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Elis F.Sapury
S1 Ilmu Keperawatan STIKes Bina Sehat PPNI Mojokerto


Contraception is an effort made to prevent pregnancy, these efforts can be temporary or

permanent. Types of contraception often make people confused to determine the choice of
contraception that is suitable for use and many factors play a role in determining the choice of
contraception. Factors that influence acceptors choosing pill and injection contraception include, such
as knowledge, level of education, economic status, parity, occupation, age, husband's support, beliefs
or religion and culture. The purpose of this study is to identify factors that influence the selection of
contraceptive pills and injections. The research method is a literature study. The data source that the
researcher will use is the secondary data source. The results showed the use of contraceptives
according to education level, namely SLTA (45.5%), according to the economic status of high
socioeconomic (54.8%), according to parity of 2 to 3 children (60.3%), according to work, namely
self-employed (34.5%), according to age, namely age 20-35 years (72.7%), according to the husband's
support factor, the husband supports the KB acceptor (95.4%), according to trust and culture, ie those
who do not believe in beliefs and culture (90%). It can be concluded that the most influential factors
in the selection of contraceptive pills and injections are the factors of husband support, trust and
culture, age, parity, economic status, education, and education factors.

Keywords: Contraception, education, economic status, parity, occupation, age, husband support,
trust and culture.

INTRODUCTION In East Java, the coverage of active

family planning is 65.69%, with the highest
Indonesia is a country with a dense family planning coverage in Pasuruan district
population. The birth rate restriction program (15.4%) and the lowest in Malang (Depkes,
in Indonesia is known as the family planning 2016). Data from the health office of
program or commonly abbreviated as KB. Mojokerto Regency shows that the number of
Family planning (KB) is an effort made to PUS in 2017 is 186,916, the number of new
assist individuals or couples in getting the family planning participants is 17,458 (9.3%)
desired birth, adjusting the interval between and the number of active family planning
pregnancies, determining the number of participants is 161,085 (86.2%). Active family
children in the family and avoiding unwanted planning participants in Mojokerto Regency in
births. In order to achieve this, several ways 2017 chose the most long-term contraceptive
have been made to prevent or delay pregnancy, method (MKJP) for the IUD type, amounting
including the use of contraception. to 7.3%, while the non-MKJP family planning
most preferred was the injection type at 66.4%
According to the BKKBN, since the last and the pill at 12.5% . The new FP participants
three years, the prevalence of contraception in in Mojokerto Regency in 2017 chose the most
Indonesia has fluctuated. In 2016, the long-term contraceptive method (MKJP) for
prevalence of contraception in Indonesia was the IUD type by 8%, while the New Non-
59.39%. This figure decreased to 58.70% in MKJP family planning that was mostly chosen
2017 and slightly increased to 58.73% in 2018. was the injection type with 62.4% and the pill
Meanwhile, the RPJMN target to be achieved for 16.7%. Based on the re-registration data
in 2019 is 66%. Differences in the percentage for family planning in the work area of
of contraceptive prevalence can be seen ​ ​ Puskesmas Puri, Mojokerto Regency, the
between regions in Indonesia. When viewed achievement of active family planning in 2019
according to the highest active Kb province was 10,892 participants with details of each
was in Bengkulu province at 71.15% and the method, 1,785 pills (16.3%) acceptors, and
lowest was in Papua province at 25.73% 7,355 injection contraceptives (67.5 %)
(Indonesian Ministry of Health, 2019). acceptors.
A preliminary study conducted in the Efforts made to increase the percentage
work area of ​ ​ Puskesmas Puri, Mojokerto of contraceptive use are by means of effective
Regency on November 20-21 2019, found 6 communication, providing information and
couples of childbearing age, 3 people using education (IEC) about the benefits of
pill contraception and 3 other people using contraception and counseling, this is really
injection contraception. The main reason that necessary in family planning services. By
supports the use of the contraceptive pill and conducting counseling, it means that the
injection contraceptive is because according to officer helps the clan in choosing and deciding
them it does not interfere with the husband and the type of contraception to use according to
wife relationship, does not cause abdominal his choice.
pain, the use is more practical, inexpensive
and comfortable, but they complain about Based on the description above, the
menstrual irregularities, some have authors are interested in examining the factors
amenorrhoea, some do not. having that influence the high selection of
menstruation at all. contraceptives for oral contraceptives and
injection contraceptives.
