Exploring young women's decisional needs for contraceptive method choice: a qualitative study

Assisting women with choosing contraceptive methods that meet their needs and preferences is essential to providing patient-centered care, but research to inform interventions supporting method choice is lacking. An assessment of patient decisional needs for contraceptive method choice may provide insight into patient-centered ways to support decision making.

Using the Ottawa Decision Support Framework as a guide, we conducted a qualitative study with semistructured interviews to identify women's decisional needs for choosing a contraceptive method. The sample consisted of 21 women aged 18-29 from an integrated health care delivery system. We employed thematic analysis to identify common themes in the participants' experience.

Overall, participants perceived choosing a contraceptive method to be a somewhat difficult decision and described feeling hesitant and unsure. Lack of knowledge of and familiarity with methods and the unpredictability of side effects contributed to participants' hesitancy. Women considered method choice in the context of their lives and their values for various contraceptive attributes, particularly side effects. Participants identified several sources for contraceptive information. Information from friends and family was highly influential. Participants desired both factual and experiential information.

Contraceptive method choice may be difficult for many young women, suggesting a need for decision support. Interventions supporting method choice may be more relevant if they directly address knowledge gaps and uncertainty as well as provide both factual and experiential information on a comprehensive set of contraceptive attributes.