{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T09:36:39Z","timestamp":1783676199974,"version":"3.55.0"},"reference-count":72,"publisher":"Duke University Press","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Adolescent women aged 19 or younger make up a substantial and growing proportion of women of reproductive age in low- and middle-income countries. Several key features of the reproductive life course ground the need to disaggregate the contraceptive behaviors of adolescent women from those of older women, including relationship dynamics, resources and autonomy, and cultural and societal expectations regarding sexual activity and childbearing. Despite the importance and unique life course features of adolescent women, we lack the information about their contraceptive dynamics\u2014especially their patterns of contraceptive discontinuation\u2014needed to direct improvements to family planning programs for this oft-neglected group. We use Demographic and Health Surveys from 55 countries to describe contraceptive dynamics among adolescent women, comparing them with trends among women aged 20\u201349. We find that adolescent women tended to use reversible, short-acting methods, whereas those later in the reproductive life course tended to use long-acting methods and female sterilization. Across all regions, 12-month all-method discontinuation rates among those who discontinued their method while not wanting to get pregnant ranged from 16.7 to 34.2 discontinuations per person-month for adolescent women and from 12.0 to 28.8 discontinuations per person-month for older women. Side effects and health concerns were a leading discontinuation reason for both age groups in most regions, and infrequent sex and desire to become pregnant were more frequent discontinuation reasons for adolescent women in most regions. Not since 2009 have scholars compared contraceptive discontinuation rates across multiple countries and disaggregated by age. Furthermore, no prior publication has compared specific reasons for discontinuation between adolescent and older women. Understanding the distinct contraceptive dynamics of those earliest in their reproductive life course can help direct policy and programmatic interventions.<\/jats:p>","DOI":"10.1215\/00703370-11876504","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T09:10:02Z","timestamp":1743671402000},"page":"657-686","source":"Crossref","is-referenced-by-count":2,"title":["Contraceptive Use and Discontinuation Among Adolescent Women in 55 Low- and Middle-Income Countries"],"prefix":"10.1215","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0178-1000","authenticated-orcid":true,"given":"Clara E.","family":"Busse","sequence":"first","affiliation":[{"name":"Carolina Population Center and Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8314-8219","authenticated-orcid":true,"given":"Katherine","family":"Tumlinson","sequence":"additional","affiliation":[{"name":"Carolina Population Center and Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6713-1473","authenticated-orcid":true,"given":"Leigh","family":"Senderowicz","sequence":"additional","affiliation":[{"name":"Department of Gender and Women's Studies and Department of Obstetrics and Gynecology, University of Wisconsin\u2013Madison, Madison, WI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"73","published-online":{"date-parts":[[2025,4,1]]},"reference":[{"key":"2025041613030181800_dem11876504C1","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1363\/3701611","article-title":"What differentiates method stoppers from switchers? 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E. K.\n            \n          , CroftT. N., FishelJ. D., & WestoffC. F. (2012). Revising unmet need for family planning (DHS Analytical Studies, No. 25). Calverton, MD: ICF International. Retrieved from https:\/\/dhsprogram.com\/pubs\/pdf\/AS25\/AS25%5B12June2012%5D.pdf"},{"key":"2025041613030181800_dem11876504C6","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/sifp.12085","article-title":"Global contraceptive failure rates: Who is most at risk?","volume":"50","author":"Bradley","year":"2019","journal-title":"Studies in Family Planning"},{"key":"2025041613030181800_dem11876504C7","doi-asserted-by":"crossref","first-page":"100063","DOI":"10.1016\/j.conx.2021.100063","article-title":"When it comes to time of removal, nothing is straightforward\u201d: A qualitative study of experiences with barriers to removal of long-acting reversible