Learning Objective #1: Describe the core category and three subcategories that best describe women’s process of contraceptive decision-making

Learning Objective #2: Describe two implications for nursing practice

---

Half of pregnancies in the United States that occur each year are unintended; half of these pregnancies occur among women using contraceptives and half are electively terminated. Reducing contraceptive discontinuation and failure could have a significant impact on abortion rates and the toll that unintended pregnancies have on women. The purpose of this study is to develop a theory of contraceptive decision-making in women using grounded theory and feminist inquiry to contribute to knowledge development, which may make a difference in women's lives as they negotiate contraceptive use. The design for this study was a feminist, grounded theory design using the data collection method of open-ended interviews. Sixteen women were interviewed on the island of Kauai, Hawaii using a semi-structured interview guide. Interviews, field notes and memos were coded and analyzed using constant comparative analysis until saturation occurred. The data was coded using the methods of open, axial and selective coding and analysis was verified via member validation of codings. The core category that describes the process of contraceptive decision-making in women is “finding the best fit”. Women choose a method or methods to prevent pregnancy based on their knowledge, experience, and evaluation of what would be the best fit within the context of their current life situation. Categories of “finding the best fit” are “becoming aware”, “weighing what's best for me” and “navigating a course”. Providers should conduct a thorough contraceptive history, identify a woman's perceptions of methods, and identify personal and clinical practice biases. Providers should offer a variety of educational materials and explore ways to link with community, educational and political agencies to offer programs for and increase access to birth control. Further knowledge development about becoming aware, having support, women's perceptions of methods is recommended as well as to repeat this study in different populations.