What do young Australian women want (when talking to doctors about contraception)?

Abstract

BackgroundAccess to most contraceptives in Australia requires a prescription from a doctor, and it has been shown that doctors can influence women’s decision-making with respect to contraception. However, little research has documented how women experience their interactions with doctors within the context of a contraceptive consultation. Understanding such experiences may contribute to our knowledge of factors that may influence women’s contraceptive decisions more broadly.MethodsWe report on findings from the Contraceptive Use, Pregnancy Intentions and Decisions (CUPID) survey of young Australian women, a large-scale longitudinal study of 3,795 women aged 18–23 years. We performed a computer-assisted search for occurrences of words that indicated an interaction within the 1,038 responses to an open-ended question about contraception and pregnancy. We then applied a combination of conventional and summative content analysis techniques to the 158 comments where women mentioned an interaction about contraception with a doctor.ResultsOur analysis showed that women desire consistent and accurate contraception information from doctors, in addition to information about options other than the oral contraceptive pill. Some young women reported frustrations about the choice limitations imposed by doctors, perceived by these women to be due to their young age. Several women expressed disappointment that their doctor did not fully discuss the potential side-effects of contraceptives with them, and that doctors made assumptions about the woman’s reasons for seeking contraception. Some women described discomfort in having contraception-related discussions, and some perceived their doctor to be unsupportive or judgmental.ConclusionsBoth the content and the process of a contraceptive consultation are important to young Australian women, and may be relevant contributors to their choice and ongoing use of a contraceptive method. These findings provide useful insights into aspects of the patient-provider interaction that will enhance the efficacy of the contraceptive consultation. It is recommended that doctors adopt patient-centred, shared decision-making strategies to support women in making choices about contraception that suit their individual circumstances. We also acknowledge the need to involve other health care providers, other than doctors, in educating, informing, and assisting women to make the best contraceptive choice for themselves.

Different Perceptions among Women and Their Physicians Regarding Contraceptive Counseling: Results from the TANCO Survey in Brazil

“…The authors described that, many times, the patients felt frustrated due to the limitations posed by their physicians or healthcare professionals, particularly when they are younger. 26 In general, healthcare professionals believe that there is a lack of interest by their patients concerning information about all contraceptive methods, and this can be a limiting factor for the use of LARCs. 15,27 In our study, 56% of the gynecologists believed that the women used the oral method inconsistently, forgetting 1 or more pills in the previous three months of use.…”

Are there unmet needs in contraceptive counselling and choice? Findings of the European TANCO Study

“…Healthcare provider beliefs about lack of interest may limit the extent to which they share information about all contraceptive methods and artificially limit use of LARCs [13]. The Contraceptive Use, Pregnancy Intentions and Decisions (CUPID) study of 3795 Australian women aged 18-23 years observed that women required consistent and accurate information that extended beyond OCs and often felt frustrated by the choice limitations imposed by their HCPs, particularly when they were seen to be linked to their age [31].…”

Prescribing for adolescents

“…A study among young Australian women (18-23 years) found that they perceived that doctors provided incomplete information about, and limited their options for, contraception because they were young. 12 A recent qualitative study involving young women (16-24 years) of culturally diverse backgrounds also suggested that clinicians may be selective about the contraception options they offer. 13 The uptake of long-acting reversible contraceptives has been slow among Australian women, despite them being recommended as first-line options for nulliparous ARTICLE Full text free online at nps.org.au/australian-prescriber Prescribing for adolescents women in Australia, the USA and the UK.…”