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Improving Contraceptive Use in the United States
Contraceptive Use Is Key To Reducing Unintended Pregnancy
Nearly half of pregnancies in the United States are unintended Approximately 6.4 million pregnancies per year
Most unintended pregnancies occur when women fail to use contraceptives or use their method inconsistently
Method Use Is Difficult
Many women are at risk Of the nearly 50 million sexually active 18–44-year-old women in the United States today, 28 million are at risk for unintended pregnancy
Half of women at risk are not fully protected from unintended pregnancy
Women report a variety of reasons for contraceptive nonuse
Inconsistent Method Use Is Common for Many Reversible Contraceptives
Thirty-eight percent of women use the pill inconsistently
Sixty-one percent of couples use condoms inconsistently
Difficulties in Contraceptive Use Are Linked to Life Changes
Half of women with gaps in use report coinciding life changes
Contraceptive providers often fail to discuss life changes with women
Personal, Relationship and Cultural Issues Play a Role
Gaps in use are related to socioeconomic disadvantage % of at-risk women experiencing contraceptive nonuse in the past year
Minority women are more likely than others to have gaps in use % of at-risk women experiencing contraceptive nonuse in the past year
Ambivalence About Pregnancy Is Associated with Difficulties in Contraceptive Use
Motivation to avoid pregnancy predicts gaps in use % of at-risk women experiencing contraceptive nonuse in the past year
A gap in use may reflect ambivalence about pregnancy % of at-risk women experiencing contraceptive nonuse in the past year
Public providers are the most likely to discuss pregnancy motivations with patients % who often or always discuss pregnancy motivations during follow-up contraceptive visits
Attitudes Toward and Experiences with Methods Are Linked to Contraceptive Use Patterns
Women who are unhappy with method options often rely on less effective methods
Inconsistent method use is elevated among women not satisfied with their method % who used their method inconsistently in the past 3 months
Providers vary widely in counseling about method difficulties % who often or always discuss during follow-up contraceptive visits
Attitudes Toward and Experiences with Providers Are Linked to Contraceptive Use Patterns
Feeling unable to call a provider with questions is linked to contraceptive nonuse % of at-risk women experiencing contraceptive nonuse in the past year
Inconsistent pill use is linked to low levels of provider satisfaction and continuity of care % of pill users who missed >1 pills during the past three months
Recommendations for Providers
Reduce the impact of life changes on successful contraceptive use Provide ongoing support Counseling is key to success Help women to be better prepared
Improve womens experiences with contraceptive care Share best practices Offer communications training Address questions fully
Reduce the impact of disadvantage on contraceptive use Assess ability to pay Tell women about subsidized funding Tap available insurance reimbursements
Reduce the impact of ambivalence Recognize the fluidity of womens reproductive goals Provide counseling Educate women about the importance of preconception planning
Anticipate and address method-related barriers to contraceptive use Assess motivation for method choice Review experiences and satisfaction Facilitate method switching as needed
What Women Can Do To Improve Their Contraceptive Use
Method choice The right method varies by individual Discuss life changes with provider Ask about back-up methods
Dissatisfaction Talk to your provider –Help using method –Find another option Do not skip use!
Risk of pregnancy Sex without contraception = high risk Chances are you will become pregnant Preconception planning is important
Insurance and public funding Know your insurance plan Seek out low-cost providers Talk to your provider about cost concerns
This presentation was developed with support from the National Institutes of Health (NIH) For more information, visit
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