Commentary Many Women Aren’t Using the Best Birth Control Method for Them—And it’s Not Their Fault

Many Women Aren’t Using the Best Birth Control Method for Them—And it’s Not Their Fault

Kyla Z. Donnelly

Imperfect contraceptive use has often been positioned as a failure on the part of patients. But it could equally be viewed as a predictable consequence of women not being supported in choosing the best method for them.

An oft-cited statistic is that nearly half of all pregnancies in the United States are unintended. What is less known is that a significant proportion (43 percent) of these pregnancies are a result of inconsistent or incorrect use of a birth control method.

For some people, the ensuing pregnancy is a welcome turn of events; for others, it is accompanied by very real medical, emotional, social, and financial costs. Imperfect patterns of contraceptive use have often been positioned as a failure on the part of patients—youth, poor motivation, or beginning or ending a relationship, to name a few. However, this could equally be viewed as a natural and predictable consequence of the dissatisfaction that arises when women are not supported in considering their unique needs, preferences, circumstances, or self-management capacity when choosing a method.

Although many providers are firmly committed to patient-centered contraceptive care, others report using information framing and even “scare tactics” to influence patients about what they perceive is best for them, rather than engaging in open discussion and deliberation. It is not surprising that nearly 40 percent of contraceptive users report not feeling completely satisfied with their current birth control method. These gaps are unacceptable, as research shows that when women are given the tools to identify the contraceptive method that best fits their lifestyle and goals, they are more likely to be satisfied and continue using the method correctly.

To address this challenge, I am working with a team of researchers, patient representatives, and clinicians affiliated with Dartmouth College to engage women and providers in helping design a tool to reposition women’s preferences as central to their contraceptive care. Known as an Option Grid, the tool will present a simple table of available methods and answer women’s most relevant frequently asked questions. The goal is to help women and providers more easily compare the features of each method using the most up-to-date evidence and come to a shared decision about the best option. This tool will be made freely available for download online for women and providers.

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Although there are numerous information materials available on contraception, end users (in other words, women and their providers) have rarely been involved in their development. This tool is different. Women and providers are driving the content of the Option Grid by taking a short survey to share their opinions about what information is essential to their contraception decision-making process and how the tool can be most successfully integrated into the busy clinical workflow. To have your say, take the survey and help us make choosing a birth control method easier for women throughout the United States.

When women are supported to choose a contraceptive method works best for them, that’s where progress starts.

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