157155 Women's perceived barriers to effective contraceptive use in a managed care population

Monday, November 5, 2007

Annette E. Aalborg, DrPH , Public Health Program, Touro University, Vallejo, CA
Gail Husson, MPH , Division of Research, Kaiser Permanente, Oakland, CA
Despite widespread availability of reproductive healthcare services and contraceptive methods, unintended pregnancy remains a major public health problem in the U.S. among all women of reproductive age. Women aged 18-24 years who reported to a managed care clinic for a pregnancy test and did not desire to be pregnant or were unsure of their pregnancy intention completed a reproductive health assessment questionnaire and answered open-ended questions. The open-ended questions addressed their perceived barriers and concerns related to contraceptive use. Data were analyzed using qualitative and quantitative techniques. The most frequently identified barriers to effective contraceptive use were forgetting (reported by 35% of participants) and concern about side effects (31%). Unmarried or cohabiting women identified forgetting as a barrier more frequently than other women. Reporting side effects as a concern was associated with having more education, while having no barriers or concerns was associated with having less education. Thirty-six percent of women who identified partner issues (disagreement about pregnancy desirability, concerns about fidelity) had used no method of contraception in the previous 30 days, and none of the women who reported partner issues used contraceptives effectively. All women, including those of relatively high socioeconomic status and good access to reproductive methods and healthcare, need careful assessment of barriers and concerns related to effective contraceptive use. This study shows that these women do report significant barriers and concerns that put them at risk for unintended pregnancy.

Learning Objectives:
1. Identify 3 barriers to effective contraceptive use among adult women in a managed care setting. 2. Discuss two barriers related to effective contraceptive use among married or cohabiting women. 3. Articulate 1 reason that adult women in a managed care setting should receive reproductive health counseling.

Keywords: Contraception, Reproductive Health

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.