Determinants of the Unmet Need for Family Planning Among Women of Udaipur, Rajasthan

Determinants of the Unmet Need for Family Planning Among Women of Udaipur, Rajasthan | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Determinants of the Unmet Need for Family Planning Among Women of Udaipur, Rajasthan Nehal Lalpuria, Nidhi Modi, Lakshya Joshi, Nilesh Kachhawha, Dr. Sachin Patil This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8613684/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract This cross-sectional observational study assessed the socio-demographic factors influencing contraceptive use and identified reasons for non-utilization of family planning methods among reproductive-age women in Udaipur, Rajasthan. A total of 50 women aged 15–45 years admitted to the Obstetrics and Gynaecology ward of GBH General Hospital were surveyed over 15 days in February 2023. The findings revealed that 32% of the population had unmet family planning needs, with opposition from husband and in-laws (37.5%) and lack of knowledge (18.7%) being the primary barriers. Age, religion, family structure, education, and employment status emerged as significant determinants of contraceptive acceptance. The study highlights the critical need for comprehensive health education and community-based interventions to address cultural and social barriers to family planning adoption. Health Economics & Outcomes Research Contraceptive acceptance Family planning Unmet need Socio-demographic factors India 1. Introduction India's population has experienced unprecedented growth over the past several decades, fundamentally reshaping the nation's demographic landscape. According to the World Population Review, India surpassed China in January 2023 to become the world's most populous nation, with an estimated population of 1.41 billion by the end of 2022—approximately 5 million more than China[ 1 ]. This demographic shift has precipitated urgent conversations about population management and sustainable development. Recognizing the need for proactive population policies, India became the first country globally to launch a national family planning programme in 1952, demonstrating early understanding of population dynamics[ 1 ]. However, the programme's trajectory was shaped by deeply rooted cultural and religious contexts. In a nation where children have traditionally been regarded as "God's gift," the concept of birth control faced significant social resistance. Historical figures like Avabai Wadia, a pioneering advocate for family planning, openly acknowledged initial cultural opposition, stating that "the first time I heard the word birth control I was revolted"[ 2 ]. This cultural backdrop continues to influence contraceptive adoption rates today. Despite nearly seven decades of programmatic efforts, family planning remains underutilized in India. Current evidence indicates that more than 100 million women globally in less developed countries—representing approximately 17% of all married women—would prefer to avoid pregnancy yet do not use any form of contraception[ 1 ]. In India specifically, demographers and health specialists refer to these individuals as having "unmet need for family planning." Despite government initiatives, the national unmet need for family planning persists at 12.8%[ 1 ]. The consequences of unmet contraceptive needs are profound and multifaceted. Non-use of contraceptives forces women into cycles of repeated pregnancy and lactation, limiting their educational, economic, and social opportunities. This pattern perpetuates intergenerational poverty and contributes to adverse maternal and child health outcomes. Research indicates that the primary reason for non-utilization of contraceptive methods is "health concerns or side effects," particularly among rural populations[ 2 ]. Non-use due to "opposition from others" disproportionately affects married women compared to unmarried women, while "lack of access" or "lack of knowledge" demonstrates a rural-urban disparity approximately 2 times higher in rural areas[ 2 ]. Additional barriers include misconceptions about contraceptive efficacy and safety. For example, some men fear that sterilization procedures would result in loss of muscularity and reduce their capacity for physically demanding work[ 2 ]. This misconception, combined with gender-specific adoption patterns—where female sterilization (36%) vastly outpaces male sterilization (0.3%)—demonstrates how gender dynamics intersect with family planning decisions[ 1 ]. Study Rationale Understanding the specific socio-demographic determinants of contraceptive use and the contextual reasons for non-utilization is essential for designing targeted, culturally sensitive interventions. This study was conducted in Udaipur, Rajasthan, to elucidate these factors within a specific regional context. 2. Objectives To determine the socio-demographic factors affecting contraceptive use among reproductive-age married women To identify and quantify reasons for non-utilization of family planning methods To estimate unmet needs for family planning among reproductive-age married women 3. Materials and Methods Study Design and Setting This was a hospital-based, cross-sectional observational study. The study was conducted at GBH General Hospital, affiliated with the American International Institute of Medical Sciences, Udaipur, Rajasthan. Study Population All women aged 15–45 years admitted to the Obstetrics and Gynaecology ward during the study period were eligible for participation. Inclusion Criteria Women aged 15–45 years Married women Willingness to provide informed verbal consent Exclusion Criteria Women below 15 years or above 45 years of age Widowed or single women Women unable or unwilling to provide consent Study Period and Sample Size The study was conducted over 15 days in February 2023. A total of 50 women meeting the inclusion criteria were enrolled. Data Collection Data was collected using a predesigned, pretested, structured questionnaire administered during face-to-face interviews following admission to the Obstetrics and Gynaecology ward. The questionnaire collected information on: Demographic characteristics (age, religion, family structure) Socio-economic factors (education level, employment status) Contraceptive use and acceptance patterns Reasons for non-utilization of family planning methods Knowledge and awareness regarding available contraceptive options Data Analysis Data was entered and analyzed to determine prevalence of contraceptive acceptance across different socio-demographic categories. Cross-tabulations were performed to identify associations between socio-demographic variables and contraceptive utilization patterns. 