Why some women are shunning contraception

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Barriers to access, finding a suitable option and underestimating fertility are some of the reasons why women don’t use contraception regularly, a leading family planning expert says.

New research has revealed that about half of unintended pregnancies happen because women are not using contraception.

About a third of these pregnancies ended in abortion, according to the the study, which was published on Monday in The Medical Journal of Australia.

The LaTrobe University researchers said more work was needed to find out why these women were having unprotected sex.

But Family Planning NSW medical director Dr Deborah Bateson told The New Daily some factors were beyond a woman’s control.

“Effectiveness is not the only thing that affects the decision-making around contraception. There are many things that influence a woman’s choice, including cost,” Dr Bateson said.

“We don’t subsidise all our contraceptives so, for young women in particular, this cost can be a considerable barrier.”

In addition, rural women who want to use an IUD or implant might find it difficult to find a local doctor who is trained to insert the device.

Some women had different cultural perspectives on contraceptive use and others struggled to find something that suited their particular needs, Dr Bateson said.

“Contraception is not just about saying to women ‘here’s a pill, here’s a prescription’. It’s really about exploring what are a woman’s priorities, what are their concerns; it’s about listening.”

The LaTrobe study found that the pill was the most popular form of contraception (64 per cent), followed by condoms (27 per cent), long-acting reversible contraception (6 per cent) and diaphragms (1 per cent).

A small proportion of women (2 per cent) said they used the withdrawal method instead of a contraceptive product or device.

Women in their mid-to-late 20s were the most likely group to have an unintended pregnancy, followed closely by 30-34 year olds, according to the researchers.

The rate of unplanned pregnancies was slightly lower in teens (11 per cent) than in women in their late 30s (14.8 per cent).

Lead researcher Dr Angela Taft said planned parenthood was important, at any age, “because it allows women and their partners to better prepare themselves physically, emotionally and financially”.

But Dr Bateson said stigma associated with emergency contraception could also make it a difficult choice for some women.

“Sometimes, women are still asked somewhat intrusive questions about why they’re accessing emergency contraception,” she said. “They can feel judged, there can be a lack of privacy, and that can be a barrier.”

The ‘morning after’ pill is a type of emergency contraception that can reduce the risk of pregnancy if used within a few days of unprotected sex.

In Australia, there are two types of pills available – one requires a prescription, the other is available from pharmacies without a prescription.

“We know from studies from young people as well, they can have concerns around privacy and confidentiality,” Dr Bateson said.

In August, federal Health Minister Greg Hunt committed $2.5 million for a new research centre in women’s sexual and reproductive health.

‘It’s becoming quite urgent that we really focus on GPs and their management of sexual and reproductive health issues,” the centre’s chief investigator Professor Danielle Mazza told newsGP. 

The Centre of Research Excellence (SPHERE) will bring together Australian and international experts to explore three specific research areas: preconception, contraception and abortion.

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