Contraceptive counseling following in-clinic pregnancy test among women not expecting pregnancy in the next two years: Disparities by service delivery setting and sociodemographic characteristics.

OBJECTIVE

To compare the frequency of the provision of contraceptive counseling at the time of clinical pregnancy test at family planning clinics to other clinical settings among women who wish to avoid pregnancy for the next 2 years or longer.

STUDY DESIGN

This was a secondary data analysis of the 2011-2017 National Survey of Family Growth. It used logistic regression to estimate the relationship between receiving contraceptive counseling with source of care, age, educational attainment, race/ethnicity, poverty status, marital status, insurance status, and pregnancy history among 1790 women aged 15-44 who received in-clinic pregnancy tests and sought to avoid pregnancy for the next two years or longer.

RESULTS

Most clinical pregnancy tests were performed by private practices (52%), community health clinics (20%), and other clinical settings (19%); 8% were performed by family planning clinics. Family planning clinics more frequently provided contraceptive counseling with pregnancy tests than other clinical settings (78% at family planning clinics versus 62% at private doctor's offices and 49% at other settings; aOR = 0.45 [0.25, 0.82], and aOR = 0.26 [0.13, 0.52]). Regardless of clinical setting, age, marital status, income, and pregnancy history, women were more likely to receive contraceptive counseling along with in-clinic pregnancy testing if they were Black (aOR = 1.84 [1.17, 2.90]); they were less likely to receive contraceptive counseling following in-clinic pregnancy test if they had educational attainment higher than a high school education (aOR = 0.53 [0.34, 0.82] and aOR = 0.57 [0.33, 0.99]).

CONCLUSION

Contraceptive counseling at the time of clinical pregnancy testing for women who wish to avoid pregnancy is more common at family planning clinics, but it varies by education and race.

IMPLICATIONS

Efforts are needed to ensure that women who wish to avoid pregnancy consistently receive contraceptive counseling when seeking clinical pregnancy testing.