4. Results 4.1 Overview of Sample Characteristics The study examined 50 women of reproductive age admitted to the Obstetrics and Gynaecology ward. Of these, 37 women (74%) had accepted contraceptive methods, while 13 women (26%) had not. 4.2 Socio-Demographic Determinants of Contraceptive Acceptance Table 1 Table 1 : Socio-Demographic Determinants of Contraceptive Acceptance and Contraceptive Type (N = 50) Variable Contraceptive Acceptance Contraceptive Type Yes No Temporary Permanent Age Group (Years) $ $ 35 2 1 1 1 Religion Hindu 35 12 32 3 Muslim 1 2 1 0 Family Type Nuclear 7 8 6 1 Joint 10 25 8 2 Education Level Illiterate 1 2 1 0 Primary 0 2 0 0 Up to 8th Grade 1 8 1 0 High School 4 10 3 1 Graduate 4 5 3 1 Post-Graduate 7 6 6 1 Employment Status Unemployed 13 33 12 1 Employed 4 0 2 2 Age and Contraceptive Acceptance The age group 26–30 years demonstrated the highest absolute number of contraceptive acceptors (n = 9), though this age group also included substantial non-acceptors (n = 12). The youngest age group (< 20 years) showed minimal participation in the study (n = 3), reflecting the inclusion criteria focusing on reproductive-age women in hospital settings. Among the 21–25 age group, contraceptive non-acceptance was notably high at 83.3% (15 of 18 women), representing the poorest contraceptive adoption rate across all age cohorts. Conversely, women above 35 years showed relatively higher acceptance, with 66.7% (2 of 3) accepting contraceptive methods. Religion as a Determinant Religion emerged as a statistically significant determinant of unmet family planning needs. Hindu women comprised the majority of the sample (n = 47, 94%) and demonstrated an unmet need rate of 25.5%. In contrast, Muslim women (n = 3, 6%) exhibited an unmet need rate of 66.6%, more than double that of Hindu women. This disparity likely reflects both cultural factors and potential differences in healthcare access or family planning messaging within Muslim communities. Family Structure Family type (nuclear vs. joint) demonstrated significant association with contraceptive acceptance. Women from joint families exhibited higher unmet needs (71.4%) compared to those from nuclear families (25.5%). The joint family structure may perpetuate traditional decision-making patterns and reduce individual agency in reproductive choices, as contraceptive decisions may be subject to collective family deliberation rather than individual preference. Education Level Education demonstrated a complex relationship with contraceptive acceptance. Post-graduate women had the highest acceptance rate at 53.8% (7 of 13), compared to illiterate women at 33.3% (1 of 3). However, unexpectedly, unmet need did not decrease proportionally with educational advancement. Illiterate women showed an unmet need of 66.6%, while post-graduate women demonstrated 46.1%—indicating other social and cultural factors beyond educational status influence contraceptive adoption. Employment Status Employment status proved to be a critical determinant. All employed women in the sample (n = 4, 100%) accepted contraceptive methods, while only 28.3% of unemployed women (13 of 46) did so. Unemployed women demonstrated an unmet need of 71.73%, suggesting that economic independence and employment facilitate contraceptive utilization, possibly through increased autonomy in decision-making and financial access to methods. 4.3 Reasons for Non-Use of Contraception Among the 33 women who reported not using any form of contraception despite awareness, the primary reasons cited were: Table 2 Table 2 : Reasons for Non-Use of Contraception (N = 33) Reason for Non-Use Frequency (n) Percentage (%) Opposition from husband/in-laws 10 30.3 Want more children 9 27.3 Want male child 6 18.2 Fear of side effects 5 15.2 Lack of knowledge 2 6.1 Costly 1 3.0 Total 33 100.0 Opposition from husband/in-laws (30.3%) emerged as the leading barrier to contraceptive use. This finding underscores the patriarchal decision-making structures prevalent in Indian families, where reproductive decisions remain subject to male authority and extended family influence. Women often lack autonomous decision-making power regarding their own reproductive health. Desire for more children (27.3%) was the second most common reason, particularly among younger married women with limited parity. Many women expressed desires to complete their family size before considering contraceptive methods, reflecting pronatalist cultural values. Preference for male children (18.2%) represented a substantial barrier, with women continuing to seek pregnancies despite having multiple children, driven by culturally embedded gender preferences. This phenomenon is particularly pronounced in patriarchal societies where male offspring traditionally carry family names and provide economic security to aging parents. Fear of side effects (15.2%) reflects widespread health concerns and misconceptions about contraceptive safety, despite limited personal experience. This suggests inadequate health communication and community-level misinformation regarding modern contraceptive methods. Lack of knowledge (6.1%) and cost barriers (3.0%) represented relatively minor obstacles among this hospitalized population, likely because hospitalization provided access to information and services. 