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Factors affecting contraceptive choice in women over 40: a qualitative study

Burgin, Jo; Bailey, Julia V; (2022) Factors affecting contraceptive choice in women over 40: a qualitative study. BMJ Open , 12 (11) , Article e064987. 10.1136/bmjopen-2022-064987. Green open access

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Abstract

Objective To explore the views of women over 40 years in choosing and using contraception, and to inform how contraceptive counselling for this age group could be improved. Design, setting and participants Fourteen women aged 40–52 years were recruited through social media platforms to take part in online, semistructured, in-depth interviews. Transcripts were analysed using a qualitative thematic approach. Results (1) Participants were anxious about unplanned pregnancy, and still highly motivated to avoid this. (2) Changes of contraceptive method over the lifecourse were occasionally precipitated by emergent health conditions, but healthcare providers often recommended a change in method on the basis of age alone. (3) Participants were experiencing perimenopausal symptoms but were largely unaware of how hormonal contraception could be used to treat these symptoms. (4) Prior negative experiences with contraceptive methods, coercive experiences with healthcare providers, and traumatic life events all contributed to a narrowing of contraceptive preference in later life. Conclusion Women over 40 years may be highly motivated to avoid pregnancy. This age group may have complex contraceptive histories with emerging perimenopausal symptoms. Women over 40 years may have accumulated adverse experiences which impact their contraceptive choices. These factors need to be explored by clinicians, to facilitate shared decision-making.

Type: Article
Title: Factors affecting contraceptive choice in women over 40: a qualitative study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bmjopen-2022-064987
Publisher version: https://doi.org/10.1136/bmjopen-2022-064987
Language: English
Additional information: This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third-party material in this article are included in the Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10160786
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