“My Body. My Choice”: A Qualitative Study of the Influence of Trust and Locus of Control on Postpartum Contraceptive Choice

Abstract

Postpartum contraception helps reduce unintended pregnancy and space births to improve maternal and child health. This study explored women's perceptions of contraceptive choice during the postpartum period in the context of locus of control and trust in healthcare providers. Researchers conducted six focus groups with 47 women, ages 18-39, receiving postpartum care at an outpatient clinic. Techniques from grounded theory methodology provided an inductive approach to analysis. HyperRESEARCH 3.5.2 qualitative data analysis software facilitated a constant-comparative coding process to identify emergent themes. Participants expressed a preference for relationship-centered care, in which healthcare providers listened, individualized their approach to care through rapport-building, and engaged women in shared decision-making about contraceptive use through open communication, reciprocity, and mutual influence. Conflicting health messages served as barriers to uptake of effective contraception. While participants trusted their healthcare provider's advice, many women prioritized personal experience and autonomy in decisions about contraception. Providers can promote trust and relationship-centered care to optimize contraceptive uptake by listening, exploring patient beliefs and preferences about contraception and birth spacing, and tailoring their advice to individuals. Results suggest that antenatal contraceptive counseling should incorporate information about effectiveness, dispel misconceptions, and engage patients in shared decision-making.

Misinformation About Health: A Review of Health Communication and Misinformation Scholarship

“…In addition to misinformation stemming from media portrayals, reporting, and/or advertising, misinformation about a variety of topics stemming from interpersonal interactions have been discussed in the literature. For example, Sundstrom, Szabo, and Dempsey’s (2018) focus groups conducted among women revealed misinformation delivered by healthcare providers about specific types of contraception to affect their decision making. Similarly, Anderson, Steinauer, Valente, Koblentz, and Dehlendorf (2014) found negative misinformation about long-acting reversible contraceptives to dominate conversations among women and their family and friends, explaining the continued resistance to acceptance of such alternatives.…”

Acceptability of immediate postpartum and post‐abortion long‐acting reversible contraception provision to adolescents: A systematic review

“…Heavy vaginal bleeding was a deterrent to Cu‐IUD use for a number of reasons across studies, including the potential impact of this on adolescents’ relationships and the perception that IPP, Cu‐IUD insertion was unsafe 68 . When selecting a contraceptive method, particularly IPP/IPA, there is an onus on the provider to sensitively navigate the consultation, build trust, elicit the patient’s needs and preferences, and ensure the decision to commence contraception is both well informed and not coerced 70‐72 . Adolescents may require additional sexuality education and, due to heightened barriers to access and experiences of medical and social stigma, 28 require a supportive healthcare climate to facilitate education and decision‐making 73 .…”

You Have Options: Implementing and evaluating a contraceptive choice social marketing campaign

“…The survey was designed based on a review of the extant literature, the research team's prior work on contraception, 16,17,25,27,28 the TPB, 29 and DOI theory. 30 LARC communication channels.…”