An in-depth interview study of women's perspectives on the effects of contraceptive use on future fertility in Ethiopia and Kenya
Infertility is a common perceived side effect of contraceptive use among women in sub-Saharan Africa, and fear of infertility can affect contraceptive choices. While no choice is inherently negative, it is critical that women have accurate information about side effects to ensure contraceptive decis...
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Elsevier
2025-12-01
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| Series: | SSM: Qualitative Research in Health |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667321525001027 |
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| author | Kristen Kirksey Hanna Feleke Sarah Okumu Hailemichael Bizuneh Pauline Wekesa Lauren Suchman Beth Phillips Zachary Kwena Jenny Liu Elizabeth Bukusi Serah Gitome Ewenat Gebrehanna Kelsey Holt |
| author_facet | Kristen Kirksey Hanna Feleke Sarah Okumu Hailemichael Bizuneh Pauline Wekesa Lauren Suchman Beth Phillips Zachary Kwena Jenny Liu Elizabeth Bukusi Serah Gitome Ewenat Gebrehanna Kelsey Holt |
| author_sort | Kristen Kirksey |
| collection | DOAJ |
| description | Infertility is a common perceived side effect of contraceptive use among women in sub-Saharan Africa, and fear of infertility can affect contraceptive choices. While no choice is inherently negative, it is critical that women have accurate information about side effects to ensure contraceptive decision-making agency. Despite the prevalence of infertility fears, little is known about women's specific beliefs, where they originate, and how they inform contraceptive decisions. We sought to fill this gap in Kenya and Ethiopia through in-depth interviews with women aged 15–45 in Nairobi and Kisumu, Kenya, and Addis Ababa and North Shoa Zone of Amhara Region, Ethiopia (N = 83). We utilized a modified grounded theory approach for data collection and analysis.While not all participants believed in a link between contraception and infertility, those that did understood several mechanisms. Some, such as delayed return to fertility and aging out of childbearing years, were supported by clinical evidence. Others, such as accumulation of harmful substances in the body, damage to the reproductive system, and negative effects from early or prolonged use, were not supported by clinical evidence. Healthcare providers were a trusted source of information, disseminating information supported and unsupported by clinical evidence. Fear of infertility led women to prefer non-hormonal or short-term methods, avoid methods that cause amenorrhea, or delay use until after having children.Results suggest the need to address side effect misinformation given by providers. Further, the specificity this study offers can inform strategies to improve contraceptive counseling and education campaigns in service of decision-making agency. |
| format | Article |
| id | doaj-art-7cf7600b330b487b8ee3a99db9849bf0 |
| institution | Kabale University |
| issn | 2667-3215 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | SSM: Qualitative Research in Health |
| spelling | doaj-art-7cf7600b330b487b8ee3a99db9849bf02025-08-26T04:14:36ZengElsevierSSM: Qualitative Research in Health2667-32152025-12-01810062410.1016/j.ssmqr.2025.100624An in-depth interview study of women's perspectives on the effects of contraceptive use on future fertility in Ethiopia and KenyaKristen Kirksey0Hanna Feleke1Sarah Okumu2Hailemichael Bizuneh3Pauline Wekesa4Lauren Suchman5Beth Phillips6Zachary Kwena7Jenny Liu8Elizabeth Bukusi9Serah Gitome10Ewenat Gebrehanna11Kelsey Holt12University of California, San Francisco, Institute for Health & Aging, 490 Illinois Street, 12th Floor, Box 0646, San Francisco, CA, 94143, USA; Corresponding author.Saint Paul's Hospital Millennium Medical College, School of Public Health, 1271 Swaziland Street, Box 1271, Addis Ababa, EthiopiaKenya Medical Research Institute, Center for Microbiology Research, Mbagathi Road, Box, 54840-00200, Nairobi, KenyaSaint Paul's Hospital Millennium Medical College, School of Public Health, 1271 Swaziland Street, Box 1271, Addis Ababa, EthiopiaKenya Medical Research Institute, Center for Microbiology Research, Mbagathi Road, Box, 54840-00200, Nairobi, KenyaUniversity of California, San Francisco, Institute for Health & Aging, 490 Illinois Street, 12th Floor, Box 0646, San