Influence of clinician counseling on contraceptive method choice among a sample of women initiating birth control

Background. Clinician counseling is an important component of women’s birth control expectations and satisfaction. However, little is known about the interplay of counseling on contraceptive decision-making among women who want to begin a new method but who state no preference for a particular birth control type. The aim of this study was to better understand how contraceptive counseling influences method choice.

Methods. Women seeking to start a new contraceptive method and who had not used any hormonal method in the past six months were enrolled into an online study after visiting family planning clinics throughout the US.

Results. Data represent N=78 women between the ages of 14-42 (mean=24.24) who indicated no preference for a specific method at the beginning of the appointment. Large discrepancies exist in the range of methods covered during a typical counseling session. The majority of participants received information on the pill (82.1%) and condoms (62.8%) with far fewer being counseled on IUDs (29.5%) or the implant (23.1%).  At the end of the visit, 50% (n=39) initiated the pill, 6.41% (n=5) started the vaginal ring, 5.13% (n=4) received the shot, 2.56% (n=2) had an IUD inserted, 7.69% (n=6) left using condoms only, 3.84% (n=3) were using other non-hormonal methods, and almost one-quarter (24.36%, n=19) left without initiating a contraceptive method. 

Conclusions. Clinicians appear to exert strong influence on method choice and should incorporate information on all available methods, particularly for women who begin the counseling session with no preference for one method over another.