{
  "abstract": "Background The clinician-patient relationship is known to impact contraceptive care utilization, but less studied is how factors external to the clinician-patient relationship, such as prior experiences seeking reproductive healthcare or family dynamics and social networks, matter to patients’ postpartum contraceptive decision-making. Objective Our objective was to examine factors external to current patient-provider relationships that contribute to women’s decision-making surrounding postpartum permanent contraception (PC). Design This was a qualitative study at four U.S. healthcare systems with 75 postpartum women who had a documented plan for PC. Methods We conducted semi-structured interviews between March 2022 and June 2023. We employed a modified grounded theory approach to codebook thematic analysis. Results Patients described experiences across four key domains: individual, family, social networking, and policy ecologies. Individual-level influences included prior experiences with clinicians, health concerns, miscarriage experiences, future life goals, and apprehension toward medical procedures. Family-level influences centered on maintaining family wellbeing and accommodating partner preferences. Social networks shaped decisions through information and experiences shared by relatives, friends, community members, and social media. Policy-level influences included concerns regarding abortion access and parental leave policies. Conclusion Women’s decisions regarding postpartum permanent contraception are shaped by a complex interplay of personal experiences, family priorities, social networks, and policy contexts. Contraceptive counseling that acknowledges these influences may better support reproductive autonomy, address misinformation, and facilitate patient-centered decision-making.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "name": "Dhweeja D. Rangaswamy MD"
    },
    {
      "name": "Kavita Shah Arora MD, MBE, MS"
    },
    {
      "name": "Brooke W. Bullington PhD"
    },
    {
      "name": "Kari White PhD"
    },
    {
      "name": "Suzanna Larkin MPH"
    },
    {
      "name": "Margaret Boozer MD"
    },
    {
      "name": "Tania Serna MD, MPH"
    },
    {
      "name": "Emily S. Miller MD, MPH"
    },
    {
      "name": "Jennifer L. Bailit MD, MPH"
    },
    {
      "name": "Kristen A. Berg PhD, CRC"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1gz9058ncef28.bib",
  "cited_by": 0,
  "doi": "10.1177/17455057261500942",
  "fulltext_url": "https://doi.org/10.1177/17455057261500942",
  "id": "1gz9058ncef28",
  "issns": [
    "1745-5065"
  ],
  "landing_url": "https://doi.org/10.1177/17455057261500942",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "R"
    ],
    [
      "openalex",
      "2739|Reproductive Health and Contraception"
    ]
  ],
  "openalex": "W7224494818",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-29",
  "publisher": "SAGE Publishing",
  "ris": "https://research.draconitic.com/paper/1gz9058ncef28.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T14:22:34Z",
      "native_id": "00900743b08e44d2aa144911cf84ed0c",
      "source": "doaj",
      "url": "https://doi.org/10.1177/17455057261500942"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2739|Reproductive Health and Contraception",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Social-ecological factors shaping women’s postpartum permanent contraception decision-making: Qualitative insights from a multi-site study",
  "title_text": "Social-ecological factors shaping women’s postpartum permanent contraception decision-making: Qualitative insights from a multi-site study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T14:22:34Z",
  "url": "https://research.draconitic.com/paper/1gz9058ncef28",
  "venue": "Women's Health",
  "versions": []
}