Factors associated with lack of effective contraception among obese women in the United States

Lisa S. Callegari, Karin M. Nelson, David E. Arterburn, Sarah W. Prager, Melissa A. Schiff, Eleanor Schwarz

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objective: To identify factors associated with contraceptive nonuse and use of less effective methods among obese women in the US. Study Design: We analyzed data from sexually active obese women (body mass index >30 kg/m 2) age 20-44 using the 2006-2010 National Survey of Family Growth. We conducted multinomial logistic regression to assess associations between current contraceptive use and demographic, reproductive and health services factors. Specifically, we compared contraceptive nonusers, behavioral method users (withdrawal and fertility awareness) and barrier method users (condoms) to prescription method users (pill, patch, ring, injection, implant and intrauterine device). Results: Of 1345 obese respondents, 21.5% used no method, 10.3% behavioral methods, 20.8% barrier methods and 47.4% prescription methods. Only 42.4% of respondents overall and 20.4% of nonprescription method users reported discussing contraception with a provider in the past year. Similar to findings in the general population, behavioral method users were more likely to have previously discontinued a contraceptive method due to dissatisfaction [adjusted RR (aRR), 1.93; 95% confidence interval (CI), 1.09-3.44], and nonusers were more likely to perceive difficulty becoming pregnant (aRR, 3.86; 95% CI, 2.04-7.29), compared to prescription method users. Respondents using nonprescription methods were significantly less likely to have discussed contraception with a healthcare provider (nonusers: aRR, 0.16; 95% CI, 0.10-0.27; behavioral methods: aRR, 0.13; 95% CI, 0.06-0.25, barrier methods: aRR, 0.15; 95% CI, 0.09-0.25) than prescription method users. Conclusions: Obese women who discuss contraception with a provider are more likely to use effective contraception and may be less likely to experience unintended pregnancy; however, over half report no recent discussion of contraception with a provider. Implications: Efforts are needed to increase contraceptive counseling for obese women, who face increased risks of morbidity from unintended pregnancy.

Original languageEnglish (US)
Pages (from-to)265-271
Number of pages7
JournalContraception
Volume90
Issue number3
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Fingerprint

Contraception
Contraceptive Agents
Prescriptions
Confidence Intervals
Reproductive Health Services
Pregnancy
Intrauterine Devices
Condoms
Health Personnel
Fertility
Counseling
Body Mass Index
Logistic Models

Keywords

  • Contraception
  • Contraceptive counseling
  • Obesity
  • Unintended pregnancy

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology
  • Medicine(all)

Cite this

Factors associated with lack of effective contraception among obese women in the United States. / Callegari, Lisa S.; Nelson, Karin M.; Arterburn, David E.; Prager, Sarah W.; Schiff, Melissa A.; Schwarz, Eleanor.

In: Contraception, Vol. 90, No. 3, 01.01.2014, p. 265-271.

