Decisional Needs of Young Women (Aged 15-24 Years) in Contraceptive Choice: A Systematic Review

Despite the wide range of contraceptive options available to women, young women worldwide are at risk of unintended pregnancy. Teenagers aged 15-19 account for 15% of abortions, while young women aged 20-24 represent 26% of abortion cases. This review aimed to identify the decisional needs of young women aged 15-24 years when considering contraceptive options based on the ODSF framework.

The PRISMA reporting guidelines guided our methodology while we were theoretically directed by the Ottawa Decision Support Framework. Our review included six databases in English and three databases in Chinese, with no publication date limits applied. Two reviewers independently screened citations and performed quality assessment with MMAT while extracting data. Sixteen studies (10 qualitative, 5 quantitative, and 1 mixed-methods) were included. The study results underwent thematic synthesis.

Sixteen studies (10 qualitative, 5 quantitative, and 1 mixed-methods) were included. Six decisional needs were identified: decisional conflict, inadequate knowledge, unrealistic expectations, unclear values, inadequate support and resources, and personal/clinical needs. Inadequate knowledge and inadequate support and resources were the most frequently reported needs. In resource-limited settings, cultural stigma, financial barriers, and limited access to contraceptive services further complicated contraceptive decision-making.

The review identified six decisional needs among young women considering contraceptive options. The findings support the applicability and validity of the Ottawa Decision-Support Framework (ODSF) in the context of young women's contraceptive decision-making, representing an important theoretical contribution of this review. Healthcare providers and policymakers should improve access to reliable contraceptive information, provide patient-centered and culturally sensitive counseling, and develop tailored decision-support tools. However, the restriction to English- and Chinese-language literature may limit the generalizability of the findings across diverse linguistic and cultural contexts.