Purpose: To use qualitative methods to identify values and preferences contributing to contraceptive decision-making among reproductive-age women.
Method: We conducted semi-structured focus groups with reproductive-age women. We recruited participants in-person from 3 healthcare clinics providing contraceptive services and by telephone from a database of minority, low-income women who had previously agreed to be contacted for research studies. We audio-recorded all focus groups. The focus group sessions were professionally transcribed. We analyzed transcripts using qualitative data analysis software to identify themes about women’s values and preferences in contraceptive decision-making. We continued focus group recruitment until thematic saturation was reached.
Results: A total of 44 women participated in 12 focus groups. Participants were racially and socioeconomically diverse; 64% were black, 43% were white; 27% were currently receiving public assistance, and 52% reported difficulty paying for basics in the past 12 months. Eighty-seven percent of participants had used one or more contraceptive methods and 33% reported at least one prior pregnancy. Table 1 shows the values and preferences identified as important by focus group participants when making decisions about contraception.
| Table 1: Values and Preferences Important for Contraceptive Decision-Making | |
| Value/Preference | Number of Participants N (%) |
| Method is affordable | 41 (93.2) |
| Method is highly effective | 32 (72.7) |
| Method avoids irregular bleeding or heavier periods | 30 (68.2) |
| Only have to think about method at the time of intercourse | 30 (68.2) |
| Method is long-acting | 28 (63.6) |
| Method provides protection against sexually transmitted infections | 27 (61.4) |
| Do not need an appointment to start or continue method | 26 (59.1) |
| Method provides a regular monthly period | 25 (56.8) |
| Method is forgettable | 24 (54.5) |
| Method avoids hormones | 20 (45.5) |
| Nobody knows you are using the method | 16 (36.4) |
| Method avoids an object inside the body | 15 (34.1) |
| Method avoids risk of thromboembolism | 9 (20.5) |
| Method does not require pelvic exam or procedure to start the method | 9 (20.5) |
Conclusion: Contraceptive decision-making is a complex process and there are multiple values and preferences important to women when selecting a contraceptive method. Attributes of a contraceptive method may not meet all identified values and preferences. Future research in contraceptive decision-making should investigate the role of these values and preferences and how women make trade-offs between factors when choosing a contraceptive method.
See more of: The 33rd Annual Meeting of the Society for Medical Decision Making