contraception in Western Kenya","volume":"3","author":"Britton","year":"2021","journal-title":"Contraception: X"},{"key":"2025041613030181800_dem11876504C8","doi-asserted-by":"crossref","first-page":"2174244","DOI":"10.1080\/26410397.2023.2174244","article-title":"Prevalence of non-preferred family planning methods among reproductive-aged women in Burkina Faso: Results from a cross-sectional, population-based study","volume":"31","author":"Bullington","year":"2023","journal-title":"Sexual and Reproductive Health Matters"},{"key":"2025041613030181800_dem11876504C9","doi-asserted-by":"crossref","first-page":"2090057","DOI":"10.1080\/26410397.2022.2090057","article-title":"Reproductive empowerment and contraceptive self-care: A systematic review","volume":"29","author":"Burke","year":"2022","journal-title":"Sexual and Reproductive Health Matters"},{"key":"2025041613030181800_dem11876504C10","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1111\/sifp.12218","article-title":"Meeting preferences for specific contraceptive methods: An overdue indicator","volume":"54","author":"Burke","year":"2023","journal-title":"Studies in Family Planning"},{"key":"2025041613030181800_dem11876504C11","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1186\/1472-6963-13-532","article-title":"Provider imposed restrictions to clients\u2019 access to family planning in urban Uttar Pradesh, India: A mixed methods study","volume":"13","author":"Calhoun","year":"2013","journal-title":"BMC Health Services Research"},{"key":"2025041613030181800_dem11876504C12","first-page":"220","article-title":"What goes in must come out: A mixed-method study of access to contraceptive implant removal services in Ghana","volume":"8","author":"Callahan","year":"2020","journal-title":"Global Health: Science and Practice"},{"key":"2025041613030181800_dem11876504C13","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1136\/jfprhc-2015-101190","volume":"43","author":"Chavane","year":"2017","journal-title":"Journal of Family Planning and Reproductive Health Care"},{"key":"2025041613030181800_dem11876504C14","first-page":"366","article-title":"Accessible contraceptive implant removal services: An essential element of quality service delivery and scale-up","volume":"4","author":"Christofield","year":"2016","journal-title":"Global Health: Science and Practice"},{"key":"2025041613030181800_dem11876504C15","unstructured":"Chung\n              S\n            \n          . (2022). \u201cShe told me no, that with my weight it is better to use the IUD\u201d: A mixed-methods study of non-preferred contraceptive method use for medical reasons (Master's thesis). Department of Maternal and Child Health, University of North Carolina at Chapel Hill, Chapel Hill, NC."},{"key":"2025041613030181800_dem11876504C16","unstructured":"Croft\n              T. N.\n            \n          , MarshallA. M., AllenC. K., ArnoldF., AssafS., & BalianS. (2018). Guide to DHS statistics: DHS-7 (Report). Rockville, MD: ICF International. Retrieved from https:\/\/www.dhsprogram.com\/pubs\/pdf\/dhsg1\/guide_to_DHS_statistics_DHS-7.pdf"},{"key":"2025041613030181800_dem11876504C17","unstructured":"Darroch\n              J. E.\n            \n          , WoogV., BankoleA., & AshfordL. S. (2016). Adding it up: Costs and benefits of meeting the contraceptive needs of adolescents (Report). Guttmacher Institute. 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(2016). The stigma of reproductive health services utilization by unmarried women. Iran Red Crescent Medical Journal, 18, e24231. https:\/\/www.ircmj.com\/article_201859_44495319bc86b6b52eb4aa4abf7442e4.pdf","DOI":"10.5812\/ircmj.24231"},{"key":"2025041613030181800_dem11876504C41","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.contraception.2007.06.008","article-title":"Contraceptive discontinuation attributed to method dissatisfaction in the United States","volume":"76","author":"Moreau","year":"2007","journal-title":"Contraception"},{"key":"2025041613030181800_dem11876504C42","doi-asserted-by":"crossref","first-page":"3076","DOI":"10.3390\/ijerph19053076","article-title":"The provider role and perspective in the denial of family planning services to women in Malawi: A mixed-methods study","volume":"19","author":"Peterson","year":"2022","journal-title":"International Journal of Environmental Research and Public Health"},{"key":"2025041613030181800_dem11876504C43","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.contraception.2016.03.011","article-title":"Typical-use contraceptive failure rates in 43 countries with Demographic and Health Survey data: Summary of a detailed report","volume":"94","author":"Polis","year":"2016","journal-title":"Contraception"},{"key":"2025041613030181800_dem11876504C44","unstructured":"Polis\n              C. B.