Contraceptive use among women with medical conditions: Factors that influence method choice

Abstract

Objective: To identify factors that influence contraceptive initiation among women with medical conditions.

Study design: We conducted an exploratory cross-sectional survey of women 18-45 years old with medical conditions who received contraception consultation from complex family planning specialists at five University of California Medical Centers from June 2014-June 2015. We asked survey participants about factors that influence their decision of choosing and initiating a contraceptive method, how they accessed family planning specialists and the impact of this consultation on their contraceptive method choice.

Results: Among 97 participants, 61 (63%) had one medical condition, 28 (29%) had two medical conditions, and 8 (8%) had three or four medical conditions. A majority of participants initiated long-acting reversible contraceptive methods including an intrauterine device (n = 54, 56%) and the contraceptive implant (n = 17, 18%). The most common reason for initiating contraception was to avoid pregnancy in the immediate future for personal reasons (n = 43, 44%). The most common reason for initiating a particular contraceptive method was safety given their medical condition (n = 19, 20%). After the consultation with the complex family planning specialist, participants commonly reported that the person with the most influence on their contraceptive method choice was the complex family planning specialist (n = 35, 36%) and less commonly the primary care provider (n = 9, 9%) and not at all by a family member or friend (n = 0, 0%).

Conclusion: Women with medical conditions are highly influenced by a complex family planning specialist in regard to their contraceptive options and when receiving such counseling, will often choose highly effective methods.

Implications: This study provides insight into contraceptive decision-making among women with medical conditions referred to a complex family planning specialist for contraceptive care.

Trial registration: ClinicalTrials.gov NCT02219269.

Keywords: Contraception; Family planning; Medical condition; Safety of pregnancy.