What constitutes a ‘positive’ contraceptive experience?

By CERT (Contraception Education Reform Team)

CERT (Contraception Education Reform Team) are a student-led policy research group based at the University of Edinburgh. We aim to improve contraceptive care and education for all contraceptive users through research and policy-based change.

Our research team, comprising of multidisciplinary university students from across the UK and Europe, was recently tasked with researching ‘what constitutes a positive contraceptive experience?’. The project was a collaboration with the student global health policy think tank, Polygeia.

This was an important research project because contraception affects a large proportion of the population. An estimated 87% of UK women and 74% of UK men have used some form of contraception in the past year. Hence, benefits from a positive contraceptive experience are wide-reaching.

Researchers argue that people’s experiences in accessing and using contraception are shaped by their gender. Within heterosexual relationships, the burden of responsibility for contraception often falls on women. This is partially due to a lack of male contraceptives outside of condoms. However, this is also partially because women face the more immediate consequences of not using contraception. Therefore, women are the ones tending to suffer most from problems associated with contraception. In consequence, they are also the ones that would benefit most from improvements.

Our research examined many different aspects of a contraceptive experience. These included:

  • People’s ability to make informed choices
  • The support available to them while making those choices
  • The control they hold over their body
  • Side effects of different methods – both mental and physical

Methods

To examine contraceptive experiences, we reviewed the academic literature already available on this topic. This was based on 31 key terms, included papers from 2010 to the present day and focused on people from Scotland and the UK.

We then analysed the stories of 80 different contraceptive users. These were publicly available online and found through media such as YouTube, online forums and blogs, with each author being contacted for consent to use their experiences. The stories differed in ages, ethnicity, location and class backgrounds. This helped to inform the team on how social factors could affect contraceptive experiences.

Results 

Literature Review:

A significant amount of literature focused on negative contraceptive experiences. Many of these papers suggested that by rectifying the specific problems, the contraceptive experiences would become positive. However, results demonstrated that this just tended to neutralise the bad experience rather than make it positive.

Our team also found that much of the literature focused on specific groups of contraceptive users or specific types of contraception. Research into long acting reversible contraceptives (LARC’s) and emergency contraception (EC) was extensive, but other forms of contraception were not as well researched. Furthermore, young, white, cisgender and heterosexual women were most commonly researched. Hence, male, older, queer, genderqueer and BAME contraceptive users are significantly less likely to be researched.

Through this analysis, we were able to establish two overlapping gaps in the literature that needed further research. Firstly, we realised that research looking into what constitutes a positive contraceptive experience was missing. Hence, we needed to ensure that our primary research would find positive experiences, rather than focus on negative experiences. Secondly, we decided that our research needed to deliberately include the experiences of contraceptive users that previous research had left out.

Narrative Analysis:

After looking into a wide range of stories of contraceptive experiences, our team found clear relationships between several key factors and positive contraceptive experiences. These common factors were:

  • Feeling in control of your body
  • Medical professionals that are trustworthy, easy to talk to and good listeners
  • Having open and supportive relationships with friends, family and sexual partners

Importantly, we found that these factors were often overlapping and found together. It became apparent that there is no ‘silver bullet’ solution for ensuring a positive contraceptive experience, and an attempt must be made to encompass as many of the themes as possible.

Further research: 

Our suggestions for further research include

  1. Bodily control and autonomy, and how exactly these affect positive contraceptive experiences. These terms remain poorly defined, making them hard to incorporate into contraceptive service policies.
  2. How our research can be applied practically in policy and healthcare settings.

Hence, we believe that our research has significance for both further academic research and practical improvements for improving contraceptive services in healthcare. Our team is excited about the prospect to use this research in order to push for change.

 

Read the full report: Contraception Education and Reform Team – 2019 Report and Policy Proposal

CERT Research Team:

Sophie Butcher, School of Social and Political Sciences, University of Edinburgh 

Federica Cucé, Department of Medicine, University of Padova

Molly Gilmour, Department of Sociology, University of Glasgow

Elise Kearsey, Deanery of Biomedical Sciences, University of Edinburgh

Ruwa Mahdi, Department of Social Science and Public Policy, King’s College London 

Kehinde Whyte-Ilori, School of Medicine, University of Leeds

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