204743 Women's experiences with contraception and their interest in over-the-counter access

Monday, November 9, 2009: 12:30 PM

Amanda Jo Dennis, MBE , Ibis Reproductive Health, Cambridge, MA
Kelly Blanchard, MS , Ibis Reproductive Health, Cambridge, MA
Daniel Grossman, MD , Ibis Reproductive Health, Oakland, CA
In addition to concerns about side effects and partner opposition, barriers to access may deter use of contraceptives. The prescription requirement for hormonal contraception is one barrier that might restrict access and consistent use. We explored women's experiences with contraceptives and opinions about over-the-counter (OTC) access to oral contraceptives (OCs). We conducted 5 focus group discussions and 10 in-depth interviews with low-income English speaking women in Boston from March 2007-January 2009. Participants cited efficacy, ease of use, and non-contraceptive benefits (i.e. lighter periods and improved acne) as advantages of their method. Many participants reported that insurance issues restricted access, including allowing only one pack of pills per month, having to pay first and apply for reimbursement, lack of clarity on covered brands, and not having health insurance. Participants also noted that travel, losing a job, or moving made it difficult to access their method. In addition, women voiced concerns about perceived side effects of hormonal contraception, including negative emotional effects, breakthrough bleeding, nausea, and weight gain. Women supported OTC access to OCs for themselves, but were concerned about whether “other” women could use OCs safely without advice from a clinician. Insurance issues, life events and perceived side effects can be barriers to consistent contraception use. Women supported OTC access to OCs to make accessing their own method easier; more information about safety and non-contraceptive benefits of hormonal methods might increase general support for OTC access.

Learning Objectives:
1. List barriers that women face in accessing hormonal contraceptive methods. 2. Discuss the impact that insurance regulations have on contraceptive use for low-income women.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be an abstract author because of extensive training and experience with social science research.
Any relevant financial relationships? No

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.