Introduction: Withdrawal as one of the traditional family planning methods has been prevalent for a long time and its history dates back to pre-Islam period. Two groups have usually been using this method more often. On the one hand, illiterate people who have had little knowledge about the modern methods of family planning, and on the other hand, highly educated people who either had knowledge or had fear of side effects of modern methods. The frequency of using traditional methods in Gilan is the highest in Iran (30%), and about one third of contraceptive methods in Gilan include withdrawal. The proportion of unwanted pregnancies is high among those who use withdrawal in this province as well. The aim of this survey is to study the effective reasons and factors in choosing withdrawal method among couples in Rasht which result will be used for designing a comprehensive family planning program. Material & Methods: Both quantitative and qualitative methods were used in this study. In the quantitative method, the Iran Fertility Transition Survey data was used. In the analysis, statistical tests such as 2, analysis of variance, and logistic regression analysis were employed. Qualitative method in this study included in-depth interview and focus group discussion. Of women under the coverage of the three health centers in Rasht city, 27 women who had used withdrawal were randomly selected and interviewed. In addition, two focus group discussions were conducted, one with provincial health officers (7 health officers employed in Provi-ncial as well as city health departments), & one with field officers (5 field officers and 3 health volunteers) in Rasht. Results: The results showed that around 70% of rural women as against 57% of urban women were using modern methods of contraception. In general, 38.3% of all women using contraceptives were using traditional methods at the time of IFTS. There was a statistically significant correlation between place of residence and method (withdrawal or modern) used. Among all independent variables included in logistic regression analy-sis, number of children ever born, duration of marriage, and source of knowledge of contraception were signi-ficant and remained in the final model. The results of qualitative method revealed that couples use withdrawal in order to avoid side effects of modern methods. The wide use of withdrawal in Rasht can be attributed to the understanding of men of the health situation of their wife. Conclusion: Expansion and the improvement of quality of family planning services can have significant effects on the selection of modern contraceptives. However, given the inclination of couples towards using withdrawal, this method should also be officially recognized by family planning centers as a family planning method and the necessary training should be provided for this method. Since the high proportion of unwanted pregnancies have occurred while couples were using this method, trainings should aim to increase the awareness of women of their menstrual cycle and emergency contraceptives particularly in urban areas.
Keywords: Withdrawal, Family planning, Reproductive period, Qualitative method To cite this article:
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