1. Contraceptive Attitudes and Removing Barriers to Access
Anduwyn Williams
Director for Reproductive Health Access
WV FREE

2. WV FREE, founded in 1989, is a reproductive health, rights and justice organization that works every day for West Virginia women and families to improve education on reproductive options, increase access to affordable birth control, reduce teen pregnancy and improve adolescent health, and protect personal decision-making, including decisions about whether or when to have a child.

3. Tramontina Trash Can

4. “For the Love of LARCs”
2 Year Initiative- Focused on Kanawha, Cabell, and Lincoln
Goal of Increasing Access, but with Cultural Competence
Three Prong Approach: Research, Public Education, and Provider Training
Guided by our Steering Committee made up of Health Professionals located throughout the state

5. Methodology
Lake Research Partners designed and administered this survey that was conducted online and by using professional telephone interviewers between June 21 – 29, The survey reached a total of 500 women between years old in the counties of Cabell, Lincoln, and Kanawha County, West Virginia. Of the 500 completes, 400 were conducted online and 100 by phone. The phone sample was drawn from listed clusters from Catalist and STS. The online sample was drawn from online panels. The data for all respondents were weighed slightly by region and age to reflect attributes of the actual population. The margin of error for the sample is +/-4.4%.

6. Key Findings – Birth Control Use and Access
Just over half (53 percent) of women are currently using birth control, which is surprisingly low for this age cohort.
Younger women are more likely to use birth control than older women.
Women younger than 30: 64 percent
Women ages 30 to 39: 55 percent
Women ages 40 to 49: 37 percent
Unmarried women, women with higher incomes, and college graduates are also more likely to use birth control currently.

7. Just over half of women are currently using a birth control method, which is surprisingly low.
Are you currently using a birth control method?

8. Current birth control use is highest among younger women, unmarried women, women with higher incomes, and college graduates.
Are you currently using a birth control method?

9. Age influences when women last used birth control
Age influences when women last used birth control. A solid majority of women in their forties last used birth control over a decade ago.
Last Birth Control Use Among Those Not Currently Using Birth Control By Age
Under 30 years old
30-39 years old
40-49 years old
0-6 months ago
6-12 months ago
1-3 years ago
4-9 years ago
More than 10 years ago
(Never used)
If not currently using birth control: When was the last time you used a birth control method?

10. Key Findings – Birth Control Use and Access
The birth control pill/ring/skin patch and condoms are the methods women are most likely to use or to have used at some point.
A majority of women have never used any of the other methods.
Over 1-in-5 (22 percent) have had an IUD, a fifth (20 percent) have used injectable hormones, and 8 percent have used implanted hormones.

11. The most commonly used methods of birth control are the pill, ring, or skin patch, and condoms. A majority of women have never used any of the other methods. Over 1-in-5 have had an IUD.
Have not used
Currently using
Have used in past
I am going to read you a list of birth control methods women have reported using. For each one, please tell me whether you are currently using or have used it in the past.

12. Women overwhelmingly defer to doctors when it comes to choosing a birth control method. About a quarter receive help from their partners.
Who helped you pick your birth control method? Select all that apply

13. In a top tier, women place effectiveness, safety, preventing pregnancy, ease of use, and side effects as the most important in choosing a birth control method.
*Split Sampled Question
A little important
Not important at all
Very important
Somewhat important
Now let me read you some different statements. For each one please tell me how important it is to you when it comes to choosing a birth control method -- very important, somewhat important, a little important, or not important at all.

14. While still important overall to about three-quarters of women, they place lower intensity on weight gain, long-term prevention, STI protection, frequency of use, bleeding and cramp control, and avoiding drugs or chemicals.
*Split Sampled Question
A little important
Not important at all
Very important
Somewhat important
Now let me read you some different statements. For each one please tell me how important it is to you when it comes to choosing a birth control method -- very important, somewhat important, a little important, or not important at all.

15. Women are divided as to whether not having a period and acne control are important or not. Nearly three-quarters of women say privacy from partners or families is not important.
Younger women are more likely to say acne control is very important compared to older women (35 percent to 14 percent).
*Split Sampled Question
A little important
Not important at all
Very important
Somewhat important
Now let me read you some different statements. For each one please tell me how important it is to you when it comes to choosing a birth control method -- very important, somewhat important, a little important, or not important at all.

16. Key Findings – Attitudes toward Different Methods
Women are more willing to tell us they feel negatively about injections over injectable hormones.
More women feel unfavorable than favorable toward injections, foam/gel, diaphragms, and implanted hormones.
Women are not familiar with LARCs, with half saying they have no opinion or have never heard of LARCs.
Women who are most likely to have no opinion or have never heard of LARCs: post-graduates (69 percent), women ages 40 to 49 (64 percent), and weak Republicans (59 percent).
Women who are the most familiar with LARCs include women under age 30 (only 38 percent have no opinion or never heard), those with high school or less education (39 percent), and women with household incomes between $50,000 and $75,000 (39 percent).

17. Across demographics, women feel very favorable toward the pill, ring, or skin patch. Women younger than 30, unmarried women, and college graduates also feel very favorable toward condoms; women in their 40s feel very favorable toward sterilization.
Favorability of Methods (% Very Favorable)
Under 30
Married
Unmarried
Non-college grad
College graduate
Pill, ring, or skin patch
55%
50%
43%
49%
46%
Condoms*
40%
36%
38%
53%
Sterilization (tubes tied)*
19%
29%
32%
35%
25%
IUDs*
16%
20%
22%
23%
15%
12%
Natural family planning/rhythm*
18%
17%
Depo shot* 5%
14%
11%
13%
10%
LARCs* 8%
Injectable hormone* 6% 9%
Injections*
Foam/gel* 7% 4%
Diaphragm* 3%
Implanted hormone* 1% 2%
*Split Sampled Question
Now I'd like to ask you your opinion of some birth control methods. For each, please tell me whether you have a very favorable, somewhat favorable, somewhat unfavorable, or very unfavorable impression of that birth control method. If you haven't heard of the method {6}, or if you don't know enough about it to have an impression {5}, just say so and we will move on.

18. Four-in-five women say they have not been denied by their provider or had a really hard time getting their preferred birth control method. However, 17 percent have experienced these roadblocks.
Women who were more likely to experience roadblocks include:
Those with household incomes below $20,000 (29 percent)
Strong Democrats (25 percent)
Women who are unmarried but have a long-term partner (24 percent).
Sometimes women find it difficult to get their preferred birth control method. Have you ever tried to get a birth control method and were denied by your provider or had a really hard time getting it?

19. Among those who have experienced barriers to accessing their preferred form of birth control, over three-quarters say it was because their insurance did not cover it or they could not afford it.
{If experienced barrier, ask:} Why was it hard for you to get your birth control method? What were the barriers that stood in your way? {Open end}

20. Removing Barriers to Care
If possible, remove the amount of visits between first visit and access to contraception
Be clear about referrals, provide information
Ask open ended questions during counseling
Lead with effectiveness, but discuss pros and cons of each method
Provide easy to read and interesting materials
Others?

21. Anduwyn Williams Director for Reproductive Health Access Margaret Chapman-Pomponio Executive Director