Miss-Conceptions: 18- to 30-year-old women's contraceptive decision-making

Approximately 50% of unintended pregnancies occur due to failure to use contraceptives or incorrect use. To prevent unintended pregnancy, women must decide to use effective contraception consistently and correctly. While contraceptive decision-making has been well studied in adolescents, relatively little research has been conducted on young adults' contraceptive decision making. Through the use of qualitative methods, this study aimed to understand contraceptive decision-making in young adult women. Twenty-seven semi-structured, individual interviews were conducted with women between the ages of 19 and 30. Participants were asked questions related to their sexual behavior, contraceptive use, and contraceptive decision-making. Interviews were audiotaped, transcribed, and analyzed for major themes. Results from the interviews indicated that women's decision making varied by whether or not the decision was to use female-centered contraceptives, condoms, or no birth control. Women use female-centered contraceptives, especially hormonal methods, when they were in long-term relationships. Perceptions of increased risk and negative consequences of pregnancy, prior good experiences with birth control, and a belief that condoms are unreliable also motivate women to choose female-centered contraception. Additionally, women noted that partners, friends, and parents, particularly mothers, encourage use of female-centered contraception. Condom use was influenced by negative experiences with female-centered contraception, short-term or casual relationships, and infrequent sex. Contraception is not used when women are ready for children, under the influence of alcohol, or “hooking up.” Decision-making models for female-centered contraception, condoms, and non-use will be described. Public health program implications to inform contraceptive decision-making in this age group will also be discussed.