title: Contraception, punishment and women who use drugs.
abstract: BACKGROUND
  In light of the recent debate on the use of financial incentives to promote long-acting contraception and sterilisation among women who use illicit drugs we discuss attitudes to contraception, pregnancy and parenting among Australian women who inject drugs.
  
  
  METHODS
  Qualitative interviews were conducted with 90 women of reproductive age about contraceptive use, preferences, reproductive histories, attitudes to and experiences of parenting. All women were either currently, or had previously injected drugs. The in-depth, semi-structured interviews were compared and contrasted for themes relating to drug use, contraception, pregnancy and parenting.
  
  
  RESULTS
  Participants aspired to control their fertility, expressed individual contraceptive preferences and concerns for their children (both born and unborn). Most had tried a number of contraceptive methods interspersed by periods of non-use related to experiences of side-effects, being single or abstinent, believing that they were infertile and trying to conceive. Attitudes varied from woman to woman and in the same individual over their life course. Some believed that they were not likely to be capable, but most aspired to be successful mothers.
  
  
  CONCLUSIONS
  Women's drug use should not automatically be associated with an inability to make informed health care choices or to care for children. Evidence suggests that women who use drugs do not need to be paid to limit or end their fertility. Rather, programs that aim to reduce barriers to obtaining free, non-discriminating reproductive advice and parenting assistance would better utilise women's agency to improve their own reproductive health.
authors.affiliation: The Kirby Institute, The University of New South Wales, Sydney, Australia. aolsen@kirby.unsw.edu.au.
authors.forename: Anna
authors.initials: A
authors.lastname: Olsen
authors.forename: Cathy
authors.initials: C
authors.lastname: Banwell
authors.forename: Annie
authors.initials: A
authors.lastname: Madden
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D001315:Australia; D002755:Choice Behavior; D003267:Contraception; D003270:Contraceptive Agents; D005260:Female; D006801:Humans; D008875:Middle Aged; D016487:Parenting; D011247:Pregnancy; D011678:Punishment; D036301:Qualitative Research; D012098:Reproduction; D015819:Substance Abuse, Intravenous; D055815:Young Adult
chemical_list: D003270:Contraceptive Agents