Skip to main content

Advertisement

SpringerLink
Log in

A Qualitative Analysis of Long-Acting Reversible Contraception

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

Increasing access to long-acting reversible contraception (LARC), including the intrauterine device and the implant is a public health and clinical imperative to reduce rates of unintended pregnancy. In 2012, the American College of Obstetricians and Gynecologists recommended these methods for all women, including adolescents. Little research explores why young women reject these safe, effective contraceptive methods. A total of 53 women aged 18–24 years completed in-depth interviews. Analytical techniques from the grounded theory approach were used to identify patterns and themes across the data. Participants initiated hormonal contraception for “the pill’s” beneficial side effects and believed a myth of perfect use, which constructed a false choice of LARC methods. Barriers to LARC options included access, medical resistance, and cost. Participants described a sense of unease about methods perceived as “alien.” These women underestimated the risks of oral contraceptive pills and overestimated the risks of long-acting reversible contraception, including infertility. The myth of perfect use emerged as participants wanted to be in control by taking “the pill” every day; however, many described imperfect adherence. Findings include strategies for public health professionals and health care providers to distribute satisfactory and effective contraception for young women. Effective health communication campaigns will emphasize the desirable side effects, safety and increased effectiveness of LARC methods.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. American College of Obstetricians and Gynecologists (ACOG). (2012). Adolescents and long-acting reversible contraception: Implants and intrauterine devices. Committee opinion no. 539. Obstetrics and Gynecology, 120, 983–988.

    Article  Google Scholar 

  2. Winner, B., Peipert, J. F., Zhao, Q., Buckel, C., Madden, T., Allsworth, J. E., & Secura, G. M. (2012). Effectiveness of long-acting reversible contraception. New England Journal of Medicine, 366(21), 1998–2007.

    Article  CAS  PubMed  Google Scholar 

  3. Guttmacher Institute. (2013 July). Contraceptive Use in the United States. Guttmacher Institute [Internet]. http://www.guttmacher.org/pubs/fb_contr_use.html#2

  4. Peipert, J., Madden, T., Allsworth, J., Zhao, Q., Eisenberg, D., & Secura, G. (2010). Continuation and satisfaction of reversible contraception: A preliminary analysis from the Contraceptive CHOICE project. Contraception, 82(2), 193–194.

    Article  Google Scholar 

  5. Sonnenberg, F. A., Burkman, R. T., Hagerty, C. G., Speroff, L., & Speroff, T. (2004). Costs and net health effects of contraceptive methods. Contraception, 69(6), 447–459.

    Article  PubMed  Google Scholar 

  6. Trussell, J., Henry, N., Hassan, F., Prezioso, A., Law, A., & Filonenko, A. (2013). Burden of unintended pregnancy in the United States: Potential savings with increased use of long-acting reversible contraception. Contraception, 87(2), 154–161.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Finer, L. B., Jerman, J., & Kavanaugh, M. L. (2012). Changes in use of long-acting contraceptive methods in the United States, 2007–2009. Fertility and Sterility, 98(4), 893–897.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Finer, L. B., & Zolna, M. R. (2011). Unintended pregnancy in the United States: Incidence and disparities, 2006. Contraception, 84(5), 478–485.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Kavanaugh, M., Frohwirth, L., Jerman, J., Popkin, R., & Ethier, K. (2013). Long-acting reversible contraception for adolescents and young adults: Service availability, provider attitudes and patient perspectives. Journal of Adolescent Health, 52(2), S88–S89.

    Article  Google Scholar 

  10. Mosher W. D., Jones J. (2010). Use of contraception in the United States: 1982–2008. Vital Health Statistics, Series 23, No. 29. National Center for Health Statistics.

  11. Jones, J., Mosher, W., & Daniels, K. (2012). Current contraceptive use in the United States, 2006–2010, and changes in patterns of use since 1995 (p. 25). Hyattsville, MD: National Center for Health Statistics.

    Google Scholar 

  12. Winner, B., Peipert, J. F., Zhao, Q., Buckel, C., Madden, T., Allsworth, J. E., & Secura, G. M. (2012). Effectiveness of long-acting reversible contraception. The New England Journal of Medicine, 366(21), 1998–2007.

    Article  CAS  PubMed  Google Scholar 

  13. Huber, L. R. B., & Ersek, J. L. (2009). Contraceptive use among sexually active university students. Journal of Women’s Health, 18(7), 1063–1070.

    Article  PubMed  Google Scholar 

  14. Abma J., Martinez G., Copen C. (2010). Teenagers in the United States: Sexual activity, contraceptive use, and childbearing, National Survey of Family Growth 2006–2008. Centers for Disease Control and Prevention. http://www.cdc.gov/nchs/data/series/sr_23/sr23_030.pdf

  15. Hickey M. T. (2009). Female college students’ knowledge, perceptions, and use of emergency contraception. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 38(4), 399–405.

  16. Bryant, K. D. (2009). Contraceptive use and attitudes among female college students. Association of Black Nursing Faculty Journal, 20(1), 12–16.

    Google Scholar 

  17. Corbin, J., & Strauss, A. (2008). Basics of qualitative research: Techniques and procedures for developing grounded theory. Thousand Oaks, CA: SAGE.

