Contraceptive Methods — Epidemiology

Among women who discontinue intrauterine device (IUD) use within the first year in India, what is the most common reason for discontinuation?

A 28-year-old multiparous woman attends the family planning clinic 6 weeks postpartum. She is exclusively breastfeeding and desires long-term contraception. She has no contraindications to any method. On counselling, she expresses concern about the reliability of lactational amenorrhea method (LAM) and asks for the most appropriate next step. What is your recommendation?

A 35-year-old woman with 3 living children presents to the reproductive health clinic requesting permanent sterilization. She has completed her family and is certain about her decision. She has no medical contraindications. Her husband is present and supportive. What is the most appropriate next step in management according to Indian guidelines?

A 28-year-old multiparous woman from rural Maharashtra attends the primary health centre for family planning counselling. She has completed her family (2 children, both healthy) and wishes to avoid pregnancy for at least 5 years. She is breastfeeding her 6-month-old infant and reports irregular menstrual cycles. Her husband is supportive of any method. On examination, she is healthy with no contraindications to hormonal methods. Which contraceptive method would provide the longest duration of protection with the highest efficacy and minimal impact on breastfeeding in her current situation?

Regarding the epidemiology and effectiveness of contraceptive methods in India, all of the following statements are TRUE EXCEPT: