"I am the expert of my own self, and this is what I choose": a qualitative investigation of diverse cultural experiences with birth control.
12 affiliations
- 1Department of Epidemiology, University of Washington, Seattle, WA, USA. [email protected].
- 2School of Public Health, University of Washington, Seattle, WA, USA.
- 3Department of Biology, University of Washington, Seattle, WA, USA.
- 4Department of Chemistry, University of Washington, Seattle, WA, USA.
- 5Department of Psychology, University of Washington, Seattle, WA, USA.
- 6Department of Bioethics, University of Washington, Seattle, WA, USA.
- 7Department of Gender, Women, and Sexuality Studies, University of Washington, Seattle, WA, USA.
- 8Department of American Ethnic Studies, University of Washington, Seattle, WA, USA.
- 9Department of Anthropology, University of Washington, Seattle, WA, USA.
- 10Department of Maternal and Child Health, University of North Carolina, Chapel Hill, NC, USA.
- 11Department of Psychology, Emory University, Atlanta, GA, USA.
- 12Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
Abstract
Background
Despite medical advances and widespread use, approximately 1 in 4 current and prospective female contraceptive users in the United States do not access their preferred method of contraception. Understanding how to address cultural barriers to contraceptives is critical to improving access. This study investigated how different aspects of cultural background influence contraceptive perceptions and experiences. We explored this question with an intersectional lens, recruiting participants with a range of multicultural identities.Methods
Between 2023 and 2024, we conducted 32 in-depth interviews with a diverse sample of pregnancy-capable people around the puget sound in Washington, asking how culture influences attitudes and decisions regarding birth control. Codes were created inductively from interview transcripts and were grouped by definitional similarities and co-occurrences with each other. The research team identified themes that represented the overarching influences of cultural norms and experiences on birth control perceptions and use.Results
From analysis of 32 in-depth interviews, our analysis revealed four main themes: (1) Cultural Birth Control Stigma Spread Through Gossip, Misinformation, and Silence; (2) Expectations from Family and Gendered Norms Hinder Preferred Birth Control Use; (3) Autonomy, Access to Culturally Competent Providers, and Access to Comprehensive Information Facilitate Positive Perceptions of Birth Control; (4) Desire for Birth Control Accessibility, Comprehensive Education, Decreased Stigma, and Shared Contraceptive Responsibility.Conclusion
A diverse group of participants reported nuanced themes of cultural birth control stigma and familial and gendered expectations as barriers to positive birth control perceptions and use, while values of autonomy, culturally understanding healthcare providers, and comprehensive education facilitated positive birth control perceptions. To address unique patient needs, providers should acknowledge perceptions of stigma, address patient and familial knowledge gaps through tailored contraceptive counseling, and prioritize full transparency on benefits and side effects. Providers must recognize patients' individual experiences and consider culture as a nuanced and complex influence.
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BibTeX
@article{eligado2026expert,
title = {{"I am the expert of my own self, and this is what I choose": a qualitative investigation of diverse cultural experiences with birth control.}},
author = {Gabriel M Eligado and Aliyah Cleveland and Emily G Ramirez and Ritika Kolan and Sabrina Madison and Laila Becker Golde and Madeleine R Bell and Astha Mishra and Lou Chow and Solana Gonzalez and Cecilia Sbai and Nede A Ovbiebo and Brynne A Harris and Natasja Hinrichsen and Suzanne E Callis and Siyu Chen and Jonathan W Kanter and K E Manbeck},
journal = {Reproductive health},
year = {2026},
month = jul,
doi = {10.1186/s12978-026-02413-x},
url = {https://europepmc.org/article/MED/42958567},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - "I am the expert of my own self, and this is what I choose": a qualitative investigation of diverse cultural experiences with birth control.
AU - Gabriel M Eligado
AU - Aliyah Cleveland
AU - Emily G Ramirez
AU - Ritika Kolan
AU - Sabrina Madison
AU - Laila Becker Golde
AU - Madeleine R Bell
AU - Astha Mishra
AU - Lou Chow
AU - Solana Gonzalez
AU - Cecilia Sbai
AU - Nede A Ovbiebo
AU - Brynne A Harris
AU - Natasja Hinrichsen
AU - Suzanne E Callis
AU - Siyu Chen
AU - Jonathan W Kanter
AU - K E Manbeck
PY - 2026
DA - 2026/07/31
JO - Reproductive health
DO - 10.1186/s12978-026-02413-x
UR - https://europepmc.org/article/MED/42958567
AB - Background Despite medical advances and widespread use, approximately 1 in 4 current and prospective female contraceptive users in the United States do not access their preferred method of contraception. Understanding how to address cultural barriers to contraceptives is critical to improving access. This study investigated how different aspects of cultural background influence contraceptive perceptions and experiences. We explored this question with an intersectional lens, recruiting participants with a range of multicultural identities.Methods Between 2023 and 2024, we conducted 32 in-depth interviews with a diverse sample of pregnancy-capable people around the puget sound in Washington, asking how culture influences attitudes and decisions regarding birth control. Codes were created inductively from interview transcripts and were grouped by definitional similarities and co-occurrences with each other. The research team identified themes that represented the overarching influences of cultural norms and experiences on birth control perceptions and use.Results From analysis of 32 in-depth interviews, our analysis revealed four main themes: (1) Cultural Birth Control Stigma Spread Through Gossip, Misinformation, and Silence; (2) Expectations from Family and Gendered Norms Hinder Preferred Birth Control Use; (3) Autonomy, Access to Culturally Competent Providers, and Access to Comprehensive Information Facilitate Positive Perceptions of Birth Control; (4) Desire for Birth Control Accessibility, Comprehensive Education, Decreased Stigma, and Shared Contraceptive Responsibility.Conclusion A diverse group of participants reported nuanced themes of cultural birth control stigma and familial and gendered expectations as barriers to positive birth control perceptions and use, while values of autonomy, culturally understanding healthcare providers, and comprehensive education facilitated positive birth control perceptions. To address unique patient needs, providers should acknowledge perceptions of stigma, address patient and familial knowledge gaps through tailored contraceptive counseling, and prioritize full transparency on benefits and side effects. Providers must recognize patients' individual experiences and consider culture as a nuanced and complex influence.
SN - 1742-4755
ER -