Access to patient-centered contraceptive information and full range of contraceptive methods is a key part of reproductive autonomy. Yet barriers to using desired methods still exist including lack of a full range of methods, costs associated with clinic visits, and difficulty traveling or taking time off work/school to obtain method or refills. Contraceptive choice, autonomy, and use of methods has never been equal in the United States. People of low socio-economic status and people of color have historically faced racism and injustice in contraceptive care, including forced sterilizations in prisons, unethical testing of methods, and reproductive coercion. There continue to be racial and ethnic disparities in contraceptive use and experiences due to systemic racism, high rates of uninsurance and unemployment, and distrust of health institutions among Black, Indigenous, and people of color (BIPOC).
This study aimed to center the experiences of people in the US who identify as Black, Indigenous, Asian American and Pacific Islander, and Latina/Latinx and assess their contraceptive use, needs, desires, and preferences. We also aimed to explore how health systems and contraceptive services can better meet their needs and how access has shifted due to changes associated with the COVID-19 pandemic. The study was designed and implemented by a Collaborative Research Team which included Black Women for Wellness, Bold Futures, California Latinas for Reproductive Justice, National Asian Pacific American Women's Forum, Native American Community Board, and Ibis Reproductive Health.
Between May 2021 and March 2022, we conducted a cross-sectional survey with people who identified with at least one of the following racial or ethnic groups: Asian American, Native Hawaiian, or Pacific Islander, Black or African American, Indigenous, and Latina/Latinx. We designed recruitment to be completed by community-based organizations and therefore did not aim for our sample to be representative of these groups across the country. We enrolled 727 participants, split evenly among the four racial/ethnic communities.
Participants reported on demographics; experiences using contraception including methods used, experiences with healthcare providers, and barriers faced accessing contraceptive services; and desires, needs and preferences for use of contraception including desired methods, characteristics of desired methods, and preferences for types of providers.