A new study challenges the assumption that women with the greatest desire to avoid pregnancy use more effective contraceptive methods and that women who might welcome pregnancy do not use contraception.
The findings show that, overall, women with a stronger preference to avoid pregnancy were far more likely to use any contraceptive method; however, over half of the women studied who reported low preference to avoid pregnancy nevertheless used a contraceptive method.
The study is published in the journal Contraception.
A research team from the University of California San Francisco (UCSF) and Columbia University Mailman School of Public Health assessed women’s preferences regarding a potential future pregnancy with the 14-item Desire to Avoid Pregnancy (DAP) scale, a new tool developed by study co-author Dr. Corinne Rocca (UCSF).
The scale, which captures feelings about both a potential pregnancy (within three months) and child (within a year), and allows for uncertainty and ambiguity in preferences, covers three domains: desires, emotions, and perceived consequences.
The study is the first to test the rigorously developed and evaluated measure of pregnancy preferences in an ethnically and geographically diverse sample of women.
The findings reveal that the odds of contraceptive use increased 64 percent for each increasing point on the DAP scale. Among women who had sex in the last 30 days, 21 percent reported not using any contraceptive method, while 17 percent used IUDs or implants, 31 percent used Short Acting Reversible Contraception including the Pill, and 20 percent used condoms.
About 13 percent of women with a high preference to avoid pregnancy reported no use of contraception. Pregnancy preferences were not associated with the types of contraceptive methods women used.
“We found that women across all ranges of desire to avoid pregnancy used a diversity of contraceptive methods,” said Goleen Samari, Ph.D., Columbia Mailman School assistant professor of population and family health.
“The finding tells us that women use contraception for all sorts of reasons, and contraceptive counseling shouldn’t be guided by pregnancy preferences alone. Even for women with strong preferences to avoid pregnancy, overemphasizing effectiveness in contraceptive counseling may not lead to contraceptive uptake and satisfaction if other contraceptive features are not addressed.”