Why Iranian married women use withdrawal instead of oral contraceptives? A qualitative study from Iran

This was a qualitative study. Participants were 50 married women, not currently pregnant, not desiring pregnancy and who had been using withdrawal for contraception. Face-to face interviews were conducted to collect data. Content analysis was performed to analyze the data.Four major themes were extracted from the interviews: advantages, disadvantages, barriers for OC use, and husband-related factors. Advantages of withdrawal use were identified as: easy to use, convenient, ease of access, natural. Even those participants who had experienced unwanted pregnancy while using withdrawal, relied on withdrawal as their contraceptive method. Disadvantages of OC included concerns about side effects. Barriers related to use of OC included the need for medical advice, vaginal examination and daily use. Husband-related factors included: the husband wanted to be the primary decision maker on the number of children and that he preferred withdrawal.Health providers should address misunderstandings that exist about OC and highlight the non-contraceptive health benefits of OC to balance the information provided for women. We suggest that not only women but also their spouses be advised in family planning programs.According to Iran's Demographic Health Survey (DHS) carried out in October 2000 by the Iranian Family Planning (FP) program, 73.7% of currently married women were using contraception, but only 55.9% used modern methods. Almost one in five married women, 18.4%, use OC; 17.1% rely on female sterilization; 2.7% rely on vasectomy; IUDs are used by 8.5%, condoms by 5.9%, and norplant implants by 0.5%. The proportion of couples relying on the traditional method of withdrawal was 17.8%, even though the national program did not encourage this method. In addition it was found that 18% of currently unintended pregnancies belonged to women who said they were using contraception, but 10% of them reported that they had used withdrawal before becoming pregnant [1].Withdrawal is known to