Elizabeth K Harrington1, Diana Gordon2, Isabel Osgood-Roach3, Jeffrey T Jensen4, Jennifer Aengst5. 1. Oregon Health & Science University, Department of Obstetrics & Gynecology, Mail code L466, 3181 SW Sam Jackson Park Rd, Portland, OR 97239. Electronic address: harringe@ohsu.edu. 2. Oregon National Primate Research Center, 1505 NW 185th Ave, Beaverton, OR 97006. 3. Oregon Health & Science University, Department of Obstetrics & Gynecology, Mail code L466, 3181 SW Sam Jackson Park Rd, Portland, OR 97239. 4. Oregon Health & Science University, Department of Obstetrics & Gynecology, Mail code L466, 3181 SW Sam Jackson Park Rd, Portland, OR 97239; Oregon National Primate Research Center, 1505 NW 185th Ave, Beaverton, OR 97006. 5. Oregon Health & Science University, Department of Obstetrics & Gynecology, Mail code L466, 3181 SW Sam Jackson Park Rd, Portland, OR 97239; Portland State University, Department of Anthropology, P.O. Box 751, Portland, OR 97207.
Abstract
OBJECTIVE: Novel approaches to nonsurgical permanent contraception (NSPC) for women that are low cost and require no incision or hysteroscope/surgical equipment could improve access to, and the acceptability of, permanent contraception (PC). To better understand opportunities and limitations for NSPC approaches, we examined women's and obstetrician-gynecologist (OB/GYN) providers' perceptions of NSPC in Portland, OR. STUDY DESIGN: Semistructured, qualitative interviews were conducted with 40 women recruited from outpatient clinics with purposive sampling, and a focus group was conducted with 9 OB/GYNs in academic and community practice. Transcripts were coded and inductively analyzed with a grounded theory approach. RESULTS: The majority of women identified as white (67%) or Latina (25%). They had a median age of 31.5 years, and median number of children was one. Perspectives on NSPC were closely aligned with women's general attitudes towards PC; over half were considering PC for themselves or partners in the future. Most respondents valued multiple aspects of a nonsurgical approach, with themes of minimizing recovery time, invasiveness and risk and avoiding hormonal contraception. Many assumed that NSPC would be less effective than surgery, however, and felt that a confirmation test would be necessary regardless of the failure rate. Providers welcomed efforts to expand contraceptive choice with NSPC, but would require long-term safety and efficacy data before recommending, and voiced concerns that NSPC's potential relative ease of administration could undermine the inherent seriousness of choosing PC. CONCLUSIONS: Women's and providers' perceptions of NSPC hinged on the ways in which they conceptualized risk and effectiveness. While perceptions were generally favorable, confirmation of safety and effectiveness would be required for a new approach to be accepted. IMPLICATIONS: This hypothesis-generating study elucidates women's and provider's perspectives on new methods of NSPC and contributes to understanding their perceptions of various types of risk. A technique to verify tubal occlusion would be needed for women and providers to accept NSPC.
OBJECTIVE: Novel approaches to nonsurgical permanent contraception (NSPC) for women that are low cost and require no incision or hysteroscope/surgical equipment could improve access to, and the acceptability of, permanent contraception (PC). To better understand opportunities and limitations for NSPC approaches, we examined women's and obstetrician-gynecologist (OB/GYN) providers' perceptions of NSPC in Portland, OR. STUDY DESIGN: Semistructured, qualitative interviews were conducted with 40 women recruited from outpatient clinics with purposive sampling, and a focus group was conducted with 9 OB/GYNs in academic and community practice. Transcripts were coded and inductively analyzed with a grounded theory approach. RESULTS: The majority of women identified as white (67%) or Latina (25%). They had a median age of 31.5 years, and median number of children was one. Perspectives on NSPC were closely aligned with women's general attitudes towards PC; over half were considering PC for themselves or partners in the future. Most respondents valued multiple aspects of a nonsurgical approach, with themes of minimizing recovery time, invasiveness and risk and avoiding hormonal contraception. Many assumed that NSPC would be less effective than surgery, however, and felt that a confirmation test would be necessary regardless of the failure rate. Providers welcomed efforts to expand contraceptive choice with NSPC, but would require long-term safety and efficacy data before recommending, and voiced concerns that NSPC's potential relative ease of administration could undermine the inherent seriousness of choosing PC. CONCLUSIONS:Women's and providers' perceptions of NSPC hinged on the ways in which they conceptualized risk and effectiveness. While perceptions were generally favorable, confirmation of safety and effectiveness would be required for a new approach to be accepted. IMPLICATIONS: This hypothesis-generating study elucidates women's and provider's perspectives on new methods of NSPC and contributes to understanding their perceptions of various types of risk. A technique to verify tubal occlusion would be needed for women and providers to accept NSPC.
Authors: Daniella De Batista Depes; Ana Maria Gomes Pereira; Umberto Gazi Lippi; João Alfredo Martins; Reginaldo Guedes Coelho Lopes Journal: Einstein (Sao Paulo) Date: 2016 Apr-Jun