Women's information-seeking behavior after receiving contraceptive versus noncontraceptive prescriptions

"Wish I Would Have Known that before I Started Using It": Contraceptive Messages and Information Seeking among Young Women

In recent decades, women's use of contraception has evolved. Women not only utilize contraceptives to prevent pregnancy, but also to manage menstruation and other factors related to their personal agency. Despite an abundance of available contraceptive options, many women struggle to navigate and address their contraceptive needs. A hundred and thirty-four female participants responded to an open-ended questionnaire about contraceptive messages and decision making in an online survey. Using Uncertainty Management Theory as a framework, we illustrate how the women make sense of and manage uncertainty from multiple contraceptive messages. Results highlighted the absence of desired information, and identified messages that women wish they had received from healthcare providers and others. Our findings suggest that women's understanding of contraceptives' side effects is a communicative process in which anecdotal evidence is often treated as medical fact and healthcare providers are viewed as ineffective and dismissive in relaying and addressing information about contraception. In the absence of satisfying healthcare interactions, women seek information elsewhere to make their contraceptive choices.

The Quality of Information on Combined Oral Contraceptives Available on the Internet

OBJECTIVE

Combined oral contraceptives (COC) are a popular choice among women. The Internet is an accessible and popular source of information on contraception. The objective of this study was to evaluate the quality of online information on COC.

METHODS

A quantitative content analysis was completed on websites containing patient health information on COCs. The search was completed in October 2016 using Google; search terms included "birth control pill," "oral contraception," "oral birth control", "birth control," and "pregnancy prevention." The first three pages of search results were screened according to inclusion criteria. The DISCERN instrument and JAMA Benchmarks were used to assess quality. Websites were analyzed independently by two coders; discrepancies were resolved by third coder (Canadian Task Force Classification III).

RESULTS

Of the 155 websites identified, 32 were eligible for review. Most websites mentioned contraceptive benefit (81.3%), and half reported the typical effectiveness of COCs (53.1%). Commonly included non-contraceptive benefits were alleviation of dysmenorrhea (87.5%) and reduced blood loss (84.4%). Risk of venous thromboembolism was listed in 81.3% of websites, including stroke (56.3%) and myocardial infarction (46.9%); however, sites failed to include details with these risks. Only 46.9% provided information on starting COC; the first-day start method was the most common (40.6%). Nearly half lacked details on managing missed pills (46.9%). The mean Flesch-Kincaid Grade Level was 9 ± 2.0. The mean DISCERN score was 46.3 ± 9.37, indicating "fair" quality.

CONCLUSION

Online information on COCs was variable in quality, often missing key information for making informed decisions. Health care providers should be aware of information gaps when advising women to seek information online.

A Qualitative Study of Young Women's Beliefs About Intrauterine Devices: Fear of Infertility

INTRODUCTION

Approximately 80% of college-aged women are at risk of unintended pregnancy. The American College of Obstetricians and Gynecologists recommends long-acting reversible contraceptive (LARC) methods, including intrauterine devices (IUDs), as first-line pregnancy prevention for adolescents and young women. Yet, less than 5% of 15- to 19-year-old women using a method of contraception use LARC. Limited research explores young women's concerns about IUDs.

METHODS

As part of a larger women's health research study, researchers conducted 53 in-depth interviews with women, aged 18 to 24 years enrolled in a midsized liberal arts college in the southeastern United States. Analytical techniques from the grounded theory approach were used to code line-by-line and identify themes emerging from these data.

RESULTS

Fear of causing harm or infertility through IUD use emerged as a significant barrier to uptake. Negative and often unfounded beliefs about IUDs led to silence and limited observability of IUDs in daily life and health care contexts. Identity as a fertile woman emerged as an antecedent factor to the compatibility of IUDs with participants' values and beliefs.

DISCUSSION

The link between fear of infertility and perceived identity was found to be a major factor in young women's contraceptive decision making. In order to increase uptake of IUDs, the beliefs of women must be addressed.