title: The Complexity of Multiple Contraceptive Method Use and the Anxiety That Informs It: Implications for Theory and Practice.
abstract: Despite clinical guidelines and national data describing the use of one contraceptive method as the best and most common way to prevent unintended pregnancy, limited evidence indicates a more complex picture of actual contraceptive practice. Face-to-face in-depth interviews were conducted in November of 2013 with a sample of women from two cities in the United States (n = 52). The interviews explored the ways participants used contraception to protect themselves from unintended pregnancy over the past 12 months. Most respondents reported using multiple methods, many of which are considered to be less-effective, within this timeframe. The practice of combining methods in order to increase one's level of protection from pregnancy was prevalent, and was mainly enacted in two ways: by backing up inconsistent method use with other methods and by "buttressing" methods. These practices were found to be more common, and more complex, than previously described in the literature. These behaviors were mainly informed by a deep anxiety about both the efficacy of contraceptive methods, and about respondents' own perceived ability to prevent pregnancy. These findings challenge prevailing assumptions about women's contraceptive method use and have implications for clinical contraceptive counseling practice.
authors.affiliation: Research Division, Guttmacher Institute, 125 Maiden Lane, 7th Floor, New York, NY, 10038, USA. lfrohwirth@guttmacher.org.
authors.forename: Lori
authors.initials: L
authors.lastname: Frohwirth
authors.affiliation: Research Division, Guttmacher Institute, 125 Maiden Lane, 7th Floor, New York, NY, 10038, USA.
authors.forename: Nakeisha
authors.initials: N
authors.lastname: Blades
authors.affiliation: Research Division, Guttmacher Institute, 125 Maiden Lane, 7th Floor, New York, NY, 10038, USA.
authors.forename: Ann M
authors.initials: AM
authors.lastname: Moore
authors.affiliation: Department of Sociomedical Sciences/Anthropology, Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Wurtz
mesh_terms: D000328:Adult; D001007:Anxiety; D003267:Contraception / Q000523:psychology*; D003268:Contraception Behavior / Q000523:psychology*; D003376:Counseling; D005193:Family Planning Services; D005260:Female; D006801:Humans; D009042:Motivation; D011247:Pregnancy; D014481:United States
keywords: Contraception; Multiple method use; Qualitative; United States