The Impact of Programs to Increase Contraceptive Use Among Adult Women: A Review of Experimental and Quasi‐Experimental Studies

Kirby, Douglas

doi:10.1363/4003408

Cited by 33 publications

(22 citation statements)

References 47 publications

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“…Furthermore, few articles specifically address the relationship between counseling and contraceptive initiation or continued use 10 . Recent data from the National Survey of Family growth showed that women who received contraceptive counseling in the past year had an 80% decreased risk of contraception non-use 11 .…”

Section: Introductionmentioning

confidence: 99%

The Impact of Contraceptive Counseling in Primary Care on Contraceptive Use

et al. 2011

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Section: Introductionmentioning

confidence: 99%

The Impact of Contraceptive Counseling in Primary Care on Contraceptive Use

et al. 2011

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“…Our understanding of what we can do in the clinical setting for women who are not very sure or have low intentions to use contraception is extremely limited. 28 Research is needed to determine how to accurately assess contraceptive intent in the clinical setting and how to effect it through counseling interventions.…”

Section: Discussionmentioning

confidence: 99%

One-Year Contraceptive Continuation and Pregnancy in Adolescent Girls and Women Initiating Hormonal Contraceptives

Raine

Foster-Rosales

Upadhyay

et al. 2011

Obstetrics &Amp; Gynecology

115

102

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OBJECTIVE To assess contraceptive discontinuation, switching, factors associated with method discontinuation, and pregnancy among women initiating hormonal contraceptives. METHODS This was a 12-month longitudinal cohort study of adolescent girls and women (n=1,387) aged 15 to 24 years attending public family planning clinics who did not desire pregnancy for at least 1 year and selected to initiate the patch, ring, depot medroxyprogesterone acetate, or pills. Participants completed follow-up assessments at 3, 6, and 12 months after baseline. Life table analysis was used to estimate survival rates for contraceptive continuation. Cox proportional hazards models were used to estimate factors associated with method discontinuation. RESULTS The continuation rate (per 100 person-years) at 12 months was low for all methods; however, it was lowest for patch and depot medroxyprogesterone acetate initiators, 10.9 and 12.1 per 100 person years, respectively (P≤.003); continuation among ring initiators was comparable to pill initiators, 29.4 and 32.7 per 100 person-years, respectively (P=.06). Discontinuation was independently associated with method initiated and younger age. The only factors associated with lower risk of discontinuation were greater intent to use the method and being in school or working. The pregnancy rate (per 100 person-years) was highest for patch and ring initiators (30.1 and 30.5) and comparable for pill and depot medroxyprogesterone acetate initiators (16.5 and 16.1; P<.001). CONCLUSION The patch and the ring may not be better options than the pill or depot medroxyprogesterone acetate for women at high risk for unintended pregnancy. This study highlights the need for counseling interventions to improve contraceptive continuation, education about longer-acting methods, and developing new contraceptives that women may be more likely to continue.

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“…Thus, efforts to reduce unintended pregnancy have primarily focused on improving education and knowledge about methods or on increasing access to contraceptive services and methods. 6,7 These efforts, however, have not to date made a substantial dent in the national rate of unintended pregnancy. Although hopes remain that widespread access to no-cost contraception under the Affordable Care Act may yet change the national landscape, there is a clear need to also consider the larger socio-cultural contexts in which pregnancy and contraceptive decision making occur.…”

Section: Introductionmentioning

confidence: 99%

“It just happens”: a qualitative study exploring low-income women’s perspectives on pregnancy intention and planning

et al. 2015

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Objective Unintended pregnancy is common and disproportionately occurs among low-income women. We conducted a qualitative study with low-income women to better typologize pregnancy intention, understand the relationship between pregnancy intention and contraceptive use, and identify the contextual factors that shape pregnancy intention and contraceptive behavior. Study design Semi-structured interviews were conducted with low-income, African-American and white women aged 18–45 recruited from reproductive health clinics in Pittsburgh, Pennsylvania to explore factors that influence women’s pregnancy-related behaviors. Narratives were analyzed using content analysis and the constant comparison method. Results Among the 66 participants (36 African-American and 30 white), we identified several factors that may impede our public health goal of increasing the proportion of pregnancies that are consciously desired and planned. First, women do not always perceive that they have reproductive control and therefore do not necessarily formulate clear pregnancy intentions. Second, the benefits of a planned pregnancy may not be evident. Third, because preconception intention and planning do not necessarily occur, decisions about the acceptability of a pregnancy are often determined after the pregnancy has already occurred. Finally, even when women express a desire to avoid pregnancy, their contraceptive behaviors are not necessarily congruent with their desires. We also identified several clinically relevant and potentially modifiable factors that help to explain this intention-behavior discrepancy, including women’s perceptions of low fecundity and their experiences with male partner contraceptive sabotage. Conclusion Our findings suggest that the current conceptual framework that views pregnancy-related behaviors from a strict planned behavior perspective may be limited, particularly among low-income populations.

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The Impact of Programs to Increase Contraceptive Use Among Adult Women: A Review of Experimental and Quasi‐Experimental Studies

Cited by 33 publications

References 47 publications

The Impact of Contraceptive Counseling in Primary Care on Contraceptive Use

The Impact of Contraceptive Counseling in Primary Care on Contraceptive Use

One-Year Contraceptive Continuation and Pregnancy in Adolescent Girls and Women Initiating Hormonal Contraceptives

“It just happens”: a qualitative study exploring low-income women’s perspectives on pregnancy intention and planning

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