Contraception use and attitudes: women’s concerns regarding hormonal contraception and copper intrauterine devices

Objective: To estimate the prevalence of contraceptive method use among women, assess concerns about hormonal contraception (HC) and copper intrauterine device (Cu-IUD) and determine characteristics associated with concerns of HC and Cu-IUD. Method: Cross-sectional study. Swedish speaking women (n = 212) aged 16–50 attending midwives at four outpatient clinics in two of Sweden’s larger cities answered a waiting room questionnaire. Content analysis was used to categorise open-ended questions with free text answers. Results: Long-acting reversible contraceptives (LARC) was used by 30.4%, short acting reversible contraceptives (SARC) by 28.0%, and 16.4% did not use any contraception during most recent intercourse. Four out of ten (41.2%) had concerns about using HC and 52.3% about using Cu-IUD. The most common reason for having concerns regarding HC was unspecified side effects, fear of hormones and adverse mood symptoms; regarding Cu-IUD, concerns related to increased bleeding and menstrual pain. Among those expressing concerns, experience of induced abortion was twice as common. Women who did not have concerns about HC were using combined oral contraception (COC) to a higher extent. Conclusion: Concerns about using HC and Cu-IUD are common. This needs to be considered during contraceptive counselling.