The fast-growing population is one of the main hazards to the development of India. India is the second-most populous country in the world and the rate of population growth is a matter of concern to the policymakers. even though India was one of the pioneers to start a family welfare program which started in the 1950s. [1,2,3]. In spite of the constant efforts by the government, the unmet need for contraception (12.8% in 2006 WHO report) is still there [4,5]. There are many social factors, taboos, myths, and ignorance, which is responsible for the underutilization of contraceptive services. This leads to many unwanted pregnancies causing maternal morbidity and mortality. The use of effective contraception is one of the primary strategies to prevent maternal mortality and morbidity by decreasing unwanted pregnancies and abortions [6]. Understanding the contraceptive needs and practices of a particular community is essential to help policymakers design various policies. The present study was undertaken in patients attending gynaecology OPD for multiple reasons to know their attitude, behaviour, knowledge, and practice of contraceptive methods.

The present study was a cross-sectional study undertaken on 1244 women attending gynaecology OPD at Great Eastern Medical school and Hospital, Srikakulam, Andhra Pradesh after obtaining IEC approval.

Duration and Type of Study: March 2017 to March 2018. Cross-sectional study.

Sample Size: One thousand two hundred forty-four married women interviewed with a set of predesigned questions.

Inclusion criteria: Married women in the age group of 20-45 years.

Exclusion Criteria: Women have any medical disorders which preclude the use of contraception, who were pregnant or lactating, infertile women excluded from the study.

Data Collection: After checking the inclusion criteria, the questionnaire mainly focused on contraceptive practices, socio-demographic data, age, parity, awareness regarding various contraceptive methods, current contraceptive use, and reason for not using any contraceptive method.

Most participants knew about at least 2 methods of contraception. The rest of the 7.7% were unaware of contraception. All of them who were aware knew about the barrier method, oral pills, and Sterilization. Only 7.8% had knowledge about CuT (Table 2).

Table-2: Knowledge and Awareness of Contraceptive Methods (n=1244).

The main source of knowledge was Healthcare Workers followed by Media and Social circles (Table 3).

Table-3: Source of Knowledge (n=1148).*

*1148 women out of 1244 were aware of contraceptive methods

A total of 43.5% of participants were currently using contraception. The most commonly used method was barrier contraception (57.4%).

More than one-fourth used oral pills and CuT use was quoted by 6.3%. Other less commonly used methods were sterilization, safe period, and coitus interruptus. (Table 4)

The main reason for not using any contraceptive was Desirous for Conception (70.5%).

A few were either worried about side effects or husband was either unwilling to use contraception or was staying away. (Table 4)

Table 4: Current Contraception being used (n=1244).

[9]. A significant source of knowledge was Healthcare Workers (56.3%) followed by Media (33.6%) and Social circle (10.1%).

Similar results were shown in a study by Pegu B et al [7] showed health workers as the primary source of information about contraceptives followed by media and social circle. In a study by Sultan et al [10], media was the primary source of information.

In a study conducted in Ethiopia, almost in 80% of cases health workers were the primary source for disseminating knowledge about contraceptives [11] Gomal et al. showed friends/relatives as the primary source of information [12].

Only 43.5% of women were using one or the other method of contraception. 56.5% were not using any contraceptive. 62% of women in the study by Pegu et al. and 55% in the study by Srivastava et al. had never used any contraceptive method [7,13].

52% of participants in the study by Sunita TH et al. were not using any contraceptive, and when analyzed separately, contraceptive use was low among rural women compared to urban women [8]. Constant motivation by healthcare workers and increasing the awareness level is essential to improve contraceptive use among the population.

The post-partum period is the crucial time to highlight the need for contraceptive use as a patient is highly receptive at that point in time, and the need for contraception should highlight at each post-partum visit.

It is crucial to counsel both the partners as almost 4.8% of women quoted opposition from husband as a reason for not using any contraceptive, and none of the users quoted male sterilization as a contraceptive method.

A barrier was the most commonly used contraceptive method. A study by Pegu B et al. showed similar results. [7]. In contrast, Sunita TH et al. showed female sterilization as primary contraceptive use [8]. Though 92.3% were aware of contraception, still 43.5% were using contraception. This gap between knowledge and practice was seen in other studies as well.

To reduce this gap, the essential method is to have a free and full availability of family planning services and strong motivation by healthcare professionals. Couples should be offered with a range of contraceptive methods so that they can decide the one which suits them the most.