4.4 Reasons for Unmet Need for Family Planning Among the 16 women categorized as having unmet family planning needs (women wanting to avoid pregnancy but not using contraception), specific barriers were identified: Table 3 Table 3 : Barriers to Contraceptive Use Among Women with Unmet Family Planning Needs (N = 16) Reason for Unmet Need Frequency (n) Percentage (%) Opposition from husband/in-laws 6 37.5 Lack of knowledge 3 18.8 Unwanted birth (failed contraception) 3 18.8 Costly 2 12.5 Fear of side effects 1 6.3 Mis-timed pregnancy 1 6.3 Total 16 100.0 Among women explicitly identifying unmet family planning needs, opposition from husband and in-laws remained the dominant barrier (37.5%) , highlighting the critical importance of engaging male partners and extended family members in family planning initiatives. Lack of knowledge (18.8%) and unwanted births following contraceptive failure (18.8%) emerged as secondary barriers of equal significance. The presence of unwanted births suggests that some women have attempted contraceptive use but experienced method failure or discontinuation, necessitating improved contraceptive counseling and follow-up. 5. Discussion This study provides valuable insights into the complex socio-demographic landscape influencing family planning decisions among women in Udaipur, Rajasthan. The findings align with and extend previous research documenting barriers to contraceptive adoption in India. Socio-Demographic Context The demographic profile of our sample reveals critical intersections between age, educational status, economic autonomy, and contraceptive utilization. The particularly low contraceptive acceptance rate among women aged 21–25 years (16.6%) requires urgent attention, as this represents the critical reproductive years when many women initiate childbearing. Early interventions targeting this demographic could yield substantial public health benefits. The stark differential between unemployed (28.3% acceptance) and employed women (100% acceptance) underscores the centrality of economic autonomy to reproductive decision-making. Employment likely operates through multiple mechanisms: increasing financial independence, reducing reliance on partner approval, facilitating access to information and healthcare services, and shifting aspirations toward education and career development rather than exclusive focus on childbearing and childrearing. The paradoxical finding that education level did not proportionally decrease unmet needs suggests that knowledge alone is insufficient to overcome social and cultural barriers. This observation aligns with theoretical frameworks emphasizing the role of both "willingness" (attitude change) and "access" (removing practical barriers) in health behavior change[ 3 ]. Educational initiatives must be complemented by community-level interventions addressing social norms and male partner engagement. Cultural and Gender Dynamics The dominance of male partner/in-law opposition as a barrier to contraceptive use (30.3% of non-users and 37.5% of women with unmet needs) reveals the profound gender inequities embedded in reproductive decision-making. This finding necessitates fundamental shifts in family planning programming, moving from exclusively women-focused interventions to partnerships engaging husbands, partners, and extended family members. The preference for male children driving continued childbearing despite multiple pregnancies reflects persistent gender biases within Indian society. While educational and economic development may gradually shift these preferences, targeted interventions specifically addressing gender equity and female child value require urgent implementation. Health Information and Misconceptions Fear of side effects, cited by 15.2% of non-users and 6.3% of those with unmet needs, represents a modifiable barrier through improved health communication and community engagement. Healthcare provider relationships and trusted community health workers may effectively counter misinformation regarding contraceptive safety. The relatively low proportion citing "lack of knowledge" (6.1% and 18.8% respectively) may underrepresent true knowledge gaps, as women with limited literacy may not recognize their own knowledge deficits. Qualitative investigation and functional knowledge assessment would provide deeper understanding of this barrier. Policy and Programming Implications These findings suggest that effective family planning interventions in this context must be multifaceted: Male Engagement : Programs should prioritize male partner and father-in-law engagement, addressing misconceptions and building support for women's reproductive autonomy. Community-Based Approaches : Beyond clinic-based counseling, community health workers should conduct neighborhood-level education addressing social norms and promoting gender equity. Economic Empowerment : Linkages between women's economic participation and contraceptive utilization suggest that vocational training and employment promotion may have synergistic family planning benefits. Age-Targeted Interventions : Specific focus on women aged 21–25 years could address the critical barrier of low acceptance during peak reproductive years. Culturally Sensitive Programming : Programs must be adapted to local religious and cultural contexts, recognizing differences between Hindu and Muslim populations. 6. Conclusion In this hospital-based cross-sectional study of 50 women in Udaipur, Rajasthan, 32% exhibited unmet family planning needs. Key socio-demographic determinants of contraceptive acceptance included employment status, family structure, and age, with religion also demonstrating statistical significance. However, education level demonstrated a weaker than expected relationship with contraceptive acceptance. Opposition from husband and in-laws emerged as the predominant barrier, affecting 30.3% of non-users and 37.5% of women with unmet needs. This finding fundamentally reframes family planning as a family issue rather than exclusively a women's health issue. Despite improved educational status, unmet needs for family planning did not show proportional reduction. This observation underscores that knowledge alone is insufficient without simultaneous attention to male partner engagement, gender equity promotion, and removal of structural barriers to access. Recommendations : Implement male-partner engagement programs in contraceptive counseling and provision Develop community-based health education addressing