Gender, Power, and Nonpreferred Contraceptive Use in the United States: Results from a National Survey

• Published in: Socius : sociological research for a dynamic world Vol. 10
• Main Authors: Burke, Kristen Lagasse, Lindberg, Laura Duberstein
• Format: Journal Article
• Language: English
• Published: SAGE Publishing 01-01-2024
• ISSN: 2378-0231; 2378-0231
• DOI: 10.1177/23780231241282641

Power dynamics in social interactions likely affect individuals’ ability to use their preferred contraception, yet research has primarily emphasized financial barriers. Using data from a national survey of people assigned female at birth, we apply a social-ecological framework to assess a broader range of factors shaping nonpreferred use. Over one-quarter of respondents were not using their preferred method; among them, nearly half preferred vasectomy, condoms, or withdrawal. Partner disagreement was the most common reason for nonpreferred use and was associated with experiencing partner contraceptive coercion. Black women, who face structural racism in the health care system, were more likely to attribute their nonpreferred use to a provider’s recommendation. These findings demonstrate how gender and power shape contraceptive use despite the preferences of those at risk of pregnancy, highlighting the need for cultural, policy, and health care shifts to resolve contraceptive preference-use discordance and increase gender equity in the responsibility of pregnancy prevention.