The use of withdrawal among birth limiters in Iran and Turkey

Despite a decline infertility, an increase in contraceptive prevalence, and a wide expansion of family planning programs in Iran and Turkey, a large proportion of "birth limiters" rely on withdrawal to avoid pregnancy. Adopting a comparative approach, this study draws on data from the 2000 Iran DHS and 2003 Turkey DHS to examine the determinants of the practice of withdrawal among birth limiters. Multivariate logistic regression analyses were employed to estimate the likelihood of withdrawal use among two representative samples of birth limiters. Higher education and wealth were associated with greater likelihood of withdrawal use among birth limiters in Iran, while an inverse association was found in Turkey. Older age was positively associated with withdrawal in both countries, whereas having more than four children was inversely related to use. Study results suggest that family planning and reproductive health programs in Iran and Turkey should be aware of the groups that have high rates of withdrawal use, should educate couples in the effective use of withdrawal, and should encourage the use of more effective modern methods and emergency contraceptives when appropriate.