Research
General gynecology
Knowledge of contraceptive effectiveness

Presented as a poster at Reproductive Health 2010, which was sponsored jointly by the Society of Family Planning, the Association of Reproductive Health Professionals, and the Planned Parenthood Federation of America, Atlanta, GA, Sept. 22-26, 2010.
https://doi.org/10.1016/j.ajog.2012.04.012Get rights and content

Objective

The purpose of this study was to determine women's knowledge of contraceptive effectiveness.

Study Design

We performed a cross-sectional analysis of a contraceptive knowledge questionnaire that had been completed by 4144 women who were enrolled in the Contraceptive CHOICE Project before they received comprehensive contraceptive counseling and chose their method. For each contraceptive method, women were asked “what percentage would get pregnant in a year: <1%, 1-5%, 6-10%, >10%, don't know.”

Results

Overall, 86% of subjects knew that the annual risk of pregnancy is >10% if no contraception is used. More than 45% of women overestimate the effectiveness of depo-medroxyprogesterone acetate, pills, the patch, the ring, and condoms. After adjustment for age, education, and contraceptive history, the data showed that women who chose the intrauterine device (adjusted relative risk, 6.9; 95% confidence interval, 5.6–8.5) or implant (adjusted relative risk, 5.9; 95% confidence interval, 4.7–7.3) were significantly more likely to identify the effectiveness of their method accurately compared with women who chose either the pill, patch, or ring.

Conclusion

This cohort demonstrated significant knowledge gaps regarding contraceptive effectiveness and over-estimated the effectiveness of pills, the patch, the ring, depo-medroxyprogesterone acetate, and condoms.

Section snippets

Materials and Methods

CHOICE is a prospective cohort study that was developed to promote the use of LARC methods in the St. Louis region. The methods for CHOICE have been previously published,11 but a brief description is provided later. The CHOICE protocol was approved by the Washington University in St. Louis School of Medicine Human Research Protection Office before the initiation of recruitment.

CHOICE is a convenience sample of women in St. Louis City and County who desire reversible contraception. The primary

Results

Of the 8413 women who were screened for eligibility, 5090 participants were eligible and enrolled in CHOICE between August 2007 and December 2009 (Figure 1). Of the women enrolled, 4144 (81%) completed the baseline contraceptive knowledge tool before contraceptive counseling. The time from screening to enrollment and completion of the knowledge tool was distributed relatively equally between same day, within 1-14 days, 15-30 days, and >30 days. Overall, 71% of participants chose LARC; 47% of

Comment

In our study of the knowledge of contraceptive effectiveness, most women overestimated the effectiveness of the oral contraceptive pill, the contraceptive patch, the ring, DMPA and condoms. Women who chose LARC methods were more likely to know the effectiveness of their chosen method than those who chose less effective methods, but they were not more knowledgeable about non-LARC method failure rates. This suggests that these women highly value contraceptive effectiveness. In fact, studies have

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    The Contraceptive Choice Project is funded by an anonymous foundation.

    The authors report no conflict of interest.

    Cite this article as: Eisenberg DL, Secura GM, Madden TE, et al. Knowledge of contraceptive effectiveness. Am J Obstet Gynecol 2012;206:479.e1-9.

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