gender norms and reproductive autonomy Promote women's economic participation as a complementary strategy to enhance contraceptive acceptance Adapt family planning messages to specific age cohorts and cultural/religious contexts Strengthen healthcare provider training in addressing side effect concerns and method selection Comprehensive, multisectoral approaches integrating health services, community mobilization, and gender-focused programming are essential to reduce unmet needs for family planning and enhance women's reproductive autonomy in Udaipur and similar contexts across India. Declarations All participants were informed about the purpose of the study, and verbal consent was obtained prior to enrollment. Participation was entirely voluntary, and confidentiality of all personal information was maintained throughout the study. The study was conducted in accordance with the ethical standards of the institutional ethics committee, which approved the use of verbal consent and waived the requirement for written consent. Author Note This research was conducted at GBH General Hospital affiliated with the American International Institute of Medical Sciences, Udaipur, Rajasthan. Data collection occurred in February 2023. All participants provided verbal informed consent prior to interview participation. References World Population Review (2023) India is now the world's most populous nation. Retrieved from World Population Review, dated 01 February 2023 Wadia A (n.d.) (ed) The light in ours: Memoirs and moments. [Historical memoir documenting early family planning advocacy in India] Reproductive health research (2019) Reasons for non-use of contraceptive methods by women with demand for contraception not satisfied. Reproductive Health 16:148 National Family Health Survey-5 (2022) Why birth control remains a women's burden in India. Published 27 June 2022 National Family Health Survey-5. (2019–2021). Phase 2 data Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Introduction","content":"\u003cp\u003eIndia's population has experienced unprecedented growth over the past several decades, fundamentally reshaping the nation's demographic landscape. According to the World Population Review, India surpassed China in January 2023 to become the world's most populous nation, with an estimated population of 1.41\u0026nbsp;billion by the end of 2022\u0026mdash;approximately 5\u0026nbsp;million more than China[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. This demographic shift has precipitated urgent conversations about population management and sustainable development.\u003c/p\u003e \u003cp\u003eRecognizing the need for proactive population policies, India became the first country globally to launch a national family planning programme in 1952, demonstrating early understanding of population dynamics[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. However, the programme's trajectory was shaped by deeply rooted cultural and religious contexts. In a nation where children have traditionally been regarded as \"God's gift,\" the concept of birth control faced significant social resistance. Historical figures like Avabai Wadia, a pioneering advocate for family planning, openly acknowledged initial cultural opposition, stating that \"the first time I heard the word birth control I was revolted\"[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. This cultural backdrop continues to influence contraceptive adoption rates today.\u003c/p\u003e \u003cp\u003eDespite nearly seven decades of programmatic efforts, family planning remains underutilized in India. Current evidence indicates that more than 100\u0026nbsp;million women globally in less developed countries\u0026mdash;representing approximately 17% of all married women\u0026mdash;would prefer to avoid pregnancy yet do not use any form of contraception[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. In India specifically, demographers and health specialists refer to these individuals as having \"unmet need for family planning.\" Despite government initiatives, the national unmet need for family planning persists at 12.8%[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe consequences of unmet contraceptive needs are profound and multifaceted. Non-use of contraceptives forces women into cycles of repeated pregnancy and lactation, limiting their educational, economic, and social opportunities. This pattern perpetuates intergenerational poverty and contributes to adverse maternal and child health outcomes.\u003c/p\u003e \u003cp\u003eResearch indicates that the primary reason for non-utilization of contraceptive methods is \"health concerns or side effects,\" particularly among rural populations[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Non-use due to \"opposition from others\" disproportionately affects married women compared to unmarried women, while \"lack of access\" or \"lack of knowledge\" demonstrates a rural-urban disparity approximately 2 times higher in rural areas[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAdditional barriers include misconceptions about contraceptive efficacy and safety. For example, some men fear that sterilization procedures would result in loss of muscularity and reduce their capacity for physically demanding work[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. This misconception, combined with gender-specific adoption patterns\u0026mdash;where female sterilization (36%) vastly outpaces male sterilization (0.3%)\u0026mdash;demonstrates how gender dynamics intersect with family planning decisions[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003cb\u003eStudy Rationale\u003c/b\u003e \u003c/p\u003e \u003cp\u003eUnderstanding the specific socio-demographic determinants of contraceptive use and the contextual reasons for non-utilization is essential for designing targeted, culturally sensitive interventions. This study was conducted in Udaipur, Rajasthan, to elucidate these factors within a specific regional context.