Healthcare providers should not assume that pregnancy preferences are the sole motivation for contraceptive use.
A new study from the University of California San Francisco (UCSF) and Columbia University Mailman School of Public Health shows that women with a stronger preference to avoid pregnancy were far more likely to use any contraceptive method and thatover half of the women studied who reported low preference to avoid pregnancy nevertheless used a contraceptive method.
The findings are published in the journal Contraception.
Desire to Avoid Pregnancy scale
Using the 14-item Desire to Avoid Pregnancy (DAP) scale, a newly developed tool by study co-author Dr Corinne Rocca (UCSF), researchers measured the ranges of women’s preferences regarding a potential future pregnancy.
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.
This is the first study to test the rigorously developed and evaluated measure of pregnancy preferences in an ethnically and geographically diverse sample of women.
The study showed that the odds of contraceptive use increased 64% for each increasing point on the DAP scale. Among women who had sex in the last 30 days, 21% reported not using any contraceptive method, while 17% used IUDs or implants, 31% used Short Acting Reversible Contraception including the Pill, and 20% used condoms.
About 13% 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.
Goleen Samari, PhD, Columbia Mailman School assistant professor of population and family health, said: “We found that women across all ranges of desire to avoid pregnancy used a diversity of contraceptive methods.
“The finding tells us that women use contraception for all sorts of reasons, and contraceptive counselling shouldn’t be guided by pregnancy preferences alone. Even for women with strong preferences to avoid pregnancy, overemphasising effectiveness in contraceptive counselling may not lead to contraceptive uptake and satisfaction if other contraceptive features are not addressed.”