A Qualitative Analysis of Long-Acting Reversible Contraception

• Published in: Maternal and child health journal Vol. 19; no. 7; pp. 1507 - 1514
• Main Authors: Sundstrom, Beth, Baker-Whitcomb, Annalise, DeMaria, Andrea L.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.07.2015; Springer; Springer Nature B.V
• Subjects: Adolescent; Age groups; Birth control; Contraception; Contraception - methods; Contraceptive Agents, Female - administration & dosage; Contraceptive Agents, Female - therapeutic use; Cross-Sectional Studies; Data analysis; Data collection; Family Planning Services; Female; Grounded Theory; Gynecologists; Gynecology; Health aspects; Health Knowledge, Attitudes, Practice; Hispanic Americans; Humans; Infertility; Interviews; Interviews as Topic; Intrauterine Devices; IUD; Maternal and Child Health; Medicine; Medicine & Public Health; Methods; Pediatrics; Population; Population Economics; Practice; Pregnancy; Pregnancy, Unplanned; Public Health; Qualitative analysis; Qualitative Research; Researchers; Side effects; Sociology; Teenagers; White people; Womens health; Young Adult; United States > US; Qualitative research; Long-acting reversible contraception; Intrauterine devices; Implants
• DOI: 10.1007/s10995-014-1655-0
• ISSN: 1092-7875

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.