RESUMEN
PIP: Institutional studies and demographic surveys have demonstrated that side effects or fear of side effects are by far the most important factor in discontinuation of usage of modern contraceptives. The most recent information in Mexico, from the 1987 National Survey of Fertility and Health, indicates that 15-24% of women who accepted IUDs, oral contraceptives (OCs), and injectable contraceptives reported discontinuing usage during the 1st year because of real or feared side effects. Discontinuance because of side effects is much less frequent with traditional methods, but such methods have much higher failure rates than do the modern methods. The reasons given for discontinuing use given by women in surveys correspond to their perceptions. Side effects thus include fears of possible future effects and effects attributed by users to the methods but which are not actually related, as well as real effects of varying severity and importance. In a recent survey, 2/3 of women who experienced contraceptive side effects were not aware of the possibility that they would arise at the time they began use of the method. This finding indicates that information services are lacking for the temporary methods promoted by institutional family planning programs. In case of female sterilization the couple is not able to terminate method use. It would be expected that a careful and fully informed decision process would precede acceptance of sterilization. But 1 out of 10 sterilized women interviewed for the survey stated they would not undergo sterilization again if they were able to choose. The women most likely to state they would not repeat sterilization were the ones who received the least information prior to operation, experienced a deficient acceptance process, received the least medical follow-up, and waited the shortest time between the sterilization decision and the actual operation. Such problems are more common among less educated and rural women. A basic condition for assuring that childbearing decisions are free and responsible is access to complete and accurate information. The reports of these women indicate that this condition is not being met.^ieng