Provider Bias in Long-Acting Reversible Contraception (LARC) Promotion and Removal: Perceptions of Young Adult Women

Jenny A. Higgins, Renee D. Kramer, Kristin M. Ryder

American Journal of Public Health · 2016 · 312 citations · 22 references

DOIFull text

Open access

Concepts

TL;DR

LARC is effective and acceptable, yet concerns about provider bias in its promotion remain unexamined among contraceptive users. The study gathered qualitative data in 2014 from 50 young adult women with contraceptive experience in Dane County, Wisconsin. Women reported trusting providers yet felt their contraceptive choices were sometimes overridden, and many believed providers disproportionately promoted LARC to socially marginalized women, underscoring the need for counseling protocols that respect patient preferences and address historical injustices.

Abstract

Long-acting reversible contraception (LARC) is effective and acceptable. However, concern exists about potential provider bias in LARC promotion. No study has documented contraceptive users' attitudes toward or experiences with provider influence and bias regarding LARC. We collected qualitative data in 2014 to address this gap. Participants were 50 young adult women with any history of contraceptive use (including LARC) in Dane County, Wisconsin. Women often described providers as a trusted source of contraceptive information. However, several women reported that their preferences regarding contraceptive selection or removal were not honored. Furthermore, many participants believed that providers recommend LARC disproportionately to socially marginalized women. We encourage contraceptive counseling and removal protocols that directly address historical reproductive injustices and that honor patients' wishes.

References

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