新生育政策背景下育龄妇女避孕需求调查

Investigation of contraceptive needs of women of childbearing age in the context of new fertility policy

目的:了解新生育政策背景下我国育龄妇女的避孕需求状况及其影响因素,以期为不同生育阶段育龄妇女提供更精准的避孕服务。方法:利用全国避孕药具不良反应监测网络体系,2021年1月发布问卷星调查表,调查对象覆盖31个省的116个国家监测点和江苏74个省级监测点。分析调查对象的避孕意愿、需求,多因素logistic回归分析可能影响因素。结果:调查对象总数为7043名。不同生育次数女性的其年龄、受教育程度、职业、收入等存在差异。选择避孕措施比例最高为避孕套(61.8%),其次为宫内节育器(IUD)(38.7%);避孕知识主要获取途径为医务人员(67.7%)、宣传手册或折页(61.5%)、网络/微信(53.5%),最想获取的避孕知识为避孕方法有效性(52.1%),其次为避孕方法副作用(51.7%);采用避孕方法顾虑最多的为担心影响身体健康(77.8%),其次为影响性生活(36.0%)。多因素分析发现,曾用IUD者选择IUD比例高于未曾使用者(OR=10.62,95%CI 9.24~12.20),且随着生育次数增加,IUD选择意愿增加。曾用避孕套者选择避孕套比例高于未曾使用者(OR=13.83,95%CI 11.89~16.09),生育≥2孩者选择避孕套意愿低于未生育者。结论:不同生育史育龄女性的避孕模式和避孕需求不同,提示各级管理部门在新的人口政策下,需根据不同群众需求及避孕特征制定宣传教育和服务模式,以为育龄人群提供安全、科学的避孕节育服务。

Objective:To understand the situation of contraceptive needs of women of childbearing age in the context of new fertility policy of our country,to study its influence factors,and to provide more accurate contraceptive services for women of different childbearing age at different reproductive stages.Methods:Based on the national contraceptive adverse reaction monitoring system,a questionnaire star survey was issued in January 2021,which covered 116 national monitoring points from 31 provinces and 74 provincial monitoring points of Jiangsu province.The contraceptive willingness and demand of the respondents were analyzed,and which possible influencing factors were analyzed by logistic regression analysis.Results:In 7,043 respondents in this survey,there were significant differences in age,education level,occupation situation,and income among the women with different birth times.The highest proportion of contraception used was condom(61.8%),followed by that(38.7%)of intrauterine device(IUD).The highest proportion of contraceptive knowledge obtained was from medical staff(67.7%),followed by that(61.5%)from pamphlet or foldout,than followed by that(53.5%)from Internet or Wechat.The highest proportion of desired contraceptive knowledge(52.1%)was the effectiveness of contraception,followed by that(51.7%)of the side effects of contraception.The highest proportion(77.8%)of worrying contraception used was about health,followed by that(36.0%)about sexual life.Multivariate analysis showed that the proportion of choosing IUD of the women with IUD used history was significantly higher than that of the women without IUD used history(OR=10.62,95%CI 9.24-12.20),with the number of births,the chorce rate of IUD had increased.The proportion of choosing condom of the women with condom used history was significantly higher than that of the women without condoms used history(OR=13.83,95%CI 11.89-16.09).women with 2 or more children are less willing to choose condoms with no child.Conclusion:The contraception selection and contraceptive needs of the women of childbearing age with different fertility history are different.It is suggested that administrative departments at all levels should formulate propaganda,education,and service mode according to different needs and contraceptive characteristics of the people in the context of new fertility policy,so as to provide safe and scientific contraceptive services for the population of childbearing age.