Reasons for contraceptive and LARC non-use: How preferences and access barriers shape decisions

Area of Science:

• Reproductive Health
• Contraceptive Behavior Research
• Public Health Surveys

Background:

• Understanding reasons for non-use of contraception and long-acting reversible contraception (LARC) is essential for effective reproductive healthcare.
• Previous research indicates varied factors influencing contraceptive choices.

Purpose of the Study:

• To investigate the primary reasons behind non-use of general contraception and long-acting reversible contraception (LARC).
• To differentiate between personal reasons and access barriers affecting contraceptive uptake.

Main Methods:

• Analysis of baseline data from population-based household surveys conducted in 2019-2020.
• Inclusion of a four-state random sample (Arizona, Iowa, New Jersey, Wisconsin; N=2039) for general contraception non-use.
• Examination of reasons for never using LARC among Iowans (N=1604).

Main Results:

• Personal reasons were the most commonly cited factor for both general contraceptive non-use (90.2%) and never using LARC (88.3%).
• Access barriers were cited by a smaller percentage of general contraceptive non-users (2.9%).
• A significant proportion of LARC non-users (50.8%) cited access barriers, though personal reasons remained more prevalent.

Conclusions:

• Personal preferences and concerns are major drivers of contraceptive behavior.
• Effective contraceptive care necessitates respecting diverse patient choices and providing preference-aligned counseling.
• Improving contraceptive care involves addressing patient concerns about side effects and procedures, beyond just expanding access.