ABSTRACT
Among 600 women at 17 family planning clinics in Texas who expressed interest in using the hormonal injectable depot medroxyprogesterone acetate (DMPA), 536 (89%) actually received the injectable. Thirty percent of the DMPA recipients were younger than 21 and 77% were not married. The average numbers of pregnancies and births were 1.9 and 1.2 per woman; one-third of the women had had at least one abortion. The majority of women receiving DMPA (66%) were using it to space births. Their main sources of information about the method were friends (42%) and health care providers (37%), and the most commonly reported reason for its use was dissatisfaction with previous contraceptive methods.
PIP: The purpose of this prospective study was to add to the little data that exists concerning the characteristics and attitudes of depot medroxyprogesterone acetate (DMPA) users. Among 600 women at 17 family planning clinics in Texas who expressed interest in using the hormonal injectable DMPA, 536 (89%) actually received the injectable. DMPA users were significantly more likely than other women to be 20-24 years old, whereas a smaller percentage were 30 or older (p 0.001). 30% of the DMPA recipients were younger than 21; 50% were Black; and the rest were either White (25%) or Hispanic (24%). 77% of women adopting DMPA were not married. In contrast, most of the other patients who received contraceptive care at these clinics were married (64%; p 0.001). The average education of the DMPA acceptors was 11.9 years: Hispanic women had significantly less education (10.6 years) than did either Blacks or Whites (p or= 0.001). The average numbers of pregnancies and births were 1.9 and 1.2 per woman; 1/3 of the women had had at least 1 abortion. 34% of the women indicated they had no desire for more children. The majority of women receiving DMPA (66%) were using it to space births. Their main sources of information about the method were friends (42%) and health care providers (37%). 58% of the women reported dissatisfaction with previous contraceptive methods as the reason for its use, while 42% chose it because they were curious about it. 17% of the women were concerned about the method's effect on future pregnancies and 10% about the women's ability to conceive. In addition, a possible hormonal effect and the newness of the method were each cited by about 15% of DMPA users. The most frequently cited reasons for not receiving the injection involved the fear of bleeding (21%), acne or skin problems (21%), abdominal pain (19%), and weight gain (14%). One potential limitation of these findings is that the attitudes of women of lower socioeconomic status about DMPA may differ from their more affluent counterparts.
