The 130th Annual Meeting of APHA

Abstract #48601

Rebecca Cabral, PhD¹, Kathryn M Curtis, PhD¹, Cathleen K Yoshida, MS², Annette Aalborg, PhD², Richard Boise, MD, MPH³, Ruth Petersen, MD, MPH⁴, and Jennifer M. Ballentine, MPH¹. (1) Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS K-34, Atlanta, GA 30341, (770)488-6399, rxc1@cdc.gov, (2) Division of Research, Kaiser Permanente, 3505 Broadway, Oakland, CA 94611, (3) Adolescent Medicine, The Permanente Medical Group, 3400 Delta Fair Blvd, Antioch, CA 94509, (4) Sheps Center for Health Services Research, University of North Carolina, CB#7590, 725 Airport Road, Chapel Hill, NC 27599-7590

Objective: To describe contraceptive patterns among two groups of women not desiring pregnancy and discuss implications for counseling. Methods: Women seeking pregnancy testing at an HMO were screened for pregnancy desire; 143 who did not currently desire pregnancy were enrolled in a counseling intervention and completed a reproductive health self-assessment, with measures of demographics, contraceptive history, and risk behavior. Results: Participants were young (mean 25 years), co-habitating (66%), and racially/ethnically diverse. Effective contraceptive use was low: 23% reported no use (past 30 days); 46% reported inconsistent use. When assessing stage of change for consistency of contraceptive use, 66% of women were in preparation, contemplation, or precontemplation. Ambivalence about pregnancy was high: 43% reported that they didn’t care or didn’t know versus 57% who hoped not to be pregnant. Ambivalent women were similar to women hoping not to be pregnant in demographic characteristics, except marital status, and in most contraceptive methods used and consistency of use (past 30 days). Fewer ambivalent women used multiple methods than women hoping not to be pregnant. Contraceptive stages of change were distributed similarly for both groups. Conclusions: In this HMO sample of women not desiring pregnancy, two-thirds were in early stages of change for consistency of contraceptive use. Only minor differences were identified between women negative toward and ambivalent about pregnancy, indicating the need for counseling for all on effective contraceptive use. Counselors should be alert to the meaning of pregnancy desire and the need to follow up with all women with negative pregnancy tests.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Describe the contraceptive use patterns among women who don't want to be pregnant or are ambivalent about being pregnant
• Identify differences between women hoping not to be pregnant and women who are ambivalent
• Discuss implications for counseling in a managed care setting

Keywords: Contraception, Reproductive Planning

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.