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e "},{"header":"2. Objectives","content":"\u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eTo determine the socio-demographic factors affecting contraceptive use among reproductive-age married women\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eTo identify and quantify reasons for non-utilization of family planning methods\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eTo estimate unmet needs for family planning among reproductive-age married women\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"3. Materials and Methods","content":"\u003cp\u003e \u003cb\u003eStudy Design and Setting\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThis was a hospital-based, cross-sectional observational study. The study was conducted at GBH General Hospital, affiliated with the American International Institute of Medical Sciences, Udaipur, Rajasthan.\u003c/p\u003e \u003cp\u003e \u003cb\u003eStudy Population\u003c/b\u003e \u003c/p\u003e \u003cp\u003eAll women aged 15\u0026ndash;45 years admitted to the Obstetrics and Gynaecology ward during the study period were eligible for participation.\u003c/p\u003e \u003cp\u003e \u003cb\u003eInclusion Criteria\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eWomen aged 15\u0026ndash;45 years\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eMarried women\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eWillingness to provide informed verbal consent\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eExclusion Criteria\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eWomen below 15 years or above 45 years of age\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eWidowed or single women\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eWomen unable or unwilling to provide consent\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eStudy Period and Sample Size\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe study was conducted over 15 days in February 2023. A total of 50 women meeting the inclusion criteria were enrolled.\u003c/p\u003e \u003cp\u003e \u003cb\u003eData Collection\u003c/b\u003e \u003c/p\u003e \u003cp\u003eData was collected using a predesigned, pretested, structured questionnaire administered during face-to-face interviews following admission to the Obstetrics and Gynaecology ward. The questionnaire collected information on:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eDemographic characteristics (age, religion, family structure)\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eSocio-economic factors (education level, employment status)\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eContraceptive use and acceptance patterns\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eReasons for non-utilization of family planning methods\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eKnowledge and awareness regarding available contraceptive options\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eData Analysis\u003c/b\u003e \u003c/p\u003e \u003cp\u003eData was entered and analyzed to determine prevalence of contraceptive acceptance across different socio-demographic categories. Cross-tabulations were performed to identify associations between socio-demographic variables and contraceptive utilization patterns.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"4. Results","content":"\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e4.1 Overview of Sample Characteristics\u003c/h2\u003e \u003cp\u003eThe study examined 50 women of reproductive age admitted to the Obstetrics and Gynaecology ward. Of these, 37 women (74%) had accepted contraceptive methods, while 13 women (26%) had not.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e4.2 Socio-Demographic Determinants of Contraceptive Acceptance\u003c/h2\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e: Socio-Demographic Determinants of Contraceptive Acceptance and Contraceptive Type (N\u0026thinsp;=\u0026thinsp;50)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eContraceptive Acceptance\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eContraceptive Type\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTemporary\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePermanent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eAge Group (Years)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cspan\u003e$\u003c/span\u003e\u0026lt;\u003cspan\u003e$\u003c/span\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e21\u0026ndash;25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e26\u0026ndash;30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e31\u0026ndash;35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cspan\u003e$\u003c/span\u003e\u0026gt;\u003cspan\u003e$\u003c/span\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eReligion\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHindu\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMuslim\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFamily Type\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNuclear\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eJoint\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducation Level\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIlliterate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUp to 8th Grade\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGraduate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePost-Graduate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEmployment Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eAge and Contraceptive Acceptance\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe age group 26\u0026ndash;30 years demonstrated the highest absolute number of contraceptive acceptors (n\u0026thinsp;=\u0026thinsp;9), though this age group also included substantial non-acceptors (n\u0026thinsp;=\u0026thinsp;12). The youngest age group (\u0026lt;\u0026thinsp;20 years) showed minimal participation in the study (n\u0026thinsp;=\u0026thinsp;3), reflecting the inclusion criteria focusing on reproductive-age women in hospital settings.\u003c/p\u003e \u003cp\u003eAmong the 21\u0026ndash;25 age group, contraceptive non-acceptance was notably high at 83.3% (15 of 18 women), representing the poorest contraceptive adoption rate across all age cohorts. Conversely, women above 35 years showed relatively higher acceptance, with 66.7% (2 of 3) accepting contraceptive methods.