Objective: Novel approaches to nonsurgical permanent contraception (NSPC) for women
that are low cost and require no incision or hysteroscope/surgical equipment could
improve access to, and the acceptability of permanent contraception (PC). To better
understand opportunities and limitations for NSPC approaches, we examined women's
and OB/GYN providers' perceptions of NSPC in Portland, OR.
Study Design: Semi-structured, qualitative interviews were conducted with 40 women
recruited from outpatient clinics with purposive sampling, and a focus group was
conducted with 9 OB/GYNs in academic and community practice. Transcripts were
coded and inductively analyzed with a grounded theory approach.
Results: The majority of women identified as white (67%) or Latina (25%). They had a
median age of 31.5, and median number of children was one. Perspectives on NSPC were
closely aligned with women's general attitudes towards PC; over half were considering
PC for themselves or partners in the future. Most respondents valued multiple aspects of
a nonsurgical approach, with themes of minimizing recovery time, invasiveness, risk, and
avoiding hormonal contraception. Many assumed NSPC would be less effective than
surgery, however, and felt a confirmation test would be necessary regardless of the
failure rate. Providers welcomed efforts to expand contraceptive choice with NSPC, but
would require long-term safety and efficacy data before recommending, and voiced
concerns that NSPC's potential relative ease of administration could undermine the
inherent seriousness of choosing PC.
Conclusions: Women’s and providers’ perceptions of NSPC hinged on the ways in which
they conceptualized risk and effectiveness. While perceptions were generally favorable,
confirmation of safety and effectiveness would be required for a new approach to be
accepted.