Contraceptive method switchers: do contraception methods vary among married, cohabiting and single women in the U.S.?

Larry Gibbs, University of Nebraska-Lincoln

It is unlikely that the same type of contraception will be used throughout women’s life course and so a large proportion of women practice contraceptive method switching. This study provides contemporary estimates of contraceptive method switching and the types of methods that women switch to by union status. The National Survey of Family Growth (2006-10) was used to create an analytic sample of 1,899 women ages 21-44 years who switched contraception and had valid responses on the contraceptive method history calendar and marital and cohabitation dates over a 3-year period. Contraceptive method switching was measured based on women’s report of different use of contraception in consecutive months as well as a change from nonuse of contraception to use of contraception or vice versa. Most married women switched to most effective methods, cohabiting women switched to least effective methods and single women switched mostly to the pill and condom. Multivariate analysis revealed that single women, more than married and cohabiting women, were more likely to switch to condoms relative to least effective contraception. Contraceptive method switching behavior is driven by single women while married and cohabiting women are more analogous. Less variation is found in the types of contraceptive methods women switch to when union status is considered. Studies on women’s reproductive health should include more analysis that moves beyond point estimates and incorporates the fluidity of contraceptive behavior, such as contraceptive method switching during the reproductive life course. Health care providers should deliberately address the needs of single sexually active women who are more at risk of negative reproductive health outcomes which may be associated with contraceptive method switching behavior.