Reasons young women choose a particular contraceptive method

Results of the 2017 online poll, of 2,632 American women aged 16 to 25 nationwide who used birth control, were published in the Journal of Women’s Health.

Overall, 32% of participants cited avoiding pregnancy as the primary reason for selecting their current method of birth control. Of them, 93% reported ever having had vaginal sex; whether they were currently sexually active is unknown.

However, while 48.6% of nonhormonal birth control users and 42.2% of hormonal birth control users reported that they wanted to prevent pregnancy, this reason was cited by only 20.6% of Copper T (CuT) intrauterine device (IUD) users, 23.0% of hormonal IUD users and 30.9% of Mirena IUD users. Mirena was evaluated separately from the other IUDs because it is the only one that is approved for treatment of heavy menstrual bleeding.

A recommendation from family or friends or hearing good things about their primary form of contraception was listed by 14.6% of respondents as the chief reason for choosing their method. The authors did not evaluate whether sources such as articles in magazines had any influence.

But a doctor’s recommendation was noted by only 5% of the sample as the primary reason for choosing their birth control, while 16% reported that a doctor’s recommendation was at least one reason why they selected it.

“Contraception method satisfaction is often gleaned from clinical trials and emphasize IUD use among young women,” said principal investigator Jacquiline Hirth, PhD, MPH, an assistant professor of population health at the University of Texas Medical Branch (UTMB) in Galveston.

“I wanted to find out what young women using long-acting reversible contraception (LARC) in the general population had to say about their experiences using various methods of contraception.”

Dr. Hirth was surprised that a relatively small proportion of young women selected their birth control method because their doctor had recommended it. “Many interventions focus on providers and their recommendations for LARC,” she said.

Another unexpected finding was that a large proportion of hormonal birth control users, of whom many used an oral birth control pill, and non-hormonal birth control users, mostly condom users, listed preventing pregnancy as the primary reason for choosing their method.

“IUDs are so much more effective at preventing pregnancy than birth control pills or condoms alone, thus I thought that more women using IUDs would find this an important reason for selecting their method,” Dr. Hirth told Contemporary OB/GYN.

The survey also revealed that Black respondents were much less likely and Hispanic respondents were much more likely to be satisfied with their birth control when compared with White women.

Providers who counsel young patients about LARC should recognize that these women are acquiring information about contraception from other sources, according to Dr. Hirth, and that these sources likely have a strong influence on patient decisions about contraception.

“However, patients may be very interested in knowing more about the benefits and side effects of their contraception, besides pregnancy prevention,” Dr. Hirth said.

“Further, because many patients value the experiences and opinions of family, friends, and partners when choosing their contraception, interventions that focus on expanding the reach of LARC user experiences through friend and family networks could help improve LARC use.”

Providers might also want to encourage patients to share their positive experiences using LARC with their female family members and friends. “It is possible that young women may not discuss this topic without encouragement from others,” Dr. Hirth said. “If discussions about contraception become more normalized, then improvements in use of more effective contraceptive methods could potentially occur.”

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Dr. Hirth reports no relevant financial disclosures.

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Reference

1. Hirth JM, Dinehart EE, Lin YL, Kuo Y-F, Patel PR. Reasons why young women in the United States choose their contraceptive method. J Womens Health. Published online August 28, 2020. doi:10.1089/jwh.2019.8182