Correct knowledge of the ovulatory cycle and its association with the use of modern contraceptives: Evidence from the 2023 Jordan Population and Family Health Survey

Background Poor knowledge of the ovulatory cycle (KOC) - that is, understanding when a woman is most likely to become pregnant between two menstruation periods, can lead to unintended pregnancies in the absence of any contraceptive use. This study explores (i) the variations in the prevalence of correct KOC among currently married women and men in Jordan by sociodemographic characteristics and (ii) the associations between correct KOC and modern contraceptive use. Data were drawn from the 2023 Jordan Population and Family Health Survey (JPFHS), a nationally representative survey covering all 12 governorates. The analysis included currently married women aged 15–49 (n = 11,623), men aged 15–59 (n = 2,728), and matched couples (n = 2,273). Respondents who reported that women are more likely to become pregnant during halfway between two periods were considered to have the correct KOC. Univariate, bivariate, and multivariable analyses were conducted. Results Approximately 41% of women and men each had correct KOC. The odds of correct KOC were greater among urban residents than among rural residents, individuals exposed to mass media than not exposed, and regular internet users than irregular users. Women who received family planning counseling were 14% less likely to have correct KOC than their counterparts (Adjusted Odds Ratio [ARR]: 0.86, 95% Confidence Interval [CI]: 0.79–0.93). Women with correct KOC were 25% more likely to use short-acting reversible methods than those who did not have correct KOC (Adjusted Relative Risk Ratio [ARRR]: 1.25, 95% CI: 1.12–1.39). In contrast, men with correct KOC were 37% more likely to use long-acting and permanent methods than their counterparts [ARRR: 1.37, 95% CI: 1.07–1.75]. Conclusions Correct KOC is associated with the choice of modern contraceptive methods—women preferred short-acting methods, whereas men favored long-acting methods. The findings underscore the need for improved counseling services targeting individuals in rural areas, those educated below secondary, and those with limited exposure to mass media to increase their fertility awareness, particularly KOC.