"Nobody's Ever Told Me That": Women's Experiences with Shared Decision Making When Accessing Contraception

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Meier, Stephanie
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Half of all pregnancies in the United States are unintended, and the rates are similarly high in South Carolina. Contraceptive methods are an effective way to reduce the burden of unintended pregnancy. The shared decision-making model serves as best practice when choosing among health care options during clinical consultation, and may be appropriate when considering contraceptive options. Limited research has examined shared decision-making in women’s health. This study examined women’s experiences and the impact of shared decision-making on contraceptive use dynamics. As part of a larger study about women’s reproductive health experiences, researchers conducted 70 in-depth interviews with women ages 18 years and older (range=18–78) living in South Carolina. A constant comparative method of data analysis was completed using HyperRESEARCH 3.7.3 to explore women’s contraceptive decision-making. Shared decision-making provided a conceptual framework for data analysis. Gaps in contraceptive knowledge, especially method effectiveness, impacted participants’ experiences accessing contraception. Although participants believed they had adequate information, findings suggest they may not be fully informed about existing contraceptive options, including their current method. Participants expressed a desire for options; however, results indicated women may not play an active role in choosing their contraceptive method. Participants described nuanced beliefs about contraception, demonstrating preferences for patient-provider communication that discussed contraception within the broader context of reproductive health and individual lifestyle needs. Findings from this study offer theoretical and practical recommendations to guide shared decision-making during contraceptive consultations in order to empower women in making informed and lifestyle-appropriate contraceptive choices.