A QUALITATIVE STUDY OF THE PERCEPTIONS OF DISSATISFIED NORPLANT USERS

Background. 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 contracept ive method. Methods. 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 t o 25 months and had requested its removal because of side effects. Res ults. 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 participant s raised questions about the psychosocial context in which patients ob tain information about Norplant and request early removal. Many partic ipants mentioned having felt pressured to accept Norplant and not bein g fully informed about possible side effects. All but two said they we re encouraged to ''wait out'' side effects and that physicians were re luctant to remove the Norplant capsules. Many participants recalled th at they had to request removal several times before their physicians c omplied with their wishes. Conclusions. The results of this study sugg est that there is a need to review the process of educating patients a bout Norplant, the situational context of Norplant counseling, and phy sician practices related to patients' requests for early removal.