\n            \n          , BradleyS. E. K., BankoleA., OndaT., CroftT., & SinghS. (2016b). Contraceptive failure rates in the developing world: An analysis of Demographic and Health Survey data in 43 countries (Report). Guttmacher Institute. Retrieved from https:\/\/www.guttmacher.org\/report\/contraceptive-failure-rates-in-developing-world"},{"key":"2025041613030181800_dem11876504C45","unstructured":"Pritchett\n              L\n            \n          . (1996, February). No need for unmet need. Paper presented at the Hopkins Population Center Seminar Series, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD. Retrieved from https:\/\/lantpritchett.org\/wp-content\/uploads\/2019\/01\/noneedforunmetneed_hopkins.pdf"},{"key":"2025041613030181800_dem11876504C46","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1097\/MLR.0000000000001048","article-title":"Psychometric evaluation of an instrument to measure prospective pregnancy preferences: The Desire to Avoid Pregnancy Scale","volume":"57","author":"Rocca","year":"2019","journal-title":"Medical Care"},{"key":"2025041613030181800_dem11876504C47","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1111\/sifp.12084","article-title":"Toward a new definition of unmet need for contraception","volume":"50","author":"Rominski","year":"2019","journal-title":"Studies in Family Planning"},{"key":"2025041613030181800_dem11876504C48","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1080\/17441692.2014.986169","article-title":"Sexual and reproductive health and rights of adolescent girls: Evidence from low- and middle-income countries","volume":"10","author":"Santhya","year":"2015","journal-title":"Global Public Health"},{"key":"2025041613030181800_dem11876504C49","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1111\/sifp.12221","volume":"54","author":"Sarnak","year":"2023","journal-title":"Studies in Family Planning"},{"key":"2025041613030181800_dem11876504C50","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1111\/j.1741-3737.2010.00718.x","article-title":"Partnering across the life course: Sex, relationships, and mate selection","volume":"72","author":"Sassler","year":"2010","journal-title":"Journal of Marriage and Family"},{"key":"2025041613030181800_dem11876504C51","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1097\/GCO.0000000000000408","article-title":"Contraceptive counseling for continuation and satisfaction","volume":"29","author":"Schivone","year":"2017","journal-title":"Current Opinion in Obstetrics and Gynecology"},{"key":"2025041613030181800_dem11876504C52","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/j.socscimed.2018.09.030","article-title":"So that's why I'm scared of these methods\u201d: Locating contraceptive side effects in embodied life circumstances in Burundi and eastern Democratic Republic of the Congo","volume":"220","author":"Schwarz","year":"2019","journal-title":"Social Science & Medicine"},{"key":"2025041613030181800_dem11876504C53","unstructured":"Sedgh\n              G.\n            \n          , AshfordL. S., & HussainR. (2016). Unmet need for contraception in developing countries: Examining women's reasons for not using a method (Report). Guttmacher Institute. Retrieved from https:\/\/www.guttmacher.org\/report\/unmet-need-for-contraception-in-developing-countries"},{"key":"2025041613030181800_dem11876504C54","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1111\/j.1728-4465.2014.00382.x","article-title":"Reasons for contraceptive nonuse among women having unmet need for contraception in developing countries","volume":"45","author":"Sedgh","year":"2014","journal-title":"Studies in Family Planning"},{"key":"2025041613030181800_dem11876504C55","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/j.contraception.2015.06.050","article-title":"Side-effects and contraceptive uptake in urban Burkina Faso","volume":"92","author":"Senderowicz","year":"2015","journal-title":"Contraception"},{"key":"2025041613030181800_dem11876504C56","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1111\/sifp.12224","article-title":"Measuring contraceptive autonomy at two sites in Burkina Faso: A first attempt to measure a novel family