What do we know about contraceptive use, pregnancy intention and decisions of young Australian women? Findings from the CUPID study
ESC Congress Library. Coombe J. May 4, 2016; 127019; A-193
Jacqueline Coombe
Jacqueline Coombe
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Objectives: This study explored the contraceptive practices and pregnancy intentions of young Australian women aged 18-23 in the Contraceptive Use, Pregnancy Intention and Decisions (CUPID) study.
Design & methods: 3795 young women were recruited at baseline. Recruitment was monitored against the Australian Census resulting in a sample demographically representative of the broader Australian population (with a slight overrepresentation of educated women). Quantitative and qualitative analyses have been conducted using the baseline survey data. The following highlights some of these findings.
Results: Contraceptive practices: Although the pill (29.8%) and condoms (12.7%), alone or in combination (17.3%), remain the most popular methods overall among women in the CUPID cohort, we found use of long-acting reversible contraception (LARC) to be higher than in other studies exploring similar age ranges (Implanon 8.7%, Mirena 2.8%). Unintended pregnancy: Of the women reporting ever being pregnant (n=716), 84.6% indicated that their pregnancy was an accident, with 73.4% reporting using contraception at the time of unintended pregnancy. The oral contraceptive pill used alone or in combination with another method (39.1%) was most commonly cited. Profile of LARC users: Women reporting a previous pregnancy were more likely to use a LARC (OR= 2.91 95% CI= 2.3, 3.7) compared to women who did not. Women who indicated use of contraception for its non-contraceptive effects, including management of their periods, bodies and medical conditions, were less likely to use one of these methods (period OR= 0.74 95% CI= 0.6, 0.9, body OR= 0.52 95% CI= 0.4, 0.8, medical OR= 0.3 95% CI= 0.1, 0.7, combined p = 0.0001). Contraceptive change: These findings are supported by our qualitative analysis of reasons why young women changed their contraceptive method, which indicated that non-contraceptive effects are a strong motivator for method change.
Conclusions: There is a significant lack of Australian research that explores the contraceptive practices and pregnancy intentions of young women. Additionally, data collected on contraceptive practices among young women have usually been collected from larger health surveys, thus lacking a nuanced and focused analysis. CUPID is unique in its collection of sexual and reproductive health data in the context of a survey, and provides an opportunity for evidenced based discussions about pregnancy intention and contraceptive practices; discussions that until recently have been precluded by a lack of representative data.

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