Female Adolescents’ Experiences with Contraceptive Method Decision-Making, Access, and Continuation: Qualitative Research

Year 2024, , 399 - 405, 28.06.2024

Ayşegül Dönmez , Zekiye Karaçam

https://doi.org/10.33808/clinexphealthsci.1323218

Abstract

Objective: Because of early sexual activity that starts in adolescence, critical problems such as unwanted pregnancies arise. The aim of this study was to examine the experiences of female adolescents in decision making, accessing, and maintaining contraception.
Methods: The study was conducted as a case study with a phenomenological design and a qualitative approach. The study included adolescents who had contraception experience and were present in the gynecology clinic(s) of the hospital to receive any care service. Participants (n=22) was selected through purposive sampling. Semi-structured in-depth interviews were conducted, transcribed, and analyzed using the approach, content, and descriptive analysis.
Results: Through the analysis of in-depth interview data with female adolescents examining their experiences related to contraceptive method use, four themes were identified: "reasons for using and deciding on pregnancy prevention methods, accessibility to pregnancy prevention methods, experiences during the use of pregnancy prevention methods, and continuity of pregnancy prevention method use."
Conclusion: In this study, it was determined that female adolescents faced some difficulties in deciding on, accessing, and maintaining contraceptive methods. In this context, units such as youth centers where adolescents can apply can be established. Unwanted pregnancies can be prevented by regulations regarding the provision of counseling and contraceptive services to adolescents.

