Abstract:
Background: Family planning has been shown to be an effective intervention for promoting maternal, newborn
and child health. Despite family planning's multiple benefits, women's experiences of - or concerns related to - side
effects present a formidable barrier to the sustained use of contraceptives, particularly in the postpartum period.
This paper presents perspectives of postpartum, rural, Tanzanian women, their partners, public opinion leaders and
community and health facility providers related to side effects associated with contraceptive use.
Methods: Qualitative interviews were conducted with postpartum women (n = 34), their partners (n = 23),
community leaders (n = 12) and health providers based in both facilities (n = 12) and communities (n = 19) across
Morogoro Region, Tanzania. Following data collection, digitally recorded data were transcribed, translated and
coded using thematic analysis.
Results: Respondents described family planning positively due to the health and economic benefits associated
with limiting and spacing births. However, side effects were consistently cited as a reason that women and their
partners choose to forgo family planning altogether, discontinue methods, switch methods or use methods in an
intermittent (and ineffective) manner. Respondents detailed side effects including excessive menstrual bleeding,
missed menses, weight gain and fatigue. Women, their partners and community leaders also described concerns
that contraceptives could induce sterility in women, or harm breastfeeding children via contamination of breast
milk. Use of family planning during the postpartum period was viewed as particularly detrimental to a newborn’s
health in the first months of life.
Conclusions: To meet Tanzania’s national target of increasing contraceptive use from 34 to 60 % by 2015,
appropriate counseling and dialogue on contraceptive side effects that speaks to pressing concerns outlined by
women, their partners, communities and service providers are needed.
