A new survey found that nearly a quarter of Appalachians with the capacity for pregnancy reported not using their preferred contraceptive method, and more than one-third reported ever experiencing coercion in their contraceptive care.
UW Collaborative for Reproductive Equity (CORE) researchers Laura Swan and Leigh Senderowicz investigated the frequency and impact of contraceptive coercion in the Appalachian region of the United States. The team’s findings were published in April in the journal Health Services Research.
The authors studied both pressure to use contraception (what Senderowicz has termed “upward coercion”) and pressure not to use contraception (“downward coercion”) to explore the relationships between contraceptive coercion and preferred contraceptive use.
The findings highlight the likely impact of contraceptive coercion on patients’ reproductive autonomy – the ability to make decisions about reproductive health and access needed services without interference or coercion.
Very little research has examined these issues – particularly in the Appalachian region of the United States, where residents face many health disparities.
Among the surveyed reproductive-age Appalachians, the study’s key findings include:
- Approximately one in four (23%) reported they were not using their preferred contraceptive method.
- 30% reported having ever experienced pressure from a provider to use contraception (upward coercion).
- 16% reported having ever experienced pressure from a provider not to use contraception (downward coercion).
Appalachians who had at least one lifetime experience of contraceptive coercion from a healthcare provider were comparatively less likely to be currently using their preferred contraceptive method.
The findings highlight the likely impact of contraceptive coercion on patients’ reproductive autonomy – the ability to make decisions about reproductive health and access needed services without interference or coercion.
The results also indicate a need for initiatives to help better meet patient contraceptive preferences. Promoting contraceptive access in Appalachia and beyond requires comprehensive and unbiased contraceptive care, the authors note.