planning indicator","volume":"54","author":"Senderowicz","year":"2023","journal-title":"Studies in Family Planning"},{"key":"2025041613030181800_dem11876504C57","doi-asserted-by":"crossref","first-page":"100154","DOI":"10.1016\/j.ssmqr.2022.100154","article-title":"She told me no, that you cannot change\u201d: Understanding provider refusal to remove contraceptive implants","volume":"2","author":"Senderowicz","year":"2022","journal-title":"SSM\u2013Qualitative Research in Health"},{"key":"2025041613030181800_dem11876504C58","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1111\/padr.12478","article-title":"Supply-side versus demand-side unmet need: Implications for family planning programs","volume":"48","author":"Senderowicz","year":"2022","journal-title":"Population and Development Review"},{"key":"2025041613030181800_dem11876504C59","doi-asserted-by":"crossref","first-page":"e005775","DOI":"10.1136\/bmjgh-2021-005775","article-title":"I haven't heard much about other methods\u201d: Quality of care and person-centredness in a programme to promote the postpartum intrauterine device in Tanzania","volume":"6","author":"Senderowicz","year":"2021","journal-title":"BMJ Global Health"},{"key":"2025041613030181800_dem11876504C60","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1363\/44e5418","article-title":"Bias in contraceptive provision to young women among private health care providers in South West Nigeria","volume":"44","author":"Sieverding","year":"2018","journal-title":"International Perspectives on Sexual and Reproductive Health"},{"key":"2025041613030181800_dem11876504C61","unstructured":"Starling\n              S.\n            \n          , BurgessS., BennetteN., & NeighborH. (2017). Literature review and expert interviews on provider bias in the provision of youth contraceptive services: Research summary and synthesis (Report). Beyond Bias Consortium. Retrieved from https:\/\/www.pathfinder.org\/wp-content\/uploads\/2018\/10\/BB_Research-Synthesis.pdf"},{"key":"2025041613030181800_dem11876504C62","doi-asserted-by":"crossref","first-page":"2642","DOI":"10.1016\/S0140-6736(18)30293-9","article-title":"Accelerate progress\u2014Sexual and reproductive health and rights for all: Report of the Guttmacher\u2013Lancet Commission","volume":"391","author":"Starrs","year":"2018","journal-title":"Lancet"},{"key":"2025041613030181800_dem11876504C63","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1111\/sifp.12232","article-title":"Misconceptions, misinformation, and misperceptions: A case for removing the \u201cmis-\u201d when discussing contraceptive beliefs","volume":"54","author":"Stevens","year":"2023","journal-title":"Studies in Family Planning"},{"key":"2025041613030181800_dem11876504C64","unstructured":"Streifel\n              C\n            \n          . (2020). Best practices for sustaining youth contraceptive use (Policy brief). Population Reference Bureau. Retrieved from https:\/\/www.prb.org\/wp-content\/uploads\/2021\/01\/best-practices-for-sustaining-youth-contraceptive-policy-brief.pdf"},{"key":"2025041613030181800_dem11876504C65","doi-asserted-by":"crossref","unstructured":"Sully\n              E. A.\n            \n          , BiddlecomA., DarrochJ. E., RileyT., AshfordL. S., Lince-DerocheN.,\u00a0.\u00a0.\u00a0.\u00a0MurroR. (2020). Adding it up: Investing in sexual and reproductive health 2019 (Report). New York, NY: Guttmacher Institute. Retrieved from https:\/\/www.guttmacher.org\/sites\/default\/files\/report_pdf\/adding-it-up-investing-in-sexual-reproductive-health-2019.pdf","DOI":"10.1363\/2020.31593"},{"key":"2025041613030181800_dem11876504C66","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.contraception.2022.06.014","article-title":"Contraceptive method denial as downward contraceptive coercion: A mixed-methods mystery client study in western Kenya","volume":"115","author":"Tumlinson","year":"2022","journal-title":"Contraception"},{"key":"2025041613030181800_dem11876504C67","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.contraception.2015.04.002","article-title":"Provider barriers to family planning access in urban Kenya","volume":"92","author":"Tumlinson","year":"2015","journal-title":"Contraception"},{"key":"2025041613030181800_dem11876504C68","first-page":"407","volume":"1","author":"Tumlinson","year":"2013","journal-title":"Global Health: Science and Practice"},{"key":"2025041613030181800_dem11876504C69","unstructured":"UNICEF. 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