What influences contraceptive behaviour in women who experience unintended pregnancy? A systematic review of qualitative research.

One in five pregnancies in the UK ends in abortion. The great majority of those pregnancies are unintended, resulting from incorrect, inconsistent or non-use of contraception, rather than contraception failure. We undertook a synthesis of qualitative research with women who have unintended pregnancies as a new approach to understanding contraceptive behaviour. A literature search was carried out using four databases. Identified studies were screened against pre-set inclusion criteria. Included studies were quality assessed. Analysis followed a meta-ethnographic approach. A total of 236 studies were identified, of which nine were included. Six categories involved in contraceptive behaviour were identified - access, method factors, knowledge, societal influence, personal beliefs and motivations and relationship factors. A model of contraceptive behaviour was developed. Contraceptive behaviour is a complex, multifactorial process. Interventions targeting one aspect are unlikely to make a difference; however identifying and affecting the important factors within a population may improve contraception adherence.