Contraceptive Use Among Low-Income and Ethnic Minority Women Living in Three Urban Underserved Neighborhoods

Purpose: Ineffective and non–use of contraceptives have been associated with increased risk of unplanned pregnancy in the United States. Unplanned pregnancy rates and their adverse outcomes such as low birth weight and preterm birth are higher among minority and low-income women. Healthy People 2020 established a family planning goal to “increase the proportion of females at risk of unplanned pregnancy or their partners who used contraception at most recent sexual intercourse” from the current baseline of 83.3% to 91.6%. This study examined the rate of contraceptive use and types of contraception used by low-income mostly minority women living in underserved neighborhoods.

Methods: One hundred and ten convenience sample of low-income women who called to be part of a larger study were included in this analysis. The women were asked in a pre-intervention screening survey about their contraceptive use and sexual behaviors 12 months prior to the time of interview. Simple descriptive analyses namely univariate and bivariate analyses were conducted using STATA 10.

Results: Forty-eight (43.6 %) of the women were African American, 39.1% were Hispanic, and 15.5% were White. The women were 18 to 55 years of age (mean =31 years). Forty percent of these women who were not pregnant or planning to get pregnant had sex without using any contraceptives in the past 12 months. The percentage of women who used a contraceptive decreased from 77.3% users in the last 12 months to 63.6 % current users. The most common methods used within the last 12 months were: condom use by male partner (28.2%), birth control pills (14.6%), depo provera (12.7%), intrauterine device (10.9%) and the patch (1.8%).

Conclusion: Many of the low-income women from medically underserved neighborhoods in this study did not use contraceptives and of those who used contraceptives, the majority used condoms, which is described as a least effective method. These women are at risk of unplanned pregnancy if they continue to use the least effective contraceptive methods. Contraceptive education and resources on effective contraception should be provided, if the U.S. is to meet the Healthy People 2020 contraceptive use goal.