Women choose contraception based on relationships not just pregnancy desires

Cynthia H. Chuang, associate professor of medicine and public health sciences and Carol S. Weisman, Distinguished Professor of Public Health Sciences and Obstetrics and Gynecology and colleagues surveyed nearly 1,000 women in Pennsylvania, all with private health insurance covering prescription contraception, on their contraception use -- including prescription and over-the-counter methods, as well as natural family planning and withdrawal. The women were also asked about their pregnancy intent, pregnancy history and pregnancy risk exposure.

The women surveyed were not planning on getting pregnant within at least the next 12 months. Thirteen percent of participants planned to have a pregnancy in the next 12 to 24 months; 25 percent in two to five years; 23 percent in five or more years; another 23 percent were not sure if or when they wanted to have a baby; and 16 percent said they did not ever intend to have a baby.

The researchers found that partnership status and frequency of sexual intercourse -- not long-term pregnancy intent, as the researchers had hypothesized -- were the strongest predictors of prescription contraceptive use. The researchers report their results online in the journal Contraception.

"Currently, oral contraceptives (the birth control pill) are the most commonly used contraception in the U.S. -- used by 16 percent of all women ages 15-44 -- while LARCs (long-acting reversible contraceptives, including intrauterine devices and implants) are used by only 7.2 percent," wrote Chuang and Weisman.

LARCs are highly effective and, due to the Affordable Care Act, are now available at no cost to women in most private health insurance plans.

"We found that a lot of women who intend to get pregnant someday, but not for at least a year, were not using LARCs," said Chuang. "However, women who don't ever want to get pregnant are more likely to use long-acting reversible contraception."

This research is part of an ongoing randomized controlled trial to test an online intervention to help women make contraceptive choices consistent with their pregnancy plans.

"Over time, if overall use of prescription contraception and adoption of LARCs increase, the rate of unintended pregnancy -- estimated at 51 percent of all U.S. pregnancies in 2008 -- would be expected to decline," the researchers said.