School of Public Health and Health Systems, Faculty of Health, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
Reprod Health. 2021 Apr 29;18(1):89. doi: 10.1186/s12978-021-01139-2.
As the prevalence of obesity increases and the age of onset decreases, more women of reproductive age will be living in larger bodies. Research on weight-related efficacy and safety has informed clinical guidelines for routine and emergency contraceptive use by women with a higher body mass index; however, patient perspectives are needed to understand women in larger bodies' experiences with contraception and contraceptive care. This scoping review summarizes the literature on women in larger bodies' experiences with contraception with the goal of gaining a better understanding of the nature of these experiences and identifying gaps in the existing research.
Following Arksey and O'Malley's framework, a scoping review of the literature was conducted. Four databases (PubMed, PsycINFO, SCOPUS, and CINAHL) were searched for peer-reviewed, empirical articles published in English between 2010 and 2020, with a focus on North America, Europe, Australia, and New Zealand. Data were summarized by identifying key themes in the reviewed literature.
Twenty-nine articles meeting the eligibility criteria were reviewed. The literature was predominantly quantitative (n = 27), with only one qualitative study and one systematic review, respectively. Five themes were identified, including (1) use of contraception among women in larger bodies; (2) knowledge, attitudes towards and beliefs about contraception; (3) contraceptive (dis)satisfaction among women in larger bodies; (4) contraceptive counseling; and (5) barriers to contraception. The findings revealed that women in larger bodies may have unmet contraceptive care needs. Despite many articles addressing the need to improve contraceptive counseling for women in larger bodies (n = 26), few explored how women felt about their care (n = 2). Finally, only two articles focused on emergency contraception, indicating a need for further research.
This scoping review emphasizes the pressing need for qualitative research to explore women in larger bodies' experiences with routine and emergency contraception, as well as receiving contraceptive counseling and care. Future research exploring the lived experiences of women in larger bodies is necessary to better characterize their contraceptive needs and identify avenues to improve patient care.
随着肥胖症的流行率增加和发病年龄降低，越来越多的育龄妇女将生活在更大的体型中。针对与体重相关的疗效和安全性的研究为体质量指数较高的女性提供了常规和紧急避孕的临床指南；然而，需要了解体型较大的女性对避孕和避孕护理的体验，以了解患者的观点。本范围综述总结了关于体型较大的女性对避孕的体验的文献，旨在更好地了解这些体验的本质，并确定现有研究中的空白。
根据 Arksey 和 O'Malley 的框架，对文献进行了范围综述。在四个数据库（PubMed、PsycINFO、SCOPUS 和 CINAHL）中搜索了 2010 年至 2020 年期间以北美、欧洲、澳大利亚和新西兰为重点发表的同行评议的实证文章，重点关注英文文献。通过识别文献综述中的关键主题来总结数据。
有 29 篇符合入选标准的文章进行了回顾。文献主要是定量的（n=27），只有一篇定性研究和一篇系统评价。确定了五个主题，包括（1）体型较大的女性使用避孕措施；（2）对避孕的知识、态度和信念；（3）体型较大的女性对避孕的不满；（4）避孕咨询；（5）避孕障碍。研究结果表明，体型较大的女性可能存在未满足的避孕护理需求。尽管许多文章都提到需要改进对体型较大的女性的避孕咨询（n=26），但很少有文章探讨女性对自身护理的感受（n=2）。最后，只有两篇文章关注紧急避孕，表明需要进一步研究。
本范围综述强调需要进行定性研究，以探索体型较大的女性在常规和紧急避孕方面的体验，以及接受避孕咨询和护理的情况。未来的研究需要探索体型较大的女性的生活体验，以更好地描述她们的避孕需求，并确定改善患者护理的途径。
