Contraceptive Counseling and Use among Women with Poorer Health

Background: To explore associations between health status, contraceptive counseling and contraceptive use.

Methods: Women aged 18-50 visiting one of 4 primary care clinics were invited to complete surveys after their visit. Perceived health status was measured using a 5-point scale. Among those considered at risk of unintended pregnancy, logistic regression was used to investigate associations between health status and contraceptive counseling and use.

Findings: Women reporting poorer health had decreased odds of receiving some contraceptive counseling at their visit (aOR=0.62, CI=0.39, 0.97) and using some contraception at last intercourse (aOR=0.63, CI=0.41, 0.97) compared to women reporting better health. However, among women with poorer health, receipt of counseling about hormonal contraception was associated with increased odds of using hormonal methods (aOR=8.22, CI=1.77, 38.19). Only 7% of women in poorer health received counseling on highly effective reversible contraception.

Conclusions: Women in poorer health may be at risk of adverse reproductive health outcomes and should receive counseling on safe hormonal and highly effective reversible contraceptives.