\u003c/p\u003e \u003cp\u003e \u003cb\u003eReligion as a Determinant\u003c/b\u003e \u003c/p\u003e \u003cp\u003eReligion emerged as a statistically significant determinant of unmet family planning needs. Hindu women comprised the majority of the sample (n\u0026thinsp;=\u0026thinsp;47, 94%) and demonstrated an unmet need rate of 25.5%. In contrast, Muslim women (n\u0026thinsp;=\u0026thinsp;3, 6%) exhibited an unmet need rate of 66.6%, more than double that of Hindu women. This disparity likely reflects both cultural factors and potential differences in healthcare access or family planning messaging within Muslim communities.\u003c/p\u003e \u003cp\u003e \u003cb\u003eFamily Structure\u003c/b\u003e \u003c/p\u003e \u003cp\u003eFamily type (nuclear vs. joint) demonstrated significant association with contraceptive acceptance. Women from joint families exhibited higher unmet needs (71.4%) compared to those from nuclear families (25.5%). The joint family structure may perpetuate traditional decision-making patterns and reduce individual agency in reproductive choices, as contraceptive decisions may be subject to collective family deliberation rather than individual preference.\u003c/p\u003e \u003cp\u003e \u003cb\u003eEducation Level\u003c/b\u003e \u003c/p\u003e \u003cp\u003eEducation demonstrated a complex relationship with contraceptive acceptance. Post-graduate women had the highest acceptance rate at 53.8% (7 of 13), compared to illiterate women at 33.3% (1 of 3). However, unexpectedly, unmet need did not decrease proportionally with educational advancement. Illiterate women showed an unmet need of 66.6%, while post-graduate women demonstrated 46.1%\u0026mdash;indicating other social and cultural factors beyond educational status influence contraceptive adoption.\u003c/p\u003e \u003cp\u003e \u003cb\u003eEmployment Status\u003c/b\u003e \u003c/p\u003e \u003cp\u003eEmployment status proved to be a critical determinant. All employed women in the sample (n\u0026thinsp;=\u0026thinsp;4, 100%) accepted contraceptive methods, while only 28.3% of unemployed women (13 of 46) did so. Unemployed women demonstrated an unmet need of 71.73%, suggesting that economic independence and employment facilitate contraceptive utilization, possibly through increased autonomy in decision-making and financial access to methods.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e4.3 Reasons for Non-Use of Contraception\u003c/h2\u003e \u003cp\u003eAmong the 33 women who reported not using any form of contraception despite awareness, the primary reasons cited were:\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e: Reasons for Non-Use of Contraception (N\u0026thinsp;=\u0026thinsp;33)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReason for Non-Use\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency (n)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercentage (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOpposition from husband/in-laws\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWant more children\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWant male child\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFear of side effects\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLack of knowledge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCostly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e33\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e100.0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eOpposition from husband/in-laws (30.3%)\u003c/b\u003e emerged as the leading barrier to contraceptive use. This finding underscores the patriarchal decision-making structures prevalent in Indian families, where reproductive decisions remain subject to male authority and extended family influence. Women often lack autonomous decision-making power regarding their own reproductive health.\u003c/p\u003e \u003cp\u003e \u003cb\u003eDesire for more children (27.3%)\u003c/b\u003e was the second most common reason, particularly among younger married women with limited parity. Many women expressed desires to complete their family size before considering contraceptive methods, reflecting pronatalist cultural values.\u003c/p\u003e \u003cp\u003e \u003cb\u003ePreference for male children (18.2%)\u003c/b\u003e represented a substantial barrier, with women continuing to seek pregnancies despite having multiple children, driven by culturally embedded gender preferences. This phenomenon is particularly pronounced in patriarchal societies where male offspring traditionally carry family names and provide economic security to aging parents.\u003c/p\u003e \u003cp\u003e \u003cb\u003eFear of side effects (15.2%)\u003c/b\u003e reflects widespread health concerns and misconceptions about contraceptive safety, despite limited personal experience. This suggests inadequate health communication and community-level misinformation regarding modern contraceptive methods.\u003c/p\u003e \u003cp\u003e \u003cb\u003eLack of knowledge (6.1%)\u003c/b\u003e and \u003cb\u003ecost barriers (3.0%)\u003c/b\u003e represented relatively minor obstacles among this hospitalized population, likely because hospitalization provided access to information and services.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e4.4 Reasons for Unmet Need for Family Planning\u003c/h2\u003e \u003cp\u003eAmong the 16 women categorized as having unmet family planning needs (women wanting to avoid pregnancy but not using contraception), specific barriers were identified:\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e: Barriers to Contraceptive Use Among Women with Unmet Family Planning Needs (N\u0026thinsp;=\u0026thinsp;16)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReason for Unmet Need\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency (n)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercentage (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOpposition from husband/in-laws\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLack of knowledge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnwanted birth (failed contraception)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCostly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFear of side effects\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMis-timed pregnancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e16\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e100.0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAmong women explicitly identifying unmet family planning needs, \u003cb\u003eopposition from husband and in-laws remained the dominant barrier (37.5%)\u003c/b\u003e, highlighting the critical importance of engaging male partners and extended family members in family planning initiatives.