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Acceptability of different mechanisms of action of contraception in women: a questionnaire survey
  1. Yu Wing Tong1,
  2. Sue Seen Tsing Lo1,2,
  3. Barbara Wai Kwan Fung3,
  4. Sharon T Cameron4,5,
  5. Ernest Hung Yu Ng1,
  6. Raymond Hang Wun Li1,2
  1. 1 Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
  2. 2 The Family Planning Association of Hong Kong, Wan Chai, Hong Kong
  3. 3 Family Health Services, Department of Health, Hong Kong SAR, Hong Kong
  4. 4 Sexual and Reproductive Health, NHS Lothian, Edinburgh, UK
  5. 5 Obstetrics and Gynaecology Section, University of Edinburgh, Edinburgh, UK
  1. Correspondence to Dr Raymond Hang Wun Li, Department of Obstetrics and Gynaecology, Queen Mary Hospital, Hong Kong, Hong Kong; raymondli{at}


Background The mechanism of action of a contraceptive method is an importantg consideration in a woman’s choice of contraception. For the development of new methods of contraception it is important to understand the acceptability of different contraceptive mechanisms within a population.

Methods We recruited women attending contraceptive, termination of pregnancy or postnatal care services in Hong Kong for a questionnaire survey on their acceptability of the different ways in which contraceptive methods prevent pregnancy. Univariable and multivariable analyses were used to establish factors which may predict acceptability of the mechanism of action.

Results A total of 1448 women completed the survey. The acceptability of contraceptive methods that act by preventing fertilisation ranked highest (78%), followed by those that inhibit ovulation (52%), disrupt implantation (43%) and dislodge an implanted embryo (30%). A history of termination of pregnancy was associated with greater acceptance of all posited contraceptive mechanisms. There was a very low degree of agreement between the declared acceptance of the various contraceptive mechanisms and the ever use of a method with the respective mechanism of action (Cohen’s kappa coefficient range 0.017–0.162).

Conclusions In this population the acceptability of contraceptive methods that act by preventing fertilisation ranked highest, followed by those that inhibit ovulation, disrupt implantation and dislodge an implanted embryo. Women who had ever had a termination of pregnancy were more likely to accept all the posited contraceptive mechanisms.

  • contraception behavior
  • family planning policy
  • family planning services
  • Patient Preference
  • surveys and questionnaires

Data availability statement

No data are available. Not applicable.

Statistics from


  • Contributors YWT and RHWL conceived the original research question. YWT, SSTL, BWKF, SC, EHYN and RHWL planned the study and designed the survey questionnaire. YWT, SSTL, BWKF and RHWL organised and liaised with the centres involved in recruitment of subjects. YWT collated data, undertook analyses, prepared tables and figures, and wrote the first draft of the manuscript. YWT, SSTL, BWKF, SC, EHYN and RHWL contributed to data interpretation, revised the first and subsequent drafts critically for intellectual content and approved the final manuscript. All authors agree to be accountable for all aspects of the work. YWT is the manuscript guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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