A Study on Contraceptive Choices and Usage Trends Among Reproductive Age Individuals in Urban and Rural Areas

Background Contraceptive utilization is a key element of reproductive health and family planning. Despite national initiatives promoting modern contraceptive methods in India, substantial disparities persist between urban and rural populations. This study was done to compare the prevalence, types, and determinants of contraceptive use, including unmet needs, among reproductive-aged individuals in urban and rural settings. Methods A mixed-methods study was conducted over three months among 1,000 individuals (608 urban, 392 rural) aged ≥18 years in Chennai, Tamil Nadu. Participants were recruited through convenience sampling from urban and rural health training centers affiliated with Sree Balaji Medical College and Hospital. Data were collected using a structured questionnaire covering demographics, reproductive history, contraceptive use, and reasons for unmet needs. Quantitative data were analyzed using SPSS software, version 23 (IBM Corp., Armonk, NY) with Chi-square tests and logistic regression; qualitative data underwent thematic analysis. Results The overall contraceptive prevalence was 58.7%, significantly higher in urban areas (74.01%) than rural areas (34.95%) (p < 0.001). Female sterilization was most common in rural areas (50%), while urban participants favored barrier methods (25%) and oral contraceptive pills (14.97%). Literacy (adjusted odds ratio (AOR) = 2.80; 95% CI: 2.05-3.82) and urban residence (AOR = 4.20; 95% CI: 3.25-5.43) were significant predictors. Barriers included fear of side effects, religious beliefs, spousal opposition, and limited service access. Conclusion This study highlights a stark contrast in contraceptive trends between urban and rural populations, shaped by educational status, access, cultural beliefs, and gender dynamics. Addressing unmet needs in family planning requires community-tailored interventions focusing on male engagement, contraceptive education, and strengthening the health system to improve accessibility and autonomy in reproductive choices.