\u003c/p\u003e \u003cp\u003e \u003cb\u003eLack of knowledge (18.8%)\u003c/b\u003e and \u003cb\u003eunwanted births following contraceptive failure (18.8%)\u003c/b\u003e emerged as secondary barriers of equal significance. The presence of unwanted births suggests that some women have attempted contraceptive use but experienced method failure or discontinuation, necessitating improved contraceptive counseling and follow-up.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"5. Discussion","content":"\u003cp\u003eThis study provides valuable insights into the complex socio-demographic landscape influencing family planning decisions among women in Udaipur, Rajasthan. The findings align with and extend previous research documenting barriers to contraceptive adoption in India.\u003c/p\u003e \u003cp\u003e \u003cb\u003eSocio-Demographic Context\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe demographic profile of our sample reveals critical intersections between age, educational status, economic autonomy, and contraceptive utilization. The particularly low contraceptive acceptance rate among women aged 21\u0026ndash;25 years (16.6%) requires urgent attention, as this represents the critical reproductive years when many women initiate childbearing. Early interventions targeting this demographic could yield substantial public health benefits.\u003c/p\u003e \u003cp\u003eThe stark differential between unemployed (28.3% acceptance) and employed women (100% acceptance) underscores the centrality of economic autonomy to reproductive decision-making. Employment likely operates through multiple mechanisms: increasing financial independence, reducing reliance on partner approval, facilitating access to information and healthcare services, and shifting aspirations toward education and career development rather than exclusive focus on childbearing and childrearing.\u003c/p\u003e \u003cp\u003eThe paradoxical finding that education level did not proportionally decrease unmet needs suggests that knowledge alone is insufficient to overcome social and cultural barriers. This observation aligns with theoretical frameworks emphasizing the role of both \"willingness\" (attitude change) and \"access\" (removing practical barriers) in health behavior change[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Educational initiatives must be complemented by community-level interventions addressing social norms and male partner engagement.\u003c/p\u003e \u003cp\u003e \u003cb\u003eCultural and Gender Dynamics\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe dominance of male partner/in-law opposition as a barrier to contraceptive use (30.3% of non-users and 37.5% of women with unmet needs) reveals the profound gender inequities embedded in reproductive decision-making. This finding necessitates fundamental shifts in family planning programming, moving from exclusively women-focused interventions to partnerships engaging husbands, partners, and extended family members.\u003c/p\u003e \u003cp\u003eThe preference for male children driving continued childbearing despite multiple pregnancies reflects persistent gender biases within Indian society. While educational and economic development may gradually shift these preferences, targeted interventions specifically addressing gender equity and female child value require urgent implementation.\u003c/p\u003e \u003cp\u003e \u003cb\u003eHealth Information and Misconceptions\u003c/b\u003e \u003c/p\u003e \u003cp\u003eFear of side effects, cited by 15.2% of non-users and 6.3% of those with unmet needs, represents a modifiable barrier through improved health communication and community engagement. Healthcare provider relationships and trusted community health workers may effectively counter misinformation regarding contraceptive safety.\u003c/p\u003e \u003cp\u003eThe relatively low proportion citing \"lack of knowledge\" (6.1% and 18.8% respectively) may underrepresent true knowledge gaps, as women with limited literacy may not recognize their own knowledge deficits. Qualitative investigation and functional knowledge assessment would provide deeper understanding of this barrier.\u003c/p\u003e \u003cp\u003e \u003cb\u003ePolicy and Programming Implications\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThese findings suggest that effective family planning interventions in this context must be multifaceted:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eMale Engagement\u003c/b\u003e: Programs should prioritize male partner and father-in-law engagement, addressing misconceptions and building support for women's reproductive autonomy.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eCommunity-Based Approaches\u003c/b\u003e: Beyond clinic-based counseling, community health workers should conduct neighborhood-level education addressing social norms and promoting gender equity.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eEconomic Empowerment\u003c/b\u003e: Linkages between women's economic participation and contraceptive utilization suggest that vocational training and employment promotion may have synergistic family planning benefits.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eAge-Targeted Interventions\u003c/b\u003e: Specific focus on women aged 21\u0026ndash;25 years could address the critical barrier of low acceptance during peak reproductive years.