Francisco, CA, 94143, USAUniversity of California, San Francisco, Institute for Health & Aging, 490 Illinois Street, 12th Floor, Box 0646, San Francisco, CA, 94143, USAKenya Medical Research Institute, Center for Microbiology Research, Mbagathi Road, Box, 54840-00200, Nairobi, KenyaUniversity of California, San Francisco, Institute for Health & Aging, 490 Illinois Street, 12th Floor, Box 0646, San Francisco, CA, 94143, USAKenya Medical Research Institute, Center for Microbiology Research, Mbagathi Road, Box, 54840-00200, Nairobi, KenyaKenya Medical Research Institute, Center for Microbiology Research, Mbagathi Road, Box, 54840-00200, Nairobi, KenyaSaint Paul's Hospital Millennium Medical College, School of Public Health, 1271 Swaziland Street, Box 1271, Addis Ababa, EthiopiaUniversity of California, San Francisco, Institute for Health & Aging, 490 Illinois Street, 12th Floor, Box 0646, San Francisco, CA, 94143, USAInfertility is a common perceived side effect of contraceptive use among women in sub-Saharan Africa, and fear of infertility can affect contraceptive choices. While no choice is inherently negative, it is critical that women have accurate information about side effects to ensure contraceptive decision-making agency. Despite the prevalence of infertility fears, little is known about women's specific beliefs, where they originate, and how they inform contraceptive decisions. We sought to fill this gap in Kenya and Ethiopia through in-depth interviews with women aged 15–45 in Nairobi and Kisumu, Kenya, and Addis Ababa and North Shoa Zone of Amhara Region, Ethiopia (N = 83). We utilized a modified grounded theory approach for data collection and analysis.While not all participants believed in a link between contraception and infertility, those that did understood several mechanisms. Some, such as delayed return to fertility and aging out of childbearing years, were supported by clinical evidence. Others, such as accumulation of harmful substances in the body, damage to the reproductive system, and negative effects from early or prolonged use, were not supported by clinical evidence. Healthcare providers were a trusted source of information, disseminating information supported and unsupported by clinical evidence. Fear of infertility led women to prefer non-hormonal or short-term methods, avoid methods that cause amenorrhea, or delay use until after having children.Results suggest the need to address side effect misinformation given by providers. Further, the specificity this study offers can inform strategies to improve contraceptive counseling and education campaigns in service of decision-making agency.http://www.sciencedirect.com/science/article/pii/S2667321525001027InfertilityContraceptive side effectsContraceptive counselingContraceptive agencyGrounded theory |
| spellingShingle | Kristen Kirksey Hanna Feleke Sarah Okumu Hailemichael Bizuneh Pauline Wekesa Lauren Suchman Beth Phillips Zachary Kwena Jenny Liu Elizabeth Bukusi Serah Gitome Ewenat Gebrehanna Kelsey Holt An in-depth interview study of women's perspectives on the effects of contraceptive use on future fertility in Ethiopia and Kenya SSM: Qualitative Research in Health Infertility Contraceptive side effects Contraceptive counseling Contraceptive agency Grounded theory |
| title | An in-depth interview study of women's perspectives on the effects of contraceptive use on future fertility in Ethiopia and Kenya |
| title_full | An in-depth interview study of women's perspectives on the effects of contraceptive use on future fertility in Ethiopia and Kenya |
| title_fullStr | An in-depth interview study of women's perspectives on the effects of contraceptive use on future fertility in Ethiopia and Kenya |
| title_full_unstemmed | An in-depth interview study of women's perspectives on the effects of contraceptive use on future fertility in Ethiopia and Kenya |
| title_short | An in-depth interview study of women's perspectives on the effects of contraceptive use on future fertility in Ethiopia and Kenya |
| title_sort | in depth interview study of women s perspectives on the effects of contraceptive use on future fertility in ethiopia and kenya |
| topic | Infertility Contraceptive side effects Contraceptive counseling Contraceptive agency Grounded theory |
| url | http://www.sciencedirect.com/science/article/pii/S2667321525001027 |
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