Preferences for decision-making about contraception and general health care among reproductive age women at an abortion clinic

Abstract Objective Studies suggest that not all patients desire shared decision making, and little is known about decision making around contraception. This study compared decision-making preferences for contraception to preferences for general health among reproductive-aged women. Methods 257 women receiving abortion care in an urban hospital completed a survey which included questions adapted from the Problem-Solving Decision-Making Scale about their preferences for medical decision making. Results Women were significantly more likely to desire autonomous decision making about contraception than about their general health care (50% vs. 19%, p < .001). No patient characteristics were associated with contraceptive decision-making preferences. Women with Medicaid insurance were more likely to desire autonomous decision making about contraception than about general health care (51% vs. 17%, p < .001). Conclusion Women desire more autonomy in their contraceptive decisions than in their decisions about general health care. Practice implications Health care providers should be attentive to the existence of variation in preferences in decision making across health domains. Contraceptive providers should proactively assess decisional preferences to ensure the most appropriate counseling is provided to each individual.