A qualitative study of the perceptions of dissatisfied Norplant users

The purpose of this study was to examine specific factors that motivated the request for early removal of Norplant among a group of young, low-income women who were dissatisfied with this contraceptive method.

Focus groups were conducted to obtain qualitative in-depth attitude and opinion data about Norplant from women who had used this method of contraception for a period ranging from 2 months to 25 months and had requested its removal because of side effects.

Patient motivation for requesting Norplant removal was based on side effects. No other reason for early removal requests emerged from the focus group discussions. However, the comments of many participants raised questions about the psychosocial context in which patients obtain information about Norplant and request early removal. Many participants mentioned having felt pressured to accept Norplant and not being fully informed about possible side effects. All but two said they were encouraged to "wait out" side effects and that physicians were reluctant to remove the Norplant capsules. Many participants recalled that they had to request removal several times before their physicians complied with their wishes.

The results of this study suggest that there is a need to review the process of educating patients about Norplant, the situational context of Norplant counseling, and physician practices related to patients' requests for early removal.