Young Women's Perspectives About the Contraceptive Counseling Received During Their Emergency Contraception Visit

Abstract

Objectives: Research aimed at understanding women's experiences accessing emergency contraception (EC) services and the extent to which providers support women's autonomous contraceptive decision making is limited. This study explores young women's experiences with contraceptive counseling when accessing EC at family planning specialty clinics that serve young adult and adolescent patients. Methods: We conducted 22 in-depth telephone interviews with women ages 15-25 years who had recently accessed EC at two San Francisco Bay Area youth-serving clinics about their thoughts and experiences using and accessing contraception. We analyzed transcripts thematically, using inductive qualitative analytic methods to identify patterns across the interviews. Results: Most respondents described their recent clinic visit to access EC positively. Specifically, they expressed appreciation about receiving comprehensive information about other methods of contraception without pressure, judgment, or the expectation that they adopt a particular method. They also pointed to the influence of prior health care experiences in which they felt pressured or judged, leading them to avoid accessing future reproductive health services. Conclusions: We found that young women seeking EC appreciated learning about other contraceptive methods, but do not want to feel pressured to adopt a method in addition to EC. Findings highlight the importance of respecting young women's contraceptive decisions for building and maintaining provider trust and suggest that contraceptive counseling approaches that prioritize specific methods may reduce some young women's trust in providers and use of reproductive health services.

The Fine Line Between Informing and Coercing: Community Health Center Clinicians’ Approaches to Counseling Young People About IUDs

“…9 A qualitative study of young people accessing emergency contraception found that respondents described the contraceptive counseling they received favorably when they felt that their provider did not have a predetermined method in mind for them and did not feel pressured to select one particular method. 49 Our study corroborates fi ndings from those in a qualitative study that showed that many family medicine physicians in New York City prefer IUDs and dissuade people from removing them. 33 The current study adds to the literature by evaluating the approaches of advanced practice clinicians and physicians working with young people in a range of CHC settings in the San Francisco Bay Area, where resources such as time for IUD placement, availability of trained providers and money to stock IUDs are limited.…”

“…Provider resistance to IUD removal may compromise patient trust in the medical system and harm the provider–patient relationship 9 . A qualitative study of young people accessing emergency contraception found that respondents described the contraceptive counseling they received favorably when they felt that their provider did not have a predetermined method in mind for them and did not feel pressured to select one particular method 49 …”

Contraceptive counselling experiences in Spain in the process of creating a web-based contraceptive decision support tool: a qualitative study

“…Receiving information on the available methods and the sensation of not feeling judged or forced by the practitioner to choose is positively valued [ 31 ]. Women are grateful that practitioners help them make the decision, in a friendly environment, provided that the opinion of the practitioner is accompanied by an underlying explanation [ 17 ].…”

Social Network Influences on Young Women's Choice to Use Long‐Acting Reversible Contraception: A Systematic Review

“…Although the time frame of the search was from 2000 to 2020, none of the included articles were published prior to 2010. Most of the 29 included articles were qualitative (n = 21), 17,23,[36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] followed by quantitative (n = 6) 30,[55][56][57][58][59] and mixed methods (n = 2). 19,60 Fourteen of the articles 17,38,41,[43][44][45][46][47]51,52,54,[55][56][57] reported exclusively on the IUD.…”

“…30,38,41,[44][45][46][47][48][49][50][51][52][53][54][56][57][58][59][60] In the remaining 10 articles, the focus was broadly on contraceptive decision-making or initiation, and LARC was included in that broader focus. 17,19,23,36,37,39,40,42,43,55 All participants in 6 studies had never used LARC. 17,41,43,51,56,57 Twentytwo articles included a mix of never users and LARC users; however, results were often not stratified by LARC experience.…”