Attitudes of women in Scotland to contraception: a qualitative study to explore the acceptability of long-acting methods

Abstract

Background and methodology Long-acting reversible contraception (LARC) (i.e. injections, implants and intrauterine methods) has the potential to reduce unintended pregnancies but in the UK these methods are under-used. To inform a campaign planned to increase awareness of LARC, eight focus discussion groups were held with 55 women in two cities in Scotland, UK. Trained interviewers sought spontaneous views of unintended pregnancy and contraception in general, and condoms and pills in particular, and attitudes towards health professionals giving contraceptive advice. Attitudes towards LARC were discussed both before and after women were given detailed information about the methods. ResultsWomen recognised the importance of using contraception but admitted to taking risks. Pills and condoms were familiar and acceptable despite undesirable side effects. Women were poorly informed about LARC, had firm but incorrect beliefs about their 213 IntroductionAlthough contraceptive prevalence rates in the developed world are high, 1 unintended pregnancy is common. In the UK the most popular contraceptives are condoms and pills; both rely on consistent and correct use and demand strict compliance for their effectiveness. Long-acting reversible methods of contraception (LARC) [i.e. intrauterine devices/intrauterine system (IUDs/IUS), implants and injectables] are highly effective, depend much less -if at all -on compliance for their effectiveness, and increasing their use has the potential to reduce unintended pregnancy. 2 Health professionals working in primary care settings in the UK have reservations about the long-term use of Depo-Provera ® , and about the side effects and continuation rates of Implanon ® , and many lack the necessary skills to insert implants and intrauterine contraceptives. safety and side effects, disliked any method which involved an invasive procedure and/or vaginal examination, and had rather a low opinion of advice given by health professionals. Accurate information was not wholly successful in dispelling negative views of LARC.Discussion and conclusions Many factors influence contraceptive choice. Attitudes towards methods are complex and may be difficult to change. Some barriers to LARC, including the need to see a health professional, cannot be overcome but giving more information about ease of use, reversibility, effects on weight and the positive experiences of other women, as well as describing these methods as lasting rather than longacting, may help improve acceptability. contraceptive implants, IUDs and the IUS is low in Scotland. 6 Recognising the potential of LARC to prevent unintended pregnancy, measures being used to monitor implementation of the National Sexual Health Strategy in Scotland 6 include increasing the uptake of LARC, and the Department of Health in England recently launched an initiative to promote LARC use. 7 The literature on acceptability of contraceptive methods is dominated by data from women already using those methods, often in the context of clinical trials...

Uptake of long-acting reversible contraceptive devices in Western region of the Gambia

“…This is in line with the findings of this study in which majority (45.1%) had secondary level of education and the lowest percentage (3.5%) were those with college education, this is not surprising considering the report of Gambian Demographic health Survey 2013, the percentage (32.4%) of women who had secondary level of education was three times higher (9.8%) than those with primary level of education. This findings is similar to other studies done in Ethiopia 12 , Ghana 16 , and Malawi 11 but is not in line with findings from scholars like Glasier, et al 15 , Kavanaugh et al 17 and Finer, et al 18 , who indicated that women with a college education were more likely to use long acting reversible contraceptive methods due to their increased knowledge on modern contraceptives. With regards to occupation of the respondents, about 84 (89.7%) were housewives and 57(45.92%) were civil servants.…”

“…This could be because majority, of women in The Gambia were in the age group 25-29 (women weighted number and percentage was 1822 and 17.8% respectively). Also the age-specific fertility rates start relatively low among women aged [15][16][17][18][19] (88 per 1,000), rise to a peak among women aged 25-29 (271 per 1,000), remain high for women aged 30-34 (237 per 1,000), and decline rapidly at older ages 3 . The result is similar to other studies done in NorthWest Ethiopia 12,13 .…”

Effect of a Low-Dose Contraceptive Patch on Efficacy, Bleeding Pattern, and Safety: A 1-Year, Multicenter, Open-Label, Uncontrolled Study

“…They report disliking methods of contraception that are invasive or involve a vaginal examination and have a low opinion of health care professionals' advice. 17 Negative views on methods of long-acting reversible contraception cannot be completely dispelled by providing women with accurate information on their efficacy and tolerability alone. 17 The principal aim of the present study was to investigate the efficacy and safety of the EE/GSD patch.…”

A Study of the Behavioural Factors Associated with Low Uptake of Intra-Uterine Contraceptive Device in Zaria, Northern Nigeria: A Qualitative Survey

“…Clients' perception of IUD association with cancer of the womb, infection and damage to the womb with resultant infertility is not uncommon myths attributable to IUD among women in Africa [12]- [14] [19] [20]. Similar finding was documented among women in Scotland [21]. Association of IUD with reduce sexual pleasure and dyspareunia by the clients further stresses the magnitude of the myths/misconceptions surrounding the IUD and this underscores the importance of provision of accurate FP information by competent providers using multiple media.…”