School of Public Health and Community Medicine

Contraception understandings and experiences of Australian women

image - J Richters Banner

Rationale / Background

Women (and men) use contraception so that they can have sex without pregnancy. Yet we know surprisingly little about how women perceive the effects of the different contraceptive methods on their bodies and on their relationships. This study asked women about their thoughts, feelings and experiences of contraception as part of their sexual lives. It has helped us understand why women change contraceptive methods, why they sometimes put up with undesirable side effects and why they sometimes take risks even when they do not wish to become pregnant. The findings have extended the sociological understanding of heterosexual interactions. What we learnt has been used in writing contraceptive information for women and in training doctors and nurses in contraceptive counselling and prescribing.

Aim and objectives

In order to examine women’s attitudes towards and understandings and experiences of fertility control and choice of contraceptive methods in relation to their sexual lives, we conducted a qualitative study based on in-depth open-ended interviews with 94 women of reproductive age (16–49) in New South Wales.

Significance, results and outcomes

As this is a qualitative study of women’s understandings and experiences, the results are not in the form ‘28% of women were using oral contraceptives’ or ‘X was less effective as a contraceptive for young women’. Rather, they are a picture of the way women think about their bodies, sex and contraception and the way they navigate information sources (mostly informal) and medical service provision.

This study adds to development of work on 'folk physiology', or lay understandings of the body. This is both a theoretical contribution to the sociology of health and immediately useful for application to health promotion.

Benefits

The findings and insights of the project are already being incorporated into service provision and development of patient information materials. They are being used in training for medical and other health professionals through the work of Family Planning NSW, which is a clinical and training organisation. As research generated at Family Planning NSW—one of the country’s largest family planning bodies—informs and feeds into the practice, policies, training and resource materials of family planning bodies in other states, the changes will gradually be reflected around Australia. As a result information will be provided in a more woman-friendly manner, reflecting women’s ways of thinking about contraception. Educational materials will also include information on the sexual effects of different methods, which has not generally been given in the past. We are currently working with FPNSW’s education team to review contraceptive method information sheets.

This project bridges the gap between the medical approach to contraception and the views of the general public. Medical research and clinical practice often take a risk–benefit approach to method choice and are at a loss to explain why women fail to use the more effective, safer methods. This study unpacks the ideas held by women about what is ‘natural’, what is safe, what constitutes control over fertility, and what is desirable in sex with a partner, with the result that women’s behaviour becomes understandable rather than mysterious. The findings will support health professionals in understanding the myriad of factors, including bodily perceptions, that influence a woman’s choice of contraceptive and her reasons for continuing or discontinuing it.


Publications and other outputs

Peer-reviewed journal articles

Inoue, K., Kelly, M., Barratt, A., Bateson, D., Rutherford, A., Black, K., Stewart, M., & Richters, J. (2016). Australian women’s attitudes towards and understandings of the subdermal contraceptive implant: A qualitative study of never-users. Journal of Family Planning and Reproductive Health Care, Online First, 3 March 2016. DOI: 10.1136/jfprhc-2014-101132.

Inoue, K., Kelly, M., Bateson, D., Rutherford, A., Stewart, M., & Richters, J. (2016). Contraceptive choices and sexual health of Japanese women living in Australia: A brief report from a qualitative study. Australian Family Physician, 45, 523–527.

Kelly, M., Inoue, K., Black, K. I., Barratt, A., Bateson, D., Rutherford, A., Stewart, M., & Richters, J. (2016). Doctors’ experience of the contraceptive consultation: A qualitative study in Australia. Journal of Family Planning and Reproductive Health Care, Online First, 12 May. DOI: 101136/jfprhc-2015-101356.

Kelly, M., Inoue, K., Barratt, A., Bateson, D., Rutherford, A., & Richters, J. (2016). Performing (heterosexual) femininity: Female agency and role in sexual life and contraceptive use—a qualitative study in Australia. Culture, Health & Sexuality, Online 23 August. DOI: 10.1080/13691058. 2016.1214872.

Inoue, K., Kelly, M., Barratt, A., Bateson, D., Rutherford, A., Black, K. I., Stewart, M., & Richters, J. (2016). Australian women’s experiences of the subdermal contraceptive implant: a qualitative perspective. Australian Family Physician, 45, 734–739.

Inoue, K., Barratt, A., & Richters, J. (2015). Does research into contraceptive method dis­continuation address women’s own reasons? A critical review. Journal of Family Planning and Reproductive Health Care, 41, 292–299. DOI: 10.1136/jfprhc-2014-100976.

