"This is what the truth is": Provider-patient interactions serving as barriers to contraception

Contraception is a vital component of women's reproductive health, but not all women use it consistently and effectively. Many studies explore individual-level barriers to contraceptive use, yet interactional barriers are important to understand since contraception is primarily obtained through provider-patient interactions. Thus, through interviews with 86 women and 51 providers in the United States, we employ a framework of biomedicalization to study how such interactions, including the knowledge bases that inform them, shape women's contraceptive decision-making. We find that when women's embodied knowledge and providers' biomedical knowledge differ, providers' preferences supersede women's. Providers, however, overlook this hierarchy, instead viewing their relationships with patients as empowering equal partnerships. This pattern precludes women from achieving their desired contraceptive method and highlights the process through which women's concerns become barriers to contraceptive use. Moreover, these findings reflect how provider-patient hierarchies continue to thrive despite purported patient-centered care models.