Early View

Associations Between Perceived Susceptibility to Pregnancy and Contraceptive Use in a National Sample of Women Veterans

CONTEXT

Women may be at risk for unintended pregnancy if they forgo contraception or use ineffective methods because they erroneously believe they are unlikely to conceive. However, the relationship between perceived susceptibility to pregnancy and contraceptive use is not fully understood.

METHODS

Data collected in 2014–2016 for the Examining Contraceptive Use and Unmet Needs study were used to examine perceived susceptibility to pregnancy among 969 women veterans aged 20–45 who were at risk for unintended pregnancy and received primary care through the U.S. Veterans Affairs Healthcare System. Multivariable logistic regression was used to identify associations between perceived susceptibility to pregnancy (perceived likelihood during one year of unprotected intercourse) and use of any contraceptive at last sex. Multinomial regression models were used to examine method effectiveness among women who used a contraceptive at last sex.

RESULTS

Forty percent of women perceived their susceptibility to pregnancy to be low. Compared with women with high perceived susceptibility to pregnancy, those with low perceived susceptibility were less likely to have used any contraceptive at last sex (86% vs. 96%; adjusted odds ratio, 0.2). Among contraceptive users, women with low perceived susceptibility were less likely than those with high perceived susceptibility to have used a highly effective method (26% vs. 34%; adjusted relative risk ratio, 0.6) or moderately effective method (34% vs. 39%; 0.6) at last sex.

CONCLUSIONS

Identifying and addressing fertility misperceptions among women with low perceived susceptibility to pregnancy could help promote informed decision making about contraception and reduce the risk of unintended pregnancy.

Authors' Affiliations

Laura E. Britton is a postdoctoral fellow, Columbia University School of Nursing, New York. Colleen P. Judge-Golden and Tierney E. Wolgemuth are medical students, University of Pittsburgh School of Medicine, Pittsburgh. Xinhua Zhao is core investigator and statistician, Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System. Maria K. Mor is director, Biostatistics and Informatics Core, Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, and adjunct research assistant professor, Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh. Lisa S. Callegari is core investigator, Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound, Seattle, and associate professor, Departments of Obstetrics & Gynecology and Health Services, University of Washington. Sonya Borrero is associate director, Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, and professor, Department of Medicine, University of Pittsburgh.

Disclaimer
The views expressed in this publication do not necessarily reflect those of the Guttmacher Institute.

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