TY - JOUR

T1 - Qualitative findings about stigma as a barrier to contraception use

T2 - the case of Emergency Hormonal Contraception in Britain and implications for future contraceptive interventions

AU - Eastham, R.

AU - Milligan, C.

AU - Limmer, M.

PY - 2020/9/1

Y1 - 2020/9/1

N2 - Background: Emergency Hormonal Contraception (EHC) has been underused in Britain and internationally since its introduction. ‘Stigmatisation’ has been identified as one of the barriers to EHC. However, few, if any publications have focussed on the significance of this factor in the British context, the social meanings for women of seeking EHC and the implications for future contraceptive provision and innovation. Method: In-depth qualitative material from 27 women across two British studies was analysed. The first, in which 11 young women were interviewed in-depth regarding EHC specifically, was supplemented by material from a multi-stage narrative study of 15 women concerning their life history experiences of using contraception more broadly. Results: Stigmatisation of EHC use is a key barrier and derives from associations with irresponsible behaviour. This irresponsibility exists on a continuum with some behaviours and some women more ir/responsible than others. In addition, despite not being an abortifacient, EHC may be closely aligned with abortion meaning users can be perceived as ‘bad women’ in a similar way to abortion seekers. This stigma can deter participants seeking EHC when they may need it. Conclusion: Stigma is a powerful barrier to EHC use due to the social significance of responsibility and expectations pertaining to the behaviour of ‘good women.’ Understandings about stigmatisation in the case of EHC should be translated to other aspects of contraceptive service delivery and future innovations, to ensure effective provision of methods and safeguard their uptake. 

AB - Background: Emergency Hormonal Contraception (EHC) has been underused in Britain and internationally since its introduction. ‘Stigmatisation’ has been identified as one of the barriers to EHC. However, few, if any publications have focussed on the significance of this factor in the British context, the social meanings for women of seeking EHC and the implications for future contraceptive provision and innovation. Method: In-depth qualitative material from 27 women across two British studies was analysed. The first, in which 11 young women were interviewed in-depth regarding EHC specifically, was supplemented by material from a multi-stage narrative study of 15 women concerning their life history experiences of using contraception more broadly. Results: Stigmatisation of EHC use is a key barrier and derives from associations with irresponsible behaviour. This irresponsibility exists on a continuum with some behaviours and some women more ir/responsible than others. In addition, despite not being an abortifacient, EHC may be closely aligned with abortion meaning users can be perceived as ‘bad women’ in a similar way to abortion seekers. This stigma can deter participants seeking EHC when they may need it. Conclusion: Stigma is a powerful barrier to EHC use due to the social significance of responsibility and expectations pertaining to the behaviour of ‘good women.’ Understandings about stigmatisation in the case of EHC should be translated to other aspects of contraceptive service delivery and future innovations, to ensure effective provision of methods and safeguard their uptake. 

KW - barriers

KW - contraception

KW - Emergency contraception

KW - gender

KW - sexuality

KW - stigma

U2 - 10.1080/13625187.2020.1806998

DO - 10.1080/13625187.2020.1806998

M3 - Journal article

VL - 25

SP - 334

EP - 338

JO - European Journal of Contraception and Reproductive Health Care

JF - European Journal of Contraception and Reproductive Health Care

IS - 5

ER -