Experience of nulliparous patients aged <30 years seeking permanent female contraception: A qualitative study

Abstract

Objective: This study aimed to describe the experience of nulliparous individuals aged <30 years when seeking permanent female contraception.

Study design: We recruited nulliparous individuals aged <30 years who underwent permanent female contraception in the United States in the last 2 years through a clinical Listserv, Facebook, and Reddit to participate in semistructured in-depth interviews. We summarized themes using the socioecological model.

Results: Thirty individuals from 20 states participated. The average age was 25 years (range 21-30). Most participants identified as White (25, 83%), non-Latine (28, 93%), had attended some college (27, 90%), and used online resources to seek permanent female contraception (22, 73%). On an individual level, childfree identity and the experience of trying other contraception methods led participants to choose permanent female contraception. On an interpersonal level, participants reported others' support of bodily autonomy and childfree identity as facilitators and questioning permanent female contraception decisions as a barrier. On an institutional level, insurance coverage created confusion and stress. At the community level, social media interactions provided information and support. At the public policy level, the Dobbs decision increased the urgency to seek permanent female contraception.

Conclusions: This qualitative study of young, nulliparous individuals focuses on characterizing patients' lived experiences and motivations for seeking permanent female contraception. Key findings included support stemming from a clinician's acceptance of childfree identity, stressors from insurance coverage, benefits of using online resources, and the impact of the Dobbs decision on the urgency to seek permanent female contraception due to perceived threats to reproductive autonomy.

Implications: This study provides insights into the perspectives of young, nulliparous people who underwent permanent female contraception. Clinicians' acceptance of childfree-identity and online resources are facilitators, and the Dobbs decision impacted urgency of seeking surgery. Findings should be integrated into policy and practice for improved person-centered care in a post-Dobbs society.

Keywords: Contraception; Permanent female contraception; Sterilization.