”It would have control over me instead of me having control”: Young Black and Latina women's perspectives on IUDs

Introduction: Women’s contraceptive preferences are a key determinant of their method choice, though family planning programs have increasingly prioritized method effectiveness in their IUD promotion efforts. This study investigates the ways that young Black and Latina women’s contraceptive preferences are revealed in their attitudes about IUDs.

Methods: In-depth individual interviews focused on contraceptive decision-making were conducted with 38 Black and Latina women (ages 18-24) in the San Francisco Bay Area in 2013.

Results: Few women (n=5) were currently using IUDs. Many women – particularly those who were the most socially disadvantaged and lacked control in their daily lives – preferred a method they could discontinue without a provider. Some desired freedom to easily stop and start a method, especially when they weren’t in a serious relationship and felt they did not need a long-term method. For others, IUDs were not viewed as compatible with their childbearing timeline. Even though most participants did not plan on becoming pregnant for 5-7 years, some desired flexibility in this timing and thus a method more flexible than they perceived IUDs to be. Among more advantaged women, concerns about IUD removal were less prevalent, with some viewing a highly effective, long-term method of contraception as a means to achieving their educational, career and relationship goals.

Conclusions: Social context and (dis)advantage are important influences on young women’s contraceptive decisionmaking processes. Engaged and interactive contraceptive counseling, centered on women’s preferences and circumstances rather than method characteristics, can support women in finding the method that best meets their needs.