more than 1 method of contraception, 8.8% of whom reported using condoms in addition to another form. However, “current use” may not be the same as “simultaneous use,” so these findings should be interpreted with caution.
Of note, the median number of abortions was 2, indicating the need for further research into the use of induced abortion as a family-planning method in China. Traditional methods such as withdrawal and rhythm were the second and third most commonly reported methods, respectively, which may indicate the need for more comprehensive family-planning education. The media was cited as the most common information source regarding contraception—ahead of doctors, nurses, and family-planning clinics; thus, evaluation of media messages may be warranted.
Despite the biases associated with recruiting women from a gynecology outpatient clinic at a large tertiary-care hospital—where women are likely to have more access to contraception than are women in other settings—the present study provided valuable information about the chosen methods of contraception in urban China.
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Conflict of interest
The authors have no conflicts of interest.