A study on the prevalence of unmet needs of contraception among women of reproductive age group in the rural field practice area of Chengalpattu medical college

Background: The unmet need for contraception remains a significant public health concern in rural India, despite high awareness of family planning methods. Aims and Objectives: This study aimed to estimate the prevalence of unmet need for contraception and identify factors associated with non-use among rural women aged 15–45 years. Materials and Methods: A community-based cross-sectional study was conducted from January to December 2020 in the rural field practice area of Chengalpattu Medical College, Tamil Nadu. Using multistage sampling, 268 eligible women aged 15–45 years were interviewed with a pre-tested semi-structured questionnaire. Unmet need for contraception was defined using standard Demographic and Health Surveys (DHS) criteria. Data were analyzed using descriptive statistics and logistic regression. Results: Awareness of contraception was high (91.0%). More than half of the women were current contraceptive users (54.85%), predominantly female sterilization (67.35%). The overall unmet need for contraception was 25.37%, mainly for spacing births (67.65%). Higher unmet need was observed among women aged 21–25 years (41.67%), those married at ≥21 years (32.24%), women with parity ≤2 (34.27%), and women with one living child (51.55%). Unmet need was significantly higher among women not involved in family planning decisions (63.64%), those unaware of contraceptive methods (50.00%), and those reporting lack of perceived availability (44.68%). Multivariable analysis identified age at first childbirth ≥23 years, lack of female participation in decision-making, poor awareness, perceived non-availability of services, and longer duration of marriage as independent predictors of unmet need. Conclusion: Despite high awareness, the unmet need for contraception remains substantial, particularly for spacing methods. Strengthening early counseling, improving access to spacing methods, and promoting shared decision-making are crucial to reducing unmet need in rural settings.