Abstract
Increasing access to long-acting reversible contraception (LARC), including the intrauterine device and the implant is a public health and clinical imperative to reduce rates of unintended pregnancy. In 2012, the American College of Obstetricians and Gynecologists recommended these methods for all women, including adolescents. Little research explores why young women reject these safe, effective contraceptive methods. A total of 53 women aged 18–24 years completed in-depth interviews. Analytical techniques from the grounded theory approach were used to identify patterns and themes across the data. Participants initiated hormonal contraception for “the pill’s” beneficial side effects and believed a myth of perfect use, which constructed a false choice of LARC methods. Barriers to LARC options included access, medical resistance, and cost. Participants described a sense of unease about methods perceived as “alien.” These women underestimated the risks of oral contraceptive pills and overestimated the risks of long-acting reversible contraception, including infertility. The myth of perfect use emerged as participants wanted to be in control by taking “the pill” every day; however, many described imperfect adherence. Findings include strategies for public health professionals and health care providers to distribute satisfactory and effective contraception for young women. Effective health communication campaigns will emphasize the desirable side effects, safety and increased effectiveness of LARC methods.
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Acknowledgments
The authors would like to acknowledge the space provided by the College of Charleston’s Center for Social Science Research in the conduct of this research. This research was supported in part by the College of Charleston’s Office of Undergraduate Research and Creative Activities. This research was also supported in part by a grant from the College of Charleston’s Humanities and Social Sciences Dean’s discretionary funds. The authors thank Jenna Barbaruolo, Stephanie McInnis, Jackelyn Payne, Emily Rogers, and Mary Frances Zeager for their assistance.
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Sundstrom, B., Baker-Whitcomb, A. & DeMaria, A.L. A Qualitative Analysis of Long-Acting Reversible Contraception. Matern Child Health J 19, 1507–1514 (2015). https://doi.org/10.1007/s10995-014-1655-0
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DOI: https://doi.org/10.1007/s10995-014-1655-0