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Do policies on access to contraceptives within the U.S. reflect individual preferences and right to self-determination?

In a recent study published in The Lancet Regional Health – Americas, researchers surveyed a nationally representative population of non-sterile individuals in the US (U.S.) between the ages of 15 and 44 years who had been assigned as female at birth to grasp the popular contraceptive method, differences in these preferences based on sociodemographic aspects, and the explanations for not using contraceptives.



Study: Estimates of use of preferred contraceptive method in the US: a population-based study. Image Credit: Bigc Studio/Shutterstock.com

Background

Sexual and reproductive health equity ensures that each one individuals can manage their fertility in a dignified, desired, and acceptable manner, have access to the resources that allow them to be sexually and reproductively healthy, and have self-determination when deciding if, how, and when to get pregnant.

Moreover, the recent overturning of the landmark legal right to abortion within the U.S. has made equity in reproductive and sexual health much more necessary.

Contraceptive access is commonly impeded resulting from misinformation and misconceptions about contraception, in addition to deliberate attempts to limit access to some contraceptives by claiming that they act as abortifacients.

Although using contraceptives relies on individual preferences, programs and policies about contraceptives have promoted using specific methods, mostly those with high effectiveness rates and long-lasting effects reminiscent of intra-uterine devices and long-acting reversible contraceptives, consequently undermining the person’s right to self-determination.

In regards to the study

In the current study, the researchers aimed to advertise a person-centered approach to improving access to contraceptives by understanding using contraceptives of alternative across a representative population of prospective and current contraceptive users across the U.S. and determining how various features of a healthcare access system that’s person-centered can influence using contraceptives of alternative.

The present methods of tracking access to contraceptives within the U.S. depend largely on the info available from clinical reports on the proportion of fertile and at-risk women who’ve been supplied with either essentially the most or moderately effective contraceptives.

Information on the person’s alternative or request for a contraceptive will not be included in these reports. Moreover, these reports also wouldn’t have data from individuals who use contraceptives for reasons, not including the prevention of pregnancies or from individuals preferring vasectomies as a way of stopping pregnancies.

Due to this fact, current metrics assessing contraceptive access neglect person-centeredness by not considering self-determination when providing access to contraceptive methods.

Moreover, features reminiscent of efficiency are also missed since contraceptive access is provided based on assumptions about who needs them and what sort of contraceptives they need, which could end in wasted resources.

The nationally representative survey conducted on this study included biologically female, non-sterile individuals between the ages of 15 and 44 years and was administered in Spanish and English.

Using the popular approach to contraception was the first interest measure. Moreover, the explanations for not using contraceptives, in addition to differences in contraceptive use based on various sociodemographic characteristics, were also analyzed.

The association between preferred use of contraception and 4 key features of person-centered healthcare access — two pertaining to self-efficacy and two based on past contraceptive care quality — were also statistically analyzed.

Results

The outcomes showed that near one-fourth of prospective or current contraceptive users, which correlates to roughly 8.1 million individuals within the U.S., reported a preference for a way of contraception different from the one they were currently using or had access to.

Vasectomy and oral contraceptives were essentially the most preferred methods. Moreover, the explanations provided by those that didn’t use the popular approach to contraception included unwanted effects, reasons related to sex, lack of expertise or logistics, concerns about safety, and price.

The regression evaluation also indicated that key features of person-centered access to healthcare played a significant role in using preferred methods of contraception.

Patients who believed that they’d adequate information to make a decision which contraceptive method to make use of and will obtain the popular approach to contraception with relative ease were more prone to use the contraception method they preferred.

Two aspects that decreased the chances of using a preferred approach to contraception were low-quality care in the shape of inadequate person-centered counseling on contraceptive use and various sorts of discrimination in features of family planning.

Conclusions

Overall, the findings suggested that over 25% of the non-sterile population of the U.S. don’t use their contraceptive methods of alternative, and a good portion of the non-usage is resulting from concerns about safety, unwanted effects, lack of expertise or logistical access, and reasons related to sex.

An individual-centered approach to enhance access to information and counseling about contraceptives and address features of discrimination related to family planning and preferences for specific methods of contraception are essential to enhance access to preferred methods of contraception.

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