Barriers to Preferred Contraception Use in Mississippi

Area of Science:

• Reproductive Health
• Health Services Research
• Sociology of Health

Background:

• Many individuals in the U.S. do not use their preferred contraceptive method.
• Limited research exists on the impact of health system barriers on contraceptive choice.

Purpose of the Study:

• To evaluate the relationship between health system barriers and unmet contraceptive preference in Mississippi.
• To identify preferred contraceptive methods among those with unmet needs.

Main Methods:

• Online survey of 462 Mississippi residents (18-45 years, assigned female at birth) recruited via social media (Sept 2020 - Feb 2021).
• Assessed desire for different/new contraceptive methods and preferred methods.
• Examined barriers to reproductive healthcare access (e.g., wait times, cost, insurance).
• Used multivariable-adjusted Poisson regression to analyze the association between barriers and unmet preference.

Main Results:

• 37% of respondents reported an unmet contraceptive preference.
• 83% experienced at least one barrier to reproductive healthcare access.
• Experiencing barriers was associated with nearly double the prevalence of unmet contraceptive preference (PR 1.81).
• Preferred methods included short-acting hormonal, long-acting reversible, and permanent options.

Conclusions:

• Nearly two-fifths of reproductive-aged women in Mississippi are not using their preferred contraceptive method.
• Structural barriers to care are prevalent and significantly linked to unmet contraceptive needs.
• These barriers undermine reproductive autonomy and highlight a critical need for improved access to contraceptive services.