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eCulturally Sensitive Programming\u003c/b\u003e: Programs must be adapted to local religious and cultural contexts, recognizing differences between Hindu and Muslim populations.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"6. Conclusion","content":"\u003cp\u003eIn this hospital-based cross-sectional study of 50 women in Udaipur, Rajasthan, 32% exhibited unmet family planning needs. Key socio-demographic determinants of contraceptive acceptance included employment status, family structure, and age, with religion also demonstrating statistical significance. However, education level demonstrated a weaker than expected relationship with contraceptive acceptance.\u003c/p\u003e \u003cp\u003eOpposition from husband and in-laws emerged as the predominant barrier, affecting 30.3% of non-users and 37.5% of women with unmet needs. This finding fundamentally reframes family planning as a family issue rather than exclusively a women's health issue.\u003c/p\u003e \u003cp\u003eDespite improved educational status, unmet needs for family planning did not show proportional reduction. This observation underscores that knowledge alone is insufficient without simultaneous attention to male partner engagement, gender equity promotion, and removal of structural barriers to access.\u003c/p\u003e \u003cp\u003e \u003cb\u003eRecommendations\u003c/b\u003e:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eImplement male-partner engagement programs in contraceptive counseling and provision\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eDevelop community-based health education addressing gender norms and reproductive autonomy\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ePromote women's economic participation as a complementary strategy to enhance contraceptive acceptance\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eAdapt family planning messages to specific age cohorts and cultural/religious contexts\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eStrengthen healthcare provider training in addressing side effect concerns and method selection\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eComprehensive, multisectoral approaches integrating health services, community mobilization, and gender-focused programming are essential to reduce unmet needs for family planning and enhance women's reproductive autonomy in Udaipur and similar contexts across India.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eAll participants were informed about the purpose of the study, and verbal consent was obtained prior to enrollment. Participation was entirely voluntary, and confidentiality of all personal information was maintained throughout the study. The study was conducted in accordance with the ethical standards of the institutional ethics committee, which approved the use of verbal consent and waived the requirement for written consent.\u003c/p\u003e\u003cp\u003e \u003ch2\u003eAuthor Note\u003c/h2\u003e \u003cp\u003eThis research was conducted at GBH General Hospital affiliated with the American International Institute of Medical Sciences, Udaipur, Rajasthan. Data collection occurred in February 2023. All participants provided verbal informed consent prior to interview participation.\u003c/p\u003e \u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWorld Population Review (2023) India is now the world's most populous nation. Retrieved from World Population Review, dated 01 February 2023\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWadia A (n.d.) (ed) The light in ours: Memoirs and moments. [Historical memoir documenting early family planning advocacy in India]\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eReproductive health research (2019) Reasons for non-use of contraceptive methods by women with demand for contraception not satisfied. Reproductive Health 16:148\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNational Family Health Survey-5 (2022) Why birth control remains a women's burden in India. Published 27 June 2022\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNational Family Health Survey-5. (2019\u0026ndash;2021). Phase 2 data\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"AIIMS, Udaipur","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Contraceptive acceptance, Family planning, Unmet need, Socio-demographic factors, India","lastPublishedDoi":"10.21203/rs.3.rs-8613684/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8613684/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThis cross-sectional observational study assessed the socio-demographic factors influencing contraceptive use and identified reasons for non-utilization of family planning methods among reproductive-age women in Udaipur, Rajasthan. A total of 50 women aged 15\u0026ndash;45 years admitted to the Obstetrics and Gynaecology ward of GBH General Hospital were surveyed over 15 days in February 2023. The findings revealed that 32% of the population had unmet family planning needs, with opposition from husband and in-laws (37.5%) and lack of knowledge (18.7%) being the primary barriers. Age, religion, family structure, education, and employment status emerged as significant determinants of contraceptive acceptance. The study highlights the critical need for comprehensive health education and community-based interventions to address cultural and social barriers to family planning adoption.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e","manuscriptTitle":"Determinants of the Unmet Need for Family Planning Among Women of Udaipur, Rajasthan","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-23 18:56:42","doi":"10.21203/rs.3.rs-8613684/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"aca27ac8-f9ae-49bc-b8c1-cce631b783bf","owner":[],"postedDate":"January 23rd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":61259934,"name":"Health Economics \u0026 Outcomes Research"}],"tags":[],"updatedAt":"2026-01-23T18:56:42+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-23 18:56:42","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8613684","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8613684","identity":"rs-8613684","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}