Attitudes toward contraception in three different populations

P. Tsikouras(1), G. Galazios(1), N. Koutlaki (1), M. Emin (1), V. Liberis (1), G. Maroulis (1), A. T. Teichmann(2).

Department of Obstetrics and Gynecology Democritus University of Thrace,Greece.(1)

Department of Obstetrics and Gynecology Aschaffenburg,Germany.(2)

Introduction: The integration of contraception into a woman‘s concept of life strongly depends on different customs, different religions and cultures, moral and ethical codes, behavioral manners and practices. Avoiding an unwanted pregnancy and subsequent pregnancy termination interacts closely with social and family policies. The aim of the present study was to explore contraceptive behavior of women belonging to three different ethnic and/or religious populations. We also intented to draw conclusions on social and economic parameters influencing female attitude towards contraception as well as to evaluate the main sources of information concerning contraception in each population.

Material and Methods: The study included representatives from three female subgroups: 140 Christian Orthodox living in Thrace (group C), 120 Muslims living in Thrace ( group B ), and 150 Muslims living in Germany (group A). Participants from each group were asked to answer a detailed questionnaire extensively, concerning data, socio-economic status, sexual activity and contraceptive practices. Statistical analysis was performed using one way analysis of variance (ANOVA), followed by Turkey _ s test, chi-square test and multiple logistic regression analysis.

Results: The three groups were compared in terms of age (p=0.904) and residence place (p=0.499), but not in terms of social status (p<0.001), standing partner (p=0.012) and occupation (p<0.001). The Contraceptive pill (41.7%), the condom (35.1%), periodic abstinence (24.4%) and interrupted coitus (21.5%) were the most common methods of contraception, with the contraceptive pill being the most prevalent method among Muslims from Germany (50.0%), Christians from Greece (54.3%) and the periodic abstinence among Muslims from Greece (39.2%). The gynaecologist (23.4%), the family consultant (12.0%) and the partner (10.2%) were the most usual sources of information.

The use of the contraceptive pill was more frequent among Muslims from Germany and Christians from Greece (p<0.001), as well as among unmarried women with a partner (p=0.021), while the use of the condom was more frequent among Christians from Greece (p=0.019) and women living in rural areas (p=0.038) and less frequent among unmarried women with a partner (p=0.022).

Muslims from Thrace were more likely to practice periodic abstinence and interrupted coitus (both p<0.001). Interrupted coitus was also frequent among unemployed women (p=0.009). The use of IUD was more frequent among Muslims from Germany or Greece (p=0.039), while spermicides were more frequent among women younger than 25 years old (p=0.028), unmarried women with or without a partner (p=0.012) and students (p=0.012). Finally, the use of the diaphragm was more common among Christians from Greece (p=0.002), women younger than 25 years old (p=0.026) and students (p=0.001).

Conclusions: Our study results reveal that there are behavioral differences between race/ethnicity and minority groups regarding contraceptive practices, that the gynecologist is a major participant in the development of the womens’ concept and that reliable contraception supports and facilitates lifestyle and provides security. Finally the need for sexual education and easy access to counselling services is apparent in order to promote optimal contraception decision-making.