Many factors influence a person in
choosing a pill and injection contraceptive RESEARCH METHODS
method such as knowledge, education level,
economic status, parity, health services, This research is a literature study or
occupation, age, husband's support, beliefs or literature review, which is a critical evaluation
religion and culture. These factors will also of several studies and theories related to
influence the success of the family planning certain topics. This process involves analysis
program (Jitowiyo & Rouf, 2019). This is in and synthesis of previous work to produce a
line with research conducted by Melisa R. summary of knowledge on the topic (Michael
(2019) saying that there is a significant Coughlan, Patricia Cronin, & Frances Ryan,
relationship between age and specialization in 2013). The problem in this study is to
Pill and Injection contraceptives, knowledge determine "the factors that influence the choice
factors with specialization in Pill and Injection of contraceptive pills and injections".
contraceptives, and the number of children In this study, literature searches were
interested in Pill and Injection contraceptives. carried out from March-May 2020 using
(Sherly, 2015). keywords and boolean operators (AND, OR
Although many acceptors choose to use NOT or AND NOT) which function to expand
contraceptive pills and injections, there are or specify searches, and the keywords used in
still many mothers who do not know the side this study are factors that influence tools
effects of contraception. Contraceptive pills selection. contraceptive pills and injections.
have side effects such as dizziness, nausea, The sources used are 10 journals consisting of
vomiting, irregular bleeding and amenorrhoea. 8 national journals and 2 international journals.
Meanwhile, injectable contraceptives have These journals are accessed from google
side effects including headaches, weight gain scholar, pubmed, Ersjournal, and MDPI.
and the most frequently complained of is the RESULTS AND DISCUSSION
disturbance of menstrual patterns in the form
of ammonera, longer bleeding and some even The results obtained in the literature
do not experience menstruation at all. Even review study found 10 journals consisting of 8
though they have side effects, the use of national and 2 international journals which
contraceptives is actually beneficial for have been selected and have similarities in this
women or mothers in improving the welfare of study and will be discussed as follows: Factors
the family. These advantages include that influence the choice of contraceptive pills
maintaining pregnancy distance, and injections.
accompanying children's growth and
development, having time to socialize with the
environment and having space for married
couples to create a harmonious family and
help the family economy.
1. Education
Results of research conducted (Bakri, a low socio-economy were 28 respondents
Kundre, & Bidjuni, 2019) The 44 respondents (45.2%). The results of the test for different
found that most of the respondents had high proportions (X2) showed a relationship
school education, 20 acceptors (45.5%). The between contraceptive choices on the socio-
results of this study are in line with the results economic conditions at Langsa Lama Public
of research conducted by (Signal, Rompas, & Health Center Langsa City (Pvalue = 0.000 <).
Bataha, 2019), which show that the largest The results showed that acceptors with high
number of respondents who use contraception socioeconomic levels chose injection as a
are at the high school education level. contraceptive tool. This is in line with research
(Lontaan, Kusmiyati, & Dompas, 2014),
Education is basically an attempt to regarding the factors associated with
develop knowledge, attitudes and skills. contraceptive selection. The results of study
According to (Notoatmodjo, 2012), generally show that there is a relationship between
the higher a person's education level, the easier socio-economics and the choice of
it is for someone to receive information from contraception.
the social environment or through social media.
This is because education is one of factors The level of social status and economic
that greatly determines one's knowledge and conditions can affect the development and
perception of the importance of something, progress of the family planning program.
including the importance of participating in Economy is a description of the level of a
using contraceptives. These results indicate a person's life in society which is determined by
good level of education will help acceptors in income and expenditure variables. Economic
understanding the information related to conditions can affect aspects of a person's life
contraceptive use. including health care according to
Notoatmodjo (2012) quoted in (Jitowiyo &
Researchers assume that in terms of Rouf, 2019).
education, the higher one's education is, the
easier it is to receive information so that the Researchers assume that a person's
more knowledge one has. So that in the income is related to a person's ability to meet
concept of education there is a process of the needs of life, the higher the socio-economy
growth, development or change to a more the more needs, facilities that can be fulfilled.
mature direction, with the development of a The income a person has will support him / her
better mindset. At the secondary education in meeting his needs for contraception which
level, a person has good insight and level of also affects the choice of contraceptive method
knowledge so that he is open to new things, he will use. Someone who has an income will
including being open to contraceptive methods. be able to choose the right contraceptive
This shows that the level of education is method.
related to public health behavior, so it can be
concluded that with higher education one is 3. Parity
expected to be easier to receive messages and
motivation in choosing the contraceptive The results of the research conducted by
method. The higher the level of education of a (Baharu, 2019) found that most respondents
person, it is expected that their knowledge will had 2-3 children 38 acceptors (60.3%), based
be higher, especially regarding the choice of on the results of the analysis, there was a
family planning they use, so that people can significant relationship between the number of
also reconsider choosing a contraceptive children and the specialization of Pill and
method, both in terms of the advantages or Injection contraception.
