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Patient Preferences or Provider Pressure? The Relationship Between Coercive Contraceptive Care and Preferred
Laura E T Swan1, Lindsay M Cannon2, Madison Lands3
1Reproductive Equity Action Lab, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53706, USA.
Healthcare (Basel, Switzerland)
|January 25, 2025
Summary
Patients pressured by providers not to use birth control were less likely to use their preferred contraceptive method. This highlights the need for unbiased, patient-centered contraceptive counseling to ensure reproductive autonomy.
Area of Science:
- Reproductive Health
- Patient-Centered Care
- Contraceptive Counseling
Background:
- Contraceptive coercion, where providers unduly influence birth control decisions, contradicts patient-centered care.
- The impact of contraceptive coercion on patients' lives and contraceptive outcomes remains under-researched.
- This study investigates the link between experiencing contraceptive coercion and preferred contraceptive use.
Purpose of the Study:
- To examine the association between experiencing contraceptive coercion and a patient-centered outcome: preferred contraceptive use.
- To understand how provider pressure to use or not use birth control affects contraceptive choices.
- To identify patterns of unmet contraceptive needs among patients who have experienced coercion.
Main Methods:
- Surveyed 1197 reproductive-aged individuals in the USA who had previously discussed contraception with a healthcare provider.
- Utilized chi-square and regression analyses to assess relationships between contraceptive coercion and preferred contraceptive use.
- Mapped current versus preferred contraceptive methods for participants experiencing coercion and unmet preferences.
Main Results:
- Downward coercion (pressure not to use birth control) was significantly associated with a lower likelihood of using preferred contraceptive methods.
- Upward coercion (pressure to use birth control) did not show a significant association with preferred contraceptive use.
- Observed patterns of unmet needs include using oral contraceptives when not preferred and desiring permanent contraception but not receiving it.
Conclusions:
- Patients experiencing provider pressure against using birth control are less likely to achieve their preferred contraceptive method.
- Ensuring reproductive autonomy necessitates contraceptive care that is comprehensive, patient-centered, and free from bias.
- Addressing coercive practices in contraceptive counseling is crucial for improving patient outcomes and respecting reproductive rights.
Keywords:
contraceptive counselingfamily planning carehealthcare provider biaspatient-centered carepreferred contraceptionreproductive autonomyMore Related Videos
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