The rise and fall of levonorgestrel implants: 1992-1996

Objective: To assess shifts over a 4-year period in attitudes of low- income US women regarding use of levonorgestrel implants. Methods: An anonymous questionnaire was administered at two different points in time to English-speaking women of reproductive age seeking gynecologic or obstetric care in southeast Texas. The first survey, administered to 762 women in 1992, elicited information on demographic and reproductive characteristics, as well as exposure to information on implants and attitudes regarding use of this method. This same survey was administered again in 1995-1996 to 502 women. χ², Student t, or Kruskal-Wallis nonparametric tests were used to evaluate shifts in attitudes and perceived barriers to use across the 4-year period. Results: Women portrayed less positive attitudes about levonorgestrel implants when surveyed in 1995-1996 as compared with 1992. Most notably, they appeared less appreciative of the convenience associated with implant use and more concerned with potential side effects. Nulliparous and parous women surveyed in 1995-1996 were significantly less likely than those surveyed in 1992 to state that they would consider using this method for birth control (P < .001) and were more likely to state that their partner, friends, and family would object to their use of levonorgestrel implants. Conclusion: This study documents the decline in popular perceptions of levonorgestrel implants among low-income English-speaking women over the 4-year period following the introduction of this contraceptive method to the US market.