jayne lucke pre-conception care and contraception for the generation
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Jayne Lucke
Pre-conception careand contraception
for the generation
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Contraception available in Australia
Bateson et al., Contraception: a practice-based update. Australian Doctor, 4 May 2012
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What do we know?
• Effective contraception reduces risk of unintended pregnancy
• Promote long-acting methods for greater effectiveness
• Minimise barriers to access and risk of adverse events
• Provide access to a wide range of methods for changing individual needs
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www.uqccr.edu.au/cupid
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Aims
To examine... • Patterns of contraception use among young
women in Australia• Use of contraception before an unintended
pregnancy• Differences between rural and urban areas
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Methods
• Three online surveys– baseline, +6 months, +12 months– mixed methods – survey questions and free-text
• Sample– 18-23 year old women across Australia
• Recruitment– through social media and other avenues
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Sample characteristicsComparison of CUPID sample characteristics with Census data from the Australian Bureau of Statistics (2011)
CensusN=847,042
%
CUPIDN=3,810
%Marital status Married 4.9 4.5
Never married 94.5 91.1Highest education School 61.0 53.0
Certificate/diploma 21.7 26.0University 9.4 18.7
Area of residence Major city 74.5 62.6Inner regional 16.0 21.5Outer regional 7.2 8.5Remote 1.1 1.9Very remote 0.9 1.0
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Sex, contraception and pregnancy
3810 recruited
3412ever had sex
2534never pregnant
720ever pregnant
93 intended
609unintended159
not usin
g contraceptio
n
440
using
contraceptio
n
85% of the women who
had been pregnant
72% of the women who had an unintended
pregnancy
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Contraception at last sex
Method (N=3810) %Pill only 25Pill and condom 11Condoms only 18Long-acting method 16Other 15
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... and before unintended pregnancy
Method (N=609) %Pill only 28Condoms only 11Withdrawal only 9Pill and condoms 7Condoms and withdrawal 4Pill and withdrawal 2Other methods 24No contraception 26
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“I want to know if the pill reduces your chances of falling pregnant in the future. I have heard from girls who have been on the pill for over 10 years and are now trying to get pregnant and find it very difficult. I believe this is because your body is so used to being on the pill, it must have something to do with it...
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... Fingers crossed I don’t fall pregnant soon. I know the pull out method is not the best form of contraception (obviously) but I’d rather stay away from any other drug related forms for in the future when I want children”
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“I don’t feel comfortable telling the doctor what I’m REALLY doing so I will create a similar (but more respectable) situation to get advice for, and then compare that with online advice. I’d rather if I could get advice from a pharmacist and didn’t need an (ongoing) script to get the pill”
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“I have had two experiences where I have gone to a male doctor to talk about contraception and they have nearly known nothing about the matter. I think male doctors should be aware of different contraceptive options in this day and age”
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What do you think?
• How can we best help young women understand their fertility?
• How should we approach pre-conception care when many pregnancies are unintended?
• How can we respond to the perception that hormonal contraception is “unnatural”?
• Does it matter if a young woman doesn’t tell her doctor what she’s REALLY doing?
• Are male doctors letting down the side when it comes to contraceptive counseling?