Women’s perspectives on long-acting reversible contraception: a critical scoping review of qualitative research

ABSTRACT

Long-acting Reversible Contraception (LARC) has significant promise both from a public health outlook and a social justice perspective. However, if women’s empowerment is to be supported, then perspectives and experiences of LARC must be considered. This scoping review assesses research about contraceptive users’ perspectives and experiences of contraceptive decision-making and practices. A content analysis was conducted to identify research trends in qualitative studies of contraceptive-user perspectives (n = 54), located by means of a systematic search. Interpreting findings through a reproductive justice lens, three main limitations in the scholarship were identified, viz., (1) an instrumentalist, individual-level focus; (2) a lack of consideration for diverse perspectives; and (3) an uncritical focus on young women. While the small body of qualitative research on LARC offers some valuable insights, when viewed from a sexual and reproductive justice perspective, it is not sufficiently user-centered or grounded within the reproductive politics surrounding contraceptive care and provision. Research is needed that draws on appropriate social theory; widens its focus beyond dominant groups; and is cognizant of the multi-level power relations surrounding LARC. Such work provides a nuanced picture of the complex social and contextual factors at play and inform person-centered approaches in sexual and reproductive health policy and programming.

KEYWORDS:

• Long-Acting Reversible Contraception (LARC)
• qualitative research
• reproductive justice
• scoping review
• service-user perspectives
• women’s health

Disclosure of potential conflicts of interest

No potential conflict of interest was reported by the author(s).

Notes

1. We use the World Bank’s (2018) Country Classification by Income as a proxy for classifying countries according to relative wealth and development.

2. There is wide variation in how the literature defined various age categories addressed in studies, with little justification for these. While categories for ‘teenage’ and ‘childbearing age’ are fairly uncontentious, defining adolescence was inconsistent. Following Sawyer et al. (2018), we included all categories under 25 years as adolescence. This reflects that social transitions such as financial independence, marriage, and childbearing, now take place, on average, later than they did fifty years ago.

Additional information

Funding

This work was supported by the Massey University Research Fund [MU00058].