Comparison of Unintended Pregnancy Rates between OCP and Injectable Contraceptive Users; A Prospective Cohort Study in Bahawalpur

Objective: To compare the rates of unintended pregnancies, adherence, and contraceptive usage patterns between oral contraceptive pill (OCP) users and injectable contraceptive users in Bahawalpur, Pakistan. Methodology: A Prospective cohort study was conducted at family planning clinics from June 2022 to May 2023 on 400 women aged 20 to 45 years using OCPs or injectable methods for at least three months. Participants were followed for one year to assess adherence, method continuation, and unintended pregnancies through regular follow-ups. SPSS version 26 was applied for data analysis. Results: The most of the participants were aged 18-30 years and belonged to middle or poor socio-economic classes, with no significant demographic differences between the groups. Adherence was significantly higher among injectable users (82%) compared to OCP users (64%) (p=0.001). The unintended pregnancy rate was also significantly lower among injectable users (1.5%) than OCP users (5.5%) (0.035), and injectable users had a higher proportion of short-term use (0-6 months) compared to OCP users (p=0.002). Conclusion: Injectable contraceptives observed with higher adherence and lower unintended pregnancy rates than OCPs. More efforts are required to improve adherence to OCPs through patient education and adherence-support strategies.