Shared responsibility in contraceptive decision-making and choice: Does it matter and how?

Prevention of unintended pregnancy and improvement of pregnancy planning and spacing are important goals of the Healthy People 2020. Involving men in family planning decision-making influences the type and consistency of a couple's contraceptive use, leading to a more favorable outcome in preventing unintended pregnancy. We assessed the importance of a couple's shared responsibility in deciding and using a contraceptive method. Three years of pooled data (2008-09-10) from the California Women's Health Survey including three questions (who initiated discussion about contraception, who chose, and who made sure a method is used) were analyzed. Responses on these questions were “You”, “Partner” or “Shared.” Of current contraceptors aged 18-49 (n=3243), more than half (54%) and nearly half (48%) of women responded “shared” on initiating discussion and making sure a method is used, respectively. More women (“you” 54%) chose the type of contraception themselves. Women reporting shared responsibility in all three questions were more likely to report using vasectomy (19%;p<.001) and condoms (50%,p<.001), which required cooperation from their partner. The preliminary multivariate analyses suggest that shared responsibility in discussing, choosing, and making sure a method is used was significantly associated with use of vasectomy and condom after controlling for women's sociodemographic characteristics. Women who initiated discussion, chose a method and made sure a method is used have higher odds of using oral and other hormonal contraception. Men's involvement means not only encouraging them to adopt condoms or vasectomy, but equally important is providing resources enabling them to appropriately support their partner.