side effects of the method. The number of children owned affects
2. Economic Status the choice of contraceptive method to be used.
Mothers who already have 2 children are
Research conducted by (Hasnani, 2019). advised to use hormonal contraceptives which
In 62 respondents who were studied at Langsa have high effectiveness, so that the possibility
Lama Public Health Center, the respondents of experiencing another pregnancy is quite low.
had a high socio-economy, namely 34 Based on the data above, most respondents
respondents (54.8%) and respondents who had chose Hormonal family planning because their
number of children was multiparous or had working women can also gain experience and
more than 2 children and the respondents were knowledge compared to women who do not
in the fertile age phase so they wanted to space work to have less information than women
their pregnancies in accordance with the who work. In accordance with the theory of
wishes of the pairs of childbearing age. Thus, Kutanegara, et al, (2010) quoted in (Jitowiyo
each child owned by a married couple will & Rouf, 2019) it is said that in general the
give consideration to whether they want to number of contraceptive use for working
have children and if so, how many they want. women is higher than for women who do not
The number of children is closely related to work. Women who work mostly spend time at
the level of family welfare. The more children work such as self-employed, civil servants /
you have, the greater the tendency to stop private sector, and employees. Those who
fertility so that you are more likely to choose a work for approximately 10 hours, resulting in
steady contraceptive device (Rosita, 2012). them having less time to take care of their
children. Therefore they use contraceptives to
Researchers assume that in general control pregnancy.
family planning acceptors prefer the pill and
injection contraceptive method for more Researchers assume that a person's job
practical reasons. However, no single affects the chosen contraceptive method. The
contraceptive method is safe and effective for value of time held by working women is more
all acceptors, because each has an individual expensive than that of women who do not
suitability and suitability for each acceptor. In work. There are fewer opportunities for
general, the requirements for the ideal women to work to care for children than for
contraceptive method are as follows: Safe, women who do not work. Therefore, working
meaning that it does not cause serious women will tend to use contraceptives to limit
complications when used, including does not the number of children. Another thing that
cause disturbing effects during intercourse. influences working women to choose this
Efficient, in the sense that it is used in contraceptive method because this
accordance with the rules, it will prevent contraceptive method is practical and effective
pregnancy. Can be accepted, not only by and does not burden them in their work.
family planning acceptors but also by the
community's cultural environment. Affordable, 5. Age
if the method is discontinued, the
acceptorswill return to its fertility. Easy to Research conducted by
implement, acceptable to use by partners. (Lieskusumastuti & Setyorini, 2019) shows
that 24 respondents (72.7%) are 20-35 years
4. Profession old, and 1 respondent (3%) is <20 years old.
The results of this study indicate that the
Research conducted by (Signal, Rompas, majority of respondents who use contraception
& Bataha, 2019), entitled the use of are at the age of 20-35 years. This research is
contraceptives by accessors in Manado in line with the research conducted by (Durul,
medical center hospitals. Based on the Emelumadu, & Iwul, 2018).
respondent's occupation, most of them work as
entrepreneurs, amounting to 20 people According to (Yanuar, 2010) quoted in
(34.5%). 14 people (24.1%) work as civil (Jitowiyo & Rouf, 2019) a person's age
servants (24.1%), 14 people (24.1%) work as determines which contraceptive method to
employees, and 10 people (17.2%) as IRT. choose. The older a person is, the higher the
Women who work have expensive time so that chances of not wanting to get pregnant again
there are fewer opportunities to take care of and to choose a suitable and effective
children than women who do not work, so that contraceptive method. Women's age has an
women who work will tend to limit the influence on the choice of family planning
number of children. programs. Age <20 years is the age to delay
pregnancy, ages 20 - 35 are the age to regulate
The results of the study pregnancy, and age> 35 is the age to limit
(Lieskusumastuti & Setyorini, 2019), show pregnancy. The more old enough, the maturity
that women who use contraceptives are more level and strength of a person will be more
likely to work. These results show that mature in thinking and working. Fertile age is
where a woman begins to have her first the advantages and disadvantages of a
menstrual period, meaning that ovulation has particular method (Jitowiyo & Rouf, 2019).
occurred until menopause (unable to produce
eggs). Generally, the fertile age in Indonesia Researchers assume that mothers who
ranges from 15-19 years. The average acceptor do not receive support from their husbands in
aged 20-35 years using hormonal birth control, choosing a contraceptive method are because
this is because the age of 20-35 years is the their husbands cannot accept changes in the
right age to become hormonal family planning side effects of the current contraceptive
acceptors. The acceptors who are old enough method used by mothers, mothers and
will be more mature in choosing and husbands do not know the types of
establishing themselves as family planning contraception.
