Abstract
Objective
The study was designed to determine the impact of structured counseling by trained contraceptive counselors in a real-life clinical setting on the adoption of modern contraceptive methods in comparison with past contraceptive experience.
Methods
Current study was a retrospective, non-interventional design, from the data collected in the time period of March to September 2013 across four clinics with predominant obstetric and gynecological practice. Three hundred and fifty-one women consulting for contraception were counseled by trained counselors using standardized counseling tools.
Results
Of the 351 women counseled, 40.74 % (n = 143) had never used a contraceptive (no method) and 42.74 % (n = 150) women whose partner had or were using a “male condom.” Post-counseling by a trained counselor, there was a significant (p < 0.001) increase in modern contraceptive use (91.74 %, n = 322) versus prior counseling (52.14 %, n = 183) proportion of women who had or were using a modern contraceptive. The change observed for each method pre-counseling (usage history) to post-counseling was as follows: combined oral contraceptive (COC) 1.99–5.41 %, progesterone-only pill (POP) 0.85–30.48 %; copper intrauterine device (Cu-IUD) 4.27–29.4 %; injectable contraceptive 1.71–20.51 %; male condom 42.74–1.42 %; no method 40.74–7.41 %; traditional 7.12–0.85 %; and sterilization 0.28–1.71 %.
Conclusion
This study is a first of its kind, conducted in the private sector, and clearly highlights the benefits of a trained counselor in contraceptive counseling with a significant proportion of women choosing a modern contraceptive. With a busy private practice, a trained counselor facilitates the clinician’s role and helped the women to choose a suitable modern contraceptive method.
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Acknowledgments
This study has been done under a grant received from the Merck investigator Initiated Studies Program (MISP). We acknowledge the help provided by Dr. Ashish Birla, Sr. Medical Advisor, MSD, in the preparation of the manuscript.
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Shakuntla Kumar, Dipti Nabh, Rupam Arora and Praveen Garg declare that they have no conflict of interest.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Protocol approved by SPECT (Society for Promotion of Ethical Clinical trials, New Delhi, dated: September 5, 2014; CTRI Registration: CTRI/2014/12/005311.
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Dr. Shakuntla Kumar MBBS, DGO, Dip. Endo Surgery (Germany), is a Director, in Nulife Hospital, Delhi; Dr. Dipti Nabh MBBS, MS (Obstetrics and Gynecology), is a Director, in Mother and Child hospital, Delhi; Dr. Rupam Arora MBBS, MS (Obstetrics and Gynecology), is a Consultant Obstetrician and Gynecologist (Lifeline Hospital and Max Hospital Delhi); Dr. Praveena Garg MBBS, MD, is a Director, in Hitaishi Hospital, Delhi.
Appendix: Counseling Tool
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Kumar, S., Nabh, D., Arora, R. et al. Impact of Structured Counseling with Trained Counselors in Choosing a Modern Contraceptive Method in India. J Obstet Gynecol India 66 (Suppl 1), 548–559 (2016). https://doi.org/10.1007/s13224-016-0887-x
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DOI: https://doi.org/10.1007/s13224-016-0887-x