Clinicians’ Role in Contraception Guidance Seen as ‘Limited’
Young adult black women interviewed for a study co-authored by School of Public Health researchers viewed themselves as “in control” of their contraceptive decision-making and had “limited expectations” of guidance from their medical providers.
In the study, published in the journal Sexual & Reproductive Healthcare, researchers interviewed 15 black women, ages 18 to 23, about pregnancy prevention and their interactions with clinicians. Past research has shown that young black women are at risk for higher rates of unwanted pregnancy and lower use of contraception at last intercourse, compared with their white peers.
The research team reported that most of the study participants “viewed themselves as independent, responsible individuals in control of their contraceptive decision-making and practices.” Although about half of the women identified clinicians as a “trusted source of contraceptive information,” most viewed their influence as “secondary,” the study found.
“Most of the women in our sample had limited expectations of clinicians and considered in-depth conversations about sexual behavior or details of contraceptive use to be unnecessary,” the authors wrote. Among women who were not sexually active, several indicated that “once they confirmed they were not having intercourse, the conversation with their clinicians ended.”
The authors said their findings suggest that young women are getting information on contraception from other sources, including family members, friends, and the internet. But they noted that because prescriptions from medical providers are required for certain methods of contraception, “such interactions are an opportunity to improve sexual health and reproductive self-efficacy.”
Specifically, the researchers recommended that pediatricians should initiate sexual health discussions, in order to help to prevent any delay during the transition to an adult medical provider. Also, they suggested that medical schools improve training in reproductive health, so that clinicians are equipped to “talk to their patients about how they make contraceptive decisions and how this relates to their life plans.
“Such a personalized discussion can allow clinicians to gain more insight into the preferences and beliefs of patients and help tailor their contraceptive counseling to support women’s goals of preventing pregnancy,” they concluded.
SPH co-authors on the study include: Lois McCloskey, associate professor of community health sciences; and Barbara Bokhour and Victoria Parker, associate professors of health law, policy, and management. Michael Paasche-Orlow, associate professor of general internal medicine at the School of Medicine, also contributed. The study was led by Meredith Manze, who did the research as part of her PhD dissertation project while at SPH. She is now an assistant professor at Hunter College, CUNY School of Public Health.