    Google Scholar 

  18. Rubin, H. J., & Rubin, I. (2012). Qualitative interviewing: The art of hearing data. Thousand Oaks, CA: SAGE.

    Google Scholar 

  19. Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. Chicago, IL: Aldine.

    Google Scholar 

  20. The Office of Institutional Research. (2013). College of Charleston, Spring 2013 statistics. The College of Charleston. Retrieved from http://irp.cofc.edu/docs/census-data/Spring2013.pdf

  21. Watkins, E. S. (2012). How the pill became a lifestyle drug: the pharmaceutical industry and birth control in the United States since 1960. American Journal of Public Health, 102(8), 1462–1472.

    Article  PubMed Central  PubMed  Google Scholar 

  22. Ersek, J. L., Huber, L. R. B., Thompson, M. E., & Warren-Findlow, J. (2011). Satisfaction and discontinuation of contraception by contraceptive method among university women. Maternal and Child Health Journal, 15(4), 497–506.

    Article  PubMed  Google Scholar 

  23. Hernandez, L. E., Sappenfield, W. M., Clark, C., & Thompson, D. (2012). Trends in contraceptive use among Florida women: Implications for policies and programs. Maternal and Child Health Journal, 16(2), 213–221.

    Article  PubMed  Google Scholar 

  24. Klerman, L. V., Johnson, K. A., Chang, C., Wright-Slaughter, P., & Goodman, D. C. (2007). Accessibility of family planning services: Impact of structural and organizational factors. Maternal and Child Health Journal, 11(1), 19–26.

    Article  PubMed  Google Scholar 

  25. Health Resources and Services Administration. Women’s Preventive Services Guidelines. U.S. Department of Health and Human Services. http://www.hrsa.gov/womensguidelines/

  26. Kittur, N. D., Secura, G. M., Peipert, J. F., Madden, T., Finer, L. B., & Allsworth, J. E. (2011). Comparison of contraceptive use between the Contraceptive CHOICE Project and state and national data. Contraception, 83(5), 479–485.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Andrews M. (2013). New coverage may spur younger women to use long-acting contraceptives. Henry J. Kaiser Family Foundation. Kaiser Health News (KHN). http://www.kaiserhealthnews.org/

  28. Dempsey, A. R., Billingsley, C. C., Savage, A. H., & Korte, J. E. (2012). Predictors of long-acting reversible contraception use among unmarried young adults. American Journal of Obstetrics and Gynecology, 206(6), 526e1–526e5.

    Article  Google Scholar 

  29. Lind, C. E., Godfrey, E. M., Rankin, K. M., & Handler, A. S. (2014). Likelihood of emergency contraception use among African-American women at risk of adverse birth outcomes. Maternal and Child Health Journal, 18(5), 1190–1195.

    Article  PubMed  Google Scholar 

  30. White, E., Rosengard, C., Weitzen, S., Meers, A., & Phipps, M. G. (2006). Fear of inability to conceive in pregnant adolescents. Obstetrics and Gynecology, 108(6), 1411–1416.

    Article  PubMed  Google Scholar 

  31. Frohwirth, L., Moore, A. M., & Maniaci, R. (2013). Perceptions of susceptibility to pregnancy among U.S. women obtaining abortions. Social Science and Medicine, 99, 18–26.

    Article  PubMed  Google Scholar 

  32. Hughey, A. B., Neustadt, A. B., Mistretta, S. Q., Tilmon, S. J., & Gilliam, M. L. (2010). Daily context matters: Predictors of missed oral contraceptive pills among college and graduate students. American Journal of Obstetrics and Gynecology, 203(4), 323e1–323e7.

    Article  Google Scholar 

  33. Potter, L., Oakley, D., de Leon Wong, E., & Canamar, R. (1996). Measuring compliance among oral contraceptive users. Family Planning Perspectives, 28(4), 154–158.

    Article  CAS  PubMed  Google Scholar 

  34. Sundstrom, B. (2012). Fifty years on “the pill”: A qualitative analysis of nondaily contraceptive options. Contraception, 86(1), 4–11.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to acknowledge the space provided by the College of Charleston’s Center for Social Science Research in the conduct of this research. This research was supported in part by the College of Charleston’s Office of Undergraduate Research and Creative Activities. This research was also supported in part by a grant from the College of Charleston’s Humanities and Social Sciences Dean’s discretionary funds. The authors thank Jenna Barbaruolo, Stephanie McInnis, Jackelyn Payne, Emily Rogers, and Mary Frances Zeager for their assistance.

Author information

Authors and Affiliations

  1. Department of Communication, College of Charleston, Charleston, SC, USA

    Beth Sundstrom & Annalise Baker-Whitcomb

  2. Department of Health and Human Performance, College of Charleston, Charleston, SC, USA

    Andrea L. DeMaria

Authors
  1. Beth Sundstrom
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Annalise Baker-Whitcomb
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andrea L. DeMaria
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Beth Sundstrom.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sundstrom, B., Baker-Whitcomb, A. & DeMaria, A.L. A Qualitative Analysis of Long-Acting Reversible Contraception. Matern Child Health J 19, 1507–1514 (2015). https://doi.org/10.1007/s10995-014-1655-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-014-1655-0

Keywords

Search

Navigation