A new study by Guttmacher Institute researchers outlines people’s preferences for how to obtain their contraceptive method. The findings, published in the Journal of Women’s Health, provide valuable considerations for contraceptive programs, particularly as use of telehealth increases due in part to the COVID-19 pandemic. Access to contraception is especially crucial given increasing restrictions on abortion access in the United States.
The researchers surveyed people of reproductive age in Arizona, New Jersey, and Wisconsin in 2019-2020. The population-representative survey included 967 respondents from Wisconsin. Eligible participants self-identified as female, transgender, or gender expansive, were aged 18 to 44, and reported using contraception in the last three months.
Both in Wisconsin and overall, most people expressed preferences for obtaining their contraceptive method through more than one source. (Participants could indicate as many preferences as they desired.)
CORE reviewed the study findings and identified the following key takeaways for Wisconsin.
- Of all options listed, Wisconsinites expressed the most interest in obtaining their contraceptive method at their doctor’s office while there for an in-person visit (63% of respondents expressed a preference for this option).
- Overall, 58% indicated a preference for receiving contraception through telehealth without a provider by using a phone app or ordering online, including 49% interested in ordering online for delivery at home.
- Many indicated a preference for receiving contraception at a pharmacy, including over the counter without a prescription (40%), directly from a pharmacy without a prescription (31%), and with a pharmacist-provided prescription (18%).
- Just under 20% noted a preference for receiving contraception by telemedicine (defined as speaking with a healthcare provider over the computer or phone).
- Respondents also expressed interest in innovative strategies such as delivery from nontraditional services like Uber (13% expressed a preference) and vending machines (11%).
The variety of preferences illustrates the importance of having diverse contraceptive access options.
Notably, these findings reflect what people want, but not necessarily what is available. For example, hormonal birth control is not currently available over the counter in the U.S. Last week, an FDA advisory committee voted unanimously to recommend that a daily birth control medication, Opill, be offered over the counter without a prescription in what would be a first. A final FDA decision is expected this summer.
And in Wisconsin, while legislators have proposed a bill to permit pharmacist-provided prescriptions for hormonal contraception, the practice is not currently legal in the state.
Across the states, the findings also show that people’s prior contraceptive care experience shapes their current preferences and needs. For example:
- Having past patient-centered care, defined as a provider meeting the patient’s needs for interpersonal connection, adequate information, and decision support during their healthcare interactions, influenced participants’ future decision making. Those who reported having received non-patient-centered contraceptive care in the past were more likely to prefer telehealth and innovative sources than those who had received patient-centered care.
- Those with some level of mistrust of the contraceptive healthcare system were more likely to prefer obtaining contraception off-site through telemedicine, telehealth, or innovative strategies than those who did not have mistrust.
- People who identified as lesbian, gay, bisexual, queer, or pansexual preferred to obtain contraception with less contact with healthcare providers.
These findings suggest that people with negative or discriminatory contraceptive care histories may be warier of in-person interactions with contraceptive care providers. Telehealth and other offsite options can help meet these patients’ needs as long as contraceptive care programs simultaneously work to reduce bias, discrimination, and lower-quality care.
“Policies that ensure access to a diversity of contraceptive sources, which acknowledge and address people’s past experiences of contraceptive care, have the greatest likelihood of closing the gap between people’s contraceptive access preferences and realities,” the study authors note.