Measuring Nuance in Individual Contraceptive Need: A Case Study from a Cohort in Malawi

Contraceptive counseling protocols tend to focus narrowly on pregnancy intentions, which may overlook other factors that contribute to whether an individual wants or needs contraception. In this report, we demonstrate the potential of two measures of individual contraceptive need that could be asses...

Full description

Saved in:
Bibliographic Details
Published in:Studies in family planning 2023-03, Vol.54 (1), p.63-74
Main Authors: Bornstein, Marta, Huber‐Krum, Sarah, Gipson, Jessica D., Norris, Alison H.
Format: Article
Language:English
Subjects:
Adult
Birth control
Case studies
Cohort analysis
Contraception
Contraception - methods
Contraception Behavior - psychology
Contraceptive Agents
Contraceptives
Counseling
Desire
Fecundity
Female
Humans
Malawi
Pregnancy
Pregnancy, Unplanned
Risk factors
Unwanted pregnancy
Women
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Contraceptive counseling protocols tend to focus narrowly on pregnancy intentions, which may overlook other factors that contribute to whether an individual wants or needs contraception. In this report, we demonstrate the potential of two measures of individual contraceptive need that could be assessed as part of contraceptive counseling: (1) a composite score constructed from pregnancy intentions, sexual frequency, and perceived fecundity and (2) a direct measure of contraceptive need (“do you feel it is necessary for you to be using contraception right now?”) We compare the two measures using data from Umoyo wa Thanzi, a cohort study in Central Malawi (N = 906; 2017–2018). More frequent sex, perceptions of being more fecund, and a stronger desire to avoid pregnancy were associated with directly reporting contraceptive need (p < 0.001). Women who directly reported contraceptive need had a higher average composite score than women who directly reported they had no need (mean = 7.4 vs. 6.3; p < 0.01), but nearly all participants had scores indicating some risk of unintended pregnancy. Contraceptive counseling protocols should consider assessing women's direct report of contraceptive need, along with risk factors for unintended pregnancy, such as sexual frequency, perceived fecundity, and desire to avoid pregnancy, to better counsel clients.
ISSN:0039-3665
1728-4465
DOI:10.1111/sifp.12223