Conference papers and posters (presenter’s name in bold)

Richters, J. (February 2017). The sociology of sexual practice. Invited opening plenary presentation, Sexual science in the 21st century: The Australasian experience, Society for the Scientific Study of Sexuality, Western Sydney University, Parramatta, NSW.

Rutherford, A., Inoue, K., Kelly, M., Bateson, D., Barratt, A., Stewart, M., Black, K., & Richters, J. (November 2015). ‘There’s a lot of trading of tips and tricks’: How women negotiate information about contraception. Presented to AFSEH 1st National Conference, Equity and Justice—in Gender, Sexuality, Education and Health, University of Western Sydney, Parramatta, NSW.

Richters, J. (April 2015). The Australian Study of Health and Relationships: Contraceptive choices. Invited presentation, RCOG World Congress 2015, Royal College of Obstetricians and Gynae­cologists (RCOG) and Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), Brisbane, 15 April 2015. Abstract in section C22: Sexual Health, p. 116 of conference program, New endeavours in women’s health. www.rcog2015.com

Le Hunte, B., Inoue, K., Kelly, M., Bateson, D., Rutherford, A., Barratt, A., Black, K., & Richters, J. (November 2014). We know what’s best for you: An analysis of the messaging and stereotyping in contraceptive advertising to doctors. Oral presentation, Second National Sexual and Reproductive Health conference, Melbourne, 18 November 2014.

Inoue, K., Kelly, M., Barratt, A., Rutherford, A., Black, K., Stewart, M., Bateson, D., & Richters, J.  Australian women’s attitudes towards and experiences of intrauterine devices. Oral presentation, Second National Sexual and Reproductive Health conference, Melbourne, 18 November 2014.

Inoue, K., Barratt, A., & Richters, J. Does research into contraceptive discontinuation address women’s own reasons? A critical review. Poster presentation, Second National Sexual and Reproductive Health conference, Melbourne, 18–19 November 2014.

Kelly, M., Inoue, K., Barratt, A., Bateson, D., Rutherford, A., Black, K., Stewart, M., & Richters, J. (October 2014). Does your contraceptive method affect your sex life? ‘No, but …’: A qualitative exploration. Oral presentation, Australasian Sexual Health Conference, Sydney.

Frost, B., Kelly, M., Inoue, K., Barratt, A., Bateson, D., Rutherford, A., Black, K., Stewart, M., Richters, J. (October 2014). Starting contraception: Not talking about sex. Oral presentation, Australasian Sexual Health Conference, Sydney.

Inoue, K., Kelly, M., Bateson, D., Rutherford, A., Barratt, A., Black, K., & Richters, J. (November 2012). What’s contraception got to do with sex? The neglect of sexual issues in contraception research. Oral presentation at First National Sexual & Reproductive Health Conference, Melbourne.

Kelly, M., Inoue, K., Barratt., A., Bateson, D., Rutherford, A., Brassil, A., Black, K., & Richters, J. (November 2012). Doctors’ approach to contraceptive decision-making. Poster presented to First National Sexual & Reproductive Health Conference, Melbourne.

Richters, J. (July 2011). What’s contraception got to do with sex? The neglect of reproductive issues in sexuality research. Presented at Naming and Framing: The Making of Sexual (In)Equality, IASSCS VIII Conference, Madrid, July 2011. Abstract 2533. The abstract was chosen for publication in the special issue of Culture, Health & Sexuality comprising a selection of the highest-scoring abstracts submitted to the conference.

Student reports

Frost, B. (2015). Starting contraception: not talking about sex. Report for Independent Learning Program, Medicine, UNSW.

Kwon, S. H. C., Inoue, K., Kelly, M., & Richters, J. (2013). Contraception attitudes, understandings and experiences among Australian-born and overseas-born students. Report for Independent Learning Program, Medicine, UNSW.

Project Members
image - Juliet Richters
Professor Juliet Richters
Honorary Visiting Professor
Project Supporters

This project was funded by ARC Linkage Grant LP110200996 to the University of New South Wales, University of Sydney, and Family Planning NSW.

Project Collaborators: External

Professor Alex Barratt
School of Public Health, University of Sydney

Dr Deborah Bateson
Family Planning NSW

Ann Brassil
Family Planning NSW

Dr Mary Stewart
Family Planning NSW