Short-Term Use of Injectable Contraception: An Effective Strategy for Safe Motherhood

  • Suvarna Satish Khadilkar
Invited Mini Review


Use of contraception is a substantial and effective preventive strategy to reduce maternal mortality, especially in developing countries. Numbers of unintended pregnancies and unmet contraceptive need are still high in many developing countries, and hence abortion-related deaths are also very high. Every two hours a woman dies from an unsafe abortion in India! Hence, the problem of unsafe abortions is especially acute. There were 620,472 reported abortions in 2012; experts say the true number of abortions performed in the country could be as high as 7 million, with two-thirds of them taking place outside authorized health facilities [1]. The global perception is also stark; the number of women with an unmet need for family planning has been projected to grow to 962 million by 2015.

Safe Motherhood Programme

Good antenatal care, intrapartum care, post-partum care and appropriate use of contraception are four ways to achieve safe motherhood.

Contraceptive use averts almost...


  1. 1.
  2. 2.
    Singh S, Darroch JE, Ashford LS, et al. Adding it up: the costs and benefits of investing in family planning and maternal and newborn health. New York: Guttmacher Institute and United Nations Population Fund; 2009.Google Scholar
  3. 3.
    Liu L, Becker S, Tsui A, et al. Three methods of estimating births averted nationally by contraception. Popul Stud (Camb). 2008;62:191–210.CrossRefGoogle Scholar
  4. 4.
    Joshi R, Khadilkar S, Patel M. Global trends in use of long-acting reversible and permanent methods of contraception: seeking a balance. Int J Gynaecol Obstet. 2015;131(Suppl 1):S60–3.CrossRefPubMedGoogle Scholar
  5. 5.
    Said S, Omar K, Koetsawang S, et al. A multicentered phase III comparative clinical trial of depot-medroxyprogesterone acetate given three-monthly at doses of 100 mg or 150 mg: II. The comparison of bleeding patterns. World Health Organization. Task Force on Long-Acting Systemic Agents for Fertility Regulation Special Programme of Research, Development and Research Training in Human Reproduction. Contraception. 1987;35:591–610.CrossRefPubMedGoogle Scholar
  6. 6.
    National Collaborating Centre for Women’s and Children’s Health (UK). NICE clinical guidelines, No. 30. London: RCOG Press; 2005.Google Scholar
  7. 7.
    Jain J, Dutton C, Nicosia A, et al. Pharmacokinetics, ovulation suppression and return to ovulation following a lower dose subcutaneous formulation of Depo-Provera(R). Contraception. 2004;70:11–8.CrossRefPubMedGoogle Scholar
  8. 8.
    Task force on long-acting agents for the regulation of fertility. Multinational comparative clinical trial of long-acting injectable contraceptives: norethisteroneenanthate given in two dosage regimens and depot-medroxyprogesterone acetate. Final report. Contraception. 1983;28:1–20.Google Scholar
  9. 9.
    Sekadde-Kigondu C, Mwathe EG, Ruminjo JK, et al. Acceptability and discontinuation of Depo-Provera, IUCD and combined pill in Kenya. East Afr Med J. 1996;73:786–94.PubMedGoogle Scholar
  10. 10.
    Khadilkar S, Sood A, Shivkar KS, et al. Short term use of INJ DMPA: key to successful family planning programme. Contraception and fertility control (EP9.033). BJOG Int J Obstet Gynaecol. 2016;123:170–7. doi: 10.1111/1471-0528.14107.CrossRefGoogle Scholar
  11. 11.
    Schwallie PC, Assenzo JR. The effect of depo-medroxyprogesterone acetate on pituitary and ovarian function, and the return of fertility following its discontinuation: a review. Contraception. 1974;10:181–202.CrossRefPubMedGoogle Scholar
  12. 12.
    Technical guidance/competence working group and World Health Organization. Progestin-only injectables (DMPA and NET-EN). Recommendations for updating selected practices in contraceptive use. Accessed 17 Sept 2005.
  13. 13.
    WHO. Medical eligibility criteria for contraceptive use. Geneva: World Health Organization; fifth, edition 2015.
  14. 14.
    Mohllajee AP, Curtis KM. Progestogen-only contraceptive use in obese women. World Health Organization, division of reproductive health, centers for disease control and prevention. US Agency for International Development and National Institute of Child Health and Human Development; 2004.Google Scholar

Copyright information

© Federation of Obstetric & Gynecological Societies of India 2017

Authors and Affiliations

  1. 1.Bombay Hospital Institute of Medical Sciences and Medical Research CenterMumbaiIndia

Personalised recommendations