Keywords

Adolescents, contraception, reproductive health, safe sex

Project Number

YOK

References

• United Nations Population Fund. A Multi-Sector Approach to Health Risks and Consequences of Child, Early, and Forced Marriage. Published [2020]. Accessed [11 January 2021]. https://turkey.unfpa.org/en/publications/multi-sector-approach-health-risks-and-consequences-child-early-and-forced-marriage.
• World Health Organization. Adolescent and Young Adult Health. Published [2021]. Accessed [11 January 2021]. https://www.who.int/en/news-room/fact-sheets/detail/adolescents-health-risks-and-solutions.
• Raine TR, Foster-Rosales A, Upadhyay UD, Boye CB, Brown BA, Sokoloff A, Harper CC. One-year contraceptive continuation and pregnancy in adolescent girls and women initiating hormonal contraceptives. Obstet Gynecol. 2011;117(2Pt1):363–371. DOI:10.1097/AOG.0b013e31820563d3.
• Walker AW, Stern L, Cipres D, Rodriguez A, Alvarez J, and Seidman D. Do adolescent women's contraceptive preferences predict method use and satisfaction? A survey of Northern California family planning clients. The Journal of Adolescent Health 2019;64(5):640–647. DOI: 10.1016/j.jadohealth.2018.10.291.
• Türkiye İstatistik Kurumu. Doğum İstatistikleri, 2019. Published [2020]. No:33706. Accessed [06 December 2020]. https://data.tuik.gov.tr/Bulten/Index?p=Dogum-Istatistikleri-2019-33706 (Turkish)
• Madden T, Secura GM, Nease RF, Politi MC, Peipert JF. The role of contraceptive attributes in women's contraceptive decision making. American Journal of Obstetrics and Gynecology 2015;213(1):46.e1–46.e6. DOI: 10.1016/j.ajog.2015.01.051.
• Goodman M, Onwumere O, Milam L, Peipert JF. Reducing health disparities by removing cost, access, and knowledge barriers. American Journal of Obstetrics and Gynecology 2017;216(4):382.e1–382.e5. DOI:10.1016/j.ajog.2016.12.015.
• Coleman-Minahan K, Dillaway CH, Canfield C, Kuhn DM, Strandberg KS, Potter JE. Low-income Texas women's experiences accessing their desired contraceptive method at the first postpartum visit. Perspectives on Sexual and Reproductive Health 2018;50(4):189–198. DOI:10.1363/psrh.12083.
• Khalifa M, Abdelaziz W, Metwally S, Sakr E. The recent increase in contraceptive discontinuation in Egypt. Journal of Biosocial Science 2020;52(1):154-157. DOI:10.1017/S0021932019000269.12.
• Marshall C, Kandahari N, Raine-Bennett T. Exploring young women's decisional needs for contraceptive method choice: a qualitative study. Contraception 2018;97(3):243–248. DOI:10.1016/j.contraception.2017.10.004.
• Jonas K, Duby Z, Maruping K, Dietrich J, Slingers N, Harrie J, Kuo C, Mathews C. Perceptions of contraception services among recipients of a combination HIV-prevention interventions for adolescent girls and young women in South Africa: A qualitative study. Reproductive Health 2020;17(1):122. DOI:/10.1186/s12978-020-00970-3.
• Gonsalves L, Wyss K, Gichangi P, Say L, Martin Hilber A. Regulating pharmacists as contraception providers: A qualitative study from Coastal Kenya on injectable contraception provision to youth. PloS One 2019;14(12):e0226133. DOI:10.1371/journal.pone.0226133.
• Raidoo S, Tschann M, Elia J, Kaneshiro B, and Soon R. Dual-method contraception among adolescents and young people: Are long-acting reversible contraception users different? A qualitative study. Pediatr Adolesc Gynecol. 2020;33(1):45–52. DOI:10.1016/j.jpag.2019.09.008.
• Cohen N, Mendy FT, Wesson J, Protti A, Cissé C, Gueye EB, Trupe L, Floreak R, Guichon D, Lorenzana K, Buttenheim A. Behavioral barriers to the use of modern methods of contraception among unmarried youth and adolescents in eastern Senegal: A qualitative study. BMC Public Health 2020;20(1):1025. DOI:10.1186/s12889-020-09131-4.
• Kirkpatrick L, Collins A, Sogawa Y, Birru Talabi M, Harrison E, Kazmerski TM. Sexual and reproductive healthcare for adolescent and young adult women with epilepsy: A qualitative study of pediatric neurologists and epileptologists. Epilepsy and Behavior 2020;104(Pt A):106911. DOI:10.1016/j.yebeh.2020.106911.
• Çubukcu M. Samsun ili 15-49 yaş grubu kadınların aile planlaması yöntemlerinin kullanım dağılımı. Ankara Med J. 2018;18;(2):207-14. DOI:10.17098/amj.435262 (Turkish)
• Karaçalı M, Özdemir R. Karabük ilinde 15-49 yaş grubu evli kadınların aile planlaması hizmetlerine erişimini etkileyen faktörler. TJPH. 2018;16(2):131-145. DOI:10.20518/tjph.458353 (Turkish)
• Yıldırım A, Şimşek H. Sosyal bilimlerde nitel araştırma yöntemleri. Genişletilmiş 10. baskı. Ankara: Seçkin Yayıncılık; 2016;322-335 (Turkish).
• World Health Organization. Recommendations On Maternal Health Guidelines Approved by The Who Guidelines Review Committee. Geneva. Published [2017]. Accessed [20 February 2021]. https://www.who.int/publications/i/item/WHO-MCA-17.10.
• United Nations Educational, Scientific and Cultural Organization (UNESCO), Emerging evidence, lessons and practice in comprehensive sexuality education a global Review. A Global Review 2015. Published [31 Dec 2015]. Accessed [21 February 2021]. https://www.unfpa.org/publications/emerging-evidence-lessons-and-practice-comprehensive-sexuality-education-global-review
• Harris ML, Coombe J, Forder PM, Lucke JC, Bateson D, Loxton D. Young women's complex patterns of contraceptive use: findings from an Australian cohort study. Perspect Sex Reprod Health 2020;52(3):181–190, DOI:10.1363/psrh.12158
• Gejo NG, Anshebo AA, Dinsa LH. Postpartum modern contraceptive use and associated factors in Hossana town. PLoS ONE 2019;14(5):e0217167. DOI:10.1371/journal. pone.0217167.
• Çalışkan T, Çevik C, Ergün S. Üniversite öğrencilerinin cinsel yolla bulaşan hastalıklar konusundaki bilgi düzeylerinin değerlendirilmesi. Balıkesir Sağlık Bilimleri Dergisi 2015;4(1):27-31. DOI:10.5505/bsbd.2015.67699 (Turkish)
• Demir G, Şahin TK. Selçuk Üniversitesi öğrencilerinin cinsel yolla bulaşan hastalıklar konusundaki bilgi düzeylerinin belirlenmesi. DÜ Sağlık Bil Enst Derg. 2014;4(3):19-24. (Turkish)
• Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü. 2018 Türkiye Nüfus ve Sağlık Araştırması. Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü, TC Cumhurbaşkanlığı Strateji ve Bütçe Başkanlığı ve TÜBİTAK, Ankara, Türkiye. Published [2019]. Accessed [01 February 2020). https://fs.hacettepe.edu.tr/hips/dosyalar/Ara%C5%9Ft%C4%B1rmalar%20-%20raporlar/2018%20TNSA/TNSA2018_ana_Rapor_compressed.pdf (Turkish)
• Blanc AK, Tsui AO, Croft TN, Trevitt JL. Patterns and trends in adolescents' contraceptive use and discontinuation in developing countries and comparisons with adult women. Int Perspect Sex Reprod Health 2009;35(2):63–71. DOI:10.1363/ipsrh.35.063.09
• Hall KS, Manu A, Morhe E, Harris LH, Loll D, Ela E, Kolenic G, Dozier JL, Challa S, Zochowski MK, Boakye A, Adanu R, Dalton VK. Development and validation of a scale to measure adolescent sexual and reproductive health stigma: Results from young women in Ghana. J Sex Res. 2018;55(1):60-72. DOI:10.1080/00224499.2017.1292493.
• Tuhebwe D, Babirye S, Ssendagire S, and Ssengooba F. The extent to which the design of available reproductive health interventions fit the reproductive health needs of adolescents living in urban poor settings of Kisenyi, Kampala, Uganda. BMC Public Health 2021;21, 933. DOI:10.1186/s12889-021-10933-3.
• Yılmaz FA, Akarsu RH, Tosun Güleroğlu F, Kadınların doğum sonu dönemde aile planlaması tercihlerinin belirlenmesi. Bozok Tıp Dergisi 2018;8(2):21-25. DOI:10.16919/bozoktip.345166 (Turkish)
• Chakraborty NM, Chang K, Bellowsr B, Grépin KA, Hameed W, Kalamar A, Gul X, Atuyambe L, Montagu D. Association between the quality of contraceptive counseling and method continuation: findings from a prospective cohort study in social franchise clinics in Pakistan and Uganda. Glob Health Sci Pract. 2019;7(1):87–102. DOI:10.9745/GHSP-D-18-00407.