7. Trust and Culture
Researchers assume that the younger the
acceptors will choose the short-term The results of research conducted by
contraceptive method, because the acceptors (Basra & Fatimah, 2017) show that of the 30
still want to have more children. Meanwhile, respondents who believe in contraception as
the older they are, the acceptors will choose a many as 3 people (10%) and do not believe as
long-term contraceptive method because many as 27 people (90%).
acceptors will limit having children. According to (Jitowiyo & Rouf, 2019)
6. Husband's Support the views of various religions on family
planning, namely the first is the Islamic
The results of the study (Lusiana, 2017), religion which prohibits the type of
65 respondents (100%) found that 62 contraceptive vasectomy and tubectomy
respondents (95.4%) husbands support family because it has permanent properties but there
planning acceptors, and 3 respondents (4.6%) are also Muslims that allow contraception.
do not support family planning acceptors. This Secondly, Catholicism is allowed only natural
shows that in the choice of contraceptive use family planning or periodic abstinence so that
by family planning acceptors, support from other types of contraception are not allowed.
partners is very influential. This is in line with As a social human being is inseparable from
the research conducted by (Bakri, Kundre, & the culture in which he lives. Culture concerns
Bidjuni, 2019) which states that there is a traditions, customs, rules and opinions. The
relationship between husband's support and the use of contraceptives is closely related to
choice of contraceptive method. culture, because contraceptives are related to
the way they are installed and the habits of
A wife in making the decision to use using them. As it is known, the insertion of the
contraception needs the consent of the husband IUD contraceptive for example, the insertion
because the husband is seen as the head of the of this device through the female genitals is
family, the protector of the family, the not accepted by people in certain cultural
breadwinner and someone who can make environments. In addition, its use is related to
decisions in a family. In making the decision the habits of people living in certain
to use contraceptives, the husband's support environments. A person will be interested in
includes efforts to obtain information, using the wrong form of contraception if the
choosing a contraceptive device, delivering people around him are using the same
him to health services and financing the contraception. for example, someone's interest
installation of contraceptives. The better the in the use of injectable contraceptives will
support provided by the husband, in making arise if people around them also use injectable
decisions according to the wishes of the contraceptives. This includes habits passed
husband and wife, on the other hand, if the down from generation to generation, from
husband's support is lacking, the husband's mother to child, and so on (Setiyaningrum,
dissatisfaction will arise in using 2016).
contraceptives. Therefore, support from
partners is influential in determining Researchers assume that it is necessary
contraceptive use decisions and also considers to involve religious and community leaders in
conducting counseling about the use of
contraceptive methods in the community. For Hopefully the results of this literature
example, by inviting clerics or village heads study can be used as a reference and
whose wives have used contraceptives so that become a collection of books in the
they can become references and role models library to prepare future researchers
for the community in using contraceptives. and as a reference in providing
guidance to students.
CONCLUSIONS AND SUGGESTIONS 3. For further researchers
For future researchers, because this
CONCLUSIONS thesis is only a literature study,
1. Acceptors using Pill and hopefully it can be used as a guide and
Injection contraceptives can explore more about the factors that
according to education level are influence the choice of contraceptive
high school seniors. pills and injections.
2. Acceptors with high
socioeconomic levels used more
pill and injection contraceptives.
3. Acceptors who use Pill and
Arum, D. N., & Sujiyatini. (2009). Panduan
Injection contraceptives have 2
Lengkap Pelayanan KB Terkini.
to 3 children.
Yogyakarta: Nuha Medika.
4. Acceptors who use the
contraceptive pill and injection Baharu, M. R. (2019). Faktor - Faktor Yang
contraceptive are those who Berhubungan Dengan Peminatan
work. Kontrasepsi Pil Dan Suntik Di
5. The majority of respondents Wilayah Kerja Puskeskamas Global
who used contraception were at Tibawa. Akasemika Jurnal Ilmiah
the age of 20-35 years. UMGo, 8, 54-66.
6. More husbands used the pill and
injection contraceptives to Fitri, I. (2018). Nifas, Kontrasepsi Terkini dan
support family planning Keluarga Berencana. Yogyakarta:
acceptors. Gosyen Publishing.
7. Acceptors who used Pill and
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