Semester Award Granted

Spring 2025

Submission Date

May 2025

Document Type

Thesis

Degree Name

Doctor of Philosophy (PhD)

College

Christine E. Lynn College of Nursing

Thesis/Dissertation Advisor [Chair]

Candy Wilson

Abstract

Background: Contraceptive discontinuation is a significant public health concern in the United States, contributing to unintended pregnancies and associated health, social, and economic consequences. Despite the availability of a wide range of contraceptive methods, many women discontinue use prematurely due to a variety of personal, social, cultural, and systemic factors. However, limited research has comprehensively examined these factors at the national level, particularly within a theoretical framework that captures the multidimensional influences on contraceptive decision-making. Objective: This study aimed to assess the factors associated with contraceptive method discontinuation among women in the U.S, guided by Ray’s Theory f Bureaucratic Caring. Methods: A cross-sectional secondary analysis was conducted using data from the 2017-2019 National Survey of Family Growth (NSFG), a nationally representative dataset. The study included adult women aged 18-49 years who had used a contraceptive method within the 12 months prior to the survey. Key variables included age, race/ethnicity, education, income, employment status, partner’s fertility desires, religious affiliation, health insurance status, healthcare access, contraceptive counseling, and reasons for discontinuation. Results: The findings indicate that short-term contraceptive methods, such as condoms and oral contraceptive pills, had the highest discontinuation rates. Racial/ethnic differences in discontinuation patterns were observed, with Black women were more likely to discontinue contraceptive methods. Side effects were a predominant reason for discontinuation across all groups. Furthermore, age, educational level, economic and limited contraceptive counseling, were significantly associated with higher discontinuation rates. Conclusions: This study stressed the complexity of contraceptive discontinuation and the multifaceted influences shaping women’s reproductive health choices. The results suggest several courses of action for healthcare providers, policymakers, and public health professionals in designing evidence-based interventions aimed at reducing contraceptive discontinuation and improving reproductive health outcomes.

Download

Share

COinS