Research output: Contribution to journalArticle

Callegari, Lisa S. ; Nelson, Karin M. ; Arterburn, David E. ; Prager, Sarah W. ; Schiff, Melissa A. ; Schwarz, Eleanor. / Factors associated with lack of effective contraception among obese women in the United States. In: Contraception. 2014 ; Vol. 90, No. 3. pp. 265-271.
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abstract = "Objective: To identify factors associated with contraceptive nonuse and use of less effective methods among obese women in the US. Study Design: We analyzed data from sexually active obese women (body mass index >30 kg/m 2) age 20-44 using the 2006-2010 National Survey of Family Growth. We conducted multinomial logistic regression to assess associations between current contraceptive use and demographic, reproductive and health services factors. Specifically, we compared contraceptive nonusers, behavioral method users (withdrawal and fertility awareness) and barrier method users (condoms) to prescription method users (pill, patch, ring, injection, implant and intrauterine device). Results: Of 1345 obese respondents, 21.5{\%} used no method, 10.3{\%} behavioral methods, 20.8{\%} barrier methods and 47.4{\%} prescription methods. Only 42.4{\%} of respondents overall and 20.4{\%} of nonprescription method users reported discussing contraception with a provider in the past year. Similar to findings in the general population, behavioral method users were more likely to have previously discontinued a contraceptive method due to dissatisfaction [adjusted RR (aRR), 1.93; 95{\%} confidence interval (CI), 1.09-3.44], and nonusers were more likely to perceive difficulty becoming pregnant (aRR, 3.86; 95{\%} CI, 2.04-7.29), compared to prescription method users. Respondents using nonprescription methods were significantly less likely to have discussed contraception with a healthcare provider (nonusers: aRR, 0.16; 95{\%} CI, 0.10-0.27; behavioral methods: aRR, 0.13; 95{\%} CI, 0.06-0.25, barrier methods: aRR, 0.15; 95{\%} CI, 0.09-0.25) than prescription method users. Conclusions: Obese women who discuss contraception with a provider are more likely to use effective contraception and may be less likely to experience unintended pregnancy; however, over half report no recent discussion of contraception with a provider. Implications: Efforts are needed to increase contraceptive counseling for obese women, who face increased risks of morbidity from unintended pregnancy.",
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N2 - Objective: To identify factors associated with contraceptive nonuse and use of less effective methods among obese women in the US. Study Design: We analyzed data from sexually active obese women (body mass index >30 kg/m 2) age 20-44 using the 2006-2010 National Survey of Family Growth. We conducted multinomial logistic regression to assess associations between current contraceptive use and demographic, reproductive and health services factors. Specifically, we compared contraceptive nonusers, behavioral method users (withdrawal and fertility awareness) and barrier method users (condoms) to prescription method users (pill, patch, ring, injection, implant and intrauterine device). Results: Of 1345 obese respondents, 21.5% used no method, 10.3% behavioral methods, 20.8% barrier methods and 47.4% prescription methods. Only 42.4% of respondents overall and 20.4% of nonprescription method users reported discussing contraception with a provider in the past year. Similar to findings in the general population, behavioral method users were more likely to have previously discontinued a contraceptive method due to dissatisfaction [adjusted RR (aRR), 1.93; 95% confidence interval (CI), 1.09-3.44], and nonusers were more likely to perceive difficulty becoming pregnant (aRR, 3.86; 95% CI, 2.04-7.29), compared to prescription method users. Respondents using nonprescription methods were significantly less likely to have discussed contraception with a healthcare provider (nonusers: aRR, 0.16; 95% CI, 0.10-0.27; behavioral methods: aRR, 0.13; 95% CI, 0.06-0.25, barrier methods: aRR, 0.15; 95% CI, 0.09-0.25) than prescription method users. Conclusions: Obese women who discuss contraception with a provider are more likely to use effective contraception and may be less likely to experience unintended pregnancy; however, over half report no recent discussion of contraception with a provider. Implications: Efforts are needed to increase contraceptive counseling for obese women, who face increased risks of morbidity from unintended pregnancy.

AB - Objective: To identify factors associated with contraceptive nonuse and use of less effective methods among obese women in the US. Study Design: We analyzed data from sexually active obese women (body mass index >30 kg/m 2) age 20-44 using the 2006-2010 National Survey of Family Growth. We conducted multinomial logistic regression to assess associations between current contraceptive use and demographic, reproductive and health services factors. Specifically, we compared contraceptive nonusers, behavioral method users (withdrawal and fertility awareness) and barrier method users (condoms) to prescription method users (pill, patch, ring, injection, implant and intrauterine device). Results: Of 1345 obese respondents, 21.5% used no method, 10.3% behavioral methods, 20.8% barrier methods and 47.4% prescription methods. Only 42.4% of respondents overall and 20.4% of nonprescription method users reported discussing contraception with a provider in the past year. Similar to findings in the general population, behavioral method users were more likely to have previously discontinued a contraceptive method due to dissatisfaction [adjusted RR (aRR), 1.93; 95% confidence interval (CI), 1.09-3.44], and nonusers were more likely to perceive difficulty becoming pregnant (aRR, 3.86; 95% CI, 2.04-7.29), compared to prescription method users. Respondents using nonprescription methods were significantly less likely to have discussed contraception with a healthcare provider (nonusers: aRR, 0.16; 95% CI, 0.10-0.27; behavioral methods: aRR, 0.13; 95% CI, 0.06-0.25, barrier methods: aRR, 0.15; 95% CI, 0.09-0.25) than prescription method users. Conclusions: Obese women who discuss contraception with a provider are more likely to use effective contraception and may be less likely to experience unintended pregnancy; however, over half report no recent discussion of contraception with a provider. Implications: Efforts are needed to increase contraceptive counseling for obese women, who face increased risks of morbidity from unintended pregnancy.

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