Objective
To examine reasons for contraception and LARC non-use.
Study design
Using baseline data from population-based, household surveys conducted in 2019–2020, we examined reasons for contraception non-use among a four-state random sample (Arizona, Iowa, New Jersey, Wisconsin; N = 2039) and reasons Iowans had never used LARC (N = 1604).
Results
Contraceptive non-users cited personal reasons more commonly (90.2%) than access barriers (2.9%). A larger proportion of LARC non-users cited access barriers (50.8%); however, personal reasons remained more common (88.3%).
Conclusions
Since personal reasons are a major driver of contraceptive behavior, care that respects diverse choices and supports informed, preference-aligned counseling is crucial.
Implications
Improving contraceptive care requires more than expanding access; approaches should respect patients' decisions not to use contraception, while working to address concerns about side effects and insertion and removal procedures.