In a first-of-its-kind survey, 417 women ages 15 to 45 at 188 facilities providing contraception, both women and practitioners were asked what matters the most when deciding on a contraceptive method. They rated the importance of the information using 34 questions.
Although the women’s number-one question was about contraceptive safety, providers considered how the method is used as the number-one concern. The question rated most important for women was “How does it work to prevent pregnancy?” but for providers, it was “How often does a patient need to remember to use it?” and “How is it used?”
Additionally, information on side effects was in the top three questions for 26 percent of women compared to 16 percent of providers.
This is the first study to simultaneously explore the priorities of women and health care providers. It highlighted the importance of efforts to obtain each woman’s preferences and values as part of a shared decision-making process.
“Everything we hear suggests that women are struggling to choose the contraceptive method that best fits their unique needs and preferences,” says lead author of the study, Kyla Donnelly of The Dartmouth Institute for Health Policy & Clinical Practice. “Our findings suggest that this mismatch between what women want to know and what providers want to discuss may be a key factor.”
There are more than 20 different methods of contraception available to women that vary substantially in their method of use, effectiveness, side effects and other features. They range from natural family planning to surgical sterilization; with many methods in between, such as an intrauterine device (IUD), birth control pills, and implantable devices. Not all women want to use the same method. For example, for religious reasons, a woman may object to using anything other than natural family planning; a woman who has completed her family may want to undergo a tubal ligation, which is highly effective at preventing pregnancy.
“Supporting women to choose the contraceptive method that fits their preferences and lifestyle is a critical part of providing patient-centered care and preventing unintended pregnancy,” says co-author, Dr. Rachel Thompson from The Dartmouth Center for Health Care Delivery Science. “Given the current unprecedented access to contraception in the U.S., facilitating shared contraceptive decision-making in the clinical encounter is critical.”