Contraceptive use and contraception type in women by body mass index category

Obese women who become pregnant have increased risk of pregnancy complications for mother and fetus. This study assessed whether body mass index (BMI) category is related to contraception use and type of contraception used in women of reproductive age.

This is a secondary data analysis of data from seven states participating in the Family Planning Module of the 2006 Behavioral Risk Factor Surveillance System (BRFSS). The subsample was 4,757 women who were sexually active with a male partner and not trying to get pregnant. Outcomes were use and type of contraception. Covariates included sociodemographic characteristics and health access variables. The relationship of BMI category and contraception use was examined using logistic regression and multinomial logit analyses for the outcome of type of contraception among users. Survey analysis procedures were used to account for the complex sampling design.

Nonuse of contraception was reported by 13.8% of women. BMI category was not associated with contraceptive use (p = .860). The relationship between BMI category and contraceptive method was significant (p = .0001). Use of procedural contraception was highest among women with a BMI greater than 25 and increased with age. Hormonal contraception use was highest for women with a BMI of 15 to 25 and decreased with age. Use of barrier methods was lower than other methods, and decreased with age.

The reasons why heavier women choose procedural methods along with the timing of weight gain and contraceptive procedures needs to be further explored. Understanding the relationship between weight and contraceptive behaviors is important for the development of health promotion programs to improve pregnancy outcomes and decrease obesity.