Assessing the Acceptance of and Compliance With Centchroman Usage, a Non-hormonal Contraceptive Pill, Among Postpartum Women: A Cross-Sectional Study at a Tertiary Care Centre in North India

Introduction: Centchroman is a non-hormonal oral contraceptive available in India through the national family planning program under the brand name "Chhaya." As the first non-hormonal oral contraceptive, it inhibits implantation without affecting ovulation or the hormonal axis, making it particularly safe for breastfeeding women. Despite these advantages, its uptake remains limited. This study aimed to assess the acceptance, satisfaction, compliance, continuation, side effects, and failure rate among centchroman users who adopted it as a contraceptive method. Materials and methods: A cross-sectional descriptive study was conducted through telephonic follow-up of postpartum centchroman users over two years (January 2023 to December 2024) at the Family Planning Clinic, Department of Obstetrics and Gynaecology, AIIMS, New Delhi. A total of 241 women were included. Data on demographics, contraceptive history, side effects, and continuation were analyzed using SPSS v21.0 (IBM Corp., Armonk, NY). Results: Of 241 users, 72% were postpartum, and 67% were primiparous. The mean age was 28.2 years. While all participants used centchroman for at least one month, 58% continued for 12 months or more (95% CI: 51.7-64.3%). Side effects were reported by 18%, most commonly delayed menses (10.7%). Discontinuation was highest in the first three months, mainly due to access issues (12%) and adoption of alternate methods (12%). Two pregnancies occurred due to missed doses, resulting in a Pearl Index of 0.42 per hundred woman-years (HWY) (95% CI: 0.05-1.52). Overall, 93% of users reported satisfaction, and 88% were willing to recommend the method. Conclusion: Centchroman demonstrated high acceptability, satisfaction, and a low failure rate among postpartum women, reaffirming its role as a reliable non-hormonal oral contraceptive. Strengthening early counseling and ensuring consistent availability may improve compliance, continuation, and wider utilization within national family planning programs.