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Citation

McMillan L, Gadsby E, Howell R, Ussher M, Hunt K & Ford A (2024) Women’s experiences of accessing contraceptive services since March 2020: qualitative findings. UKSBM, Glasgow, Scotland, 13.03.2024.

Abstract
Background The COVID-19 pandemic response prompted rapid changes to how contraceptive services were delivered in England. Our aim was to examine women’s experiences of accessing contraceptive services since the start of the pandemic, both for new users of contraception and those with prior experience, and to understand any inequalities of access. Methods We conducted telephone interviews with 31 women aged 17-54 years old who had accessed contraceptive services in England since March 2020. The sample was skewed to include participants with lower educational attainment and living in areas of higher deprivation. Interview transcripts were thematically analysed using inductive and deductive approaches. Results Few differences in experience were found regarding educational attainment. Participants using contraceptive injections (all living in areas in the most deprived quintile), experienced the greatest access challenges causing some to switch to less preferred contraceptive methods or stopping contraception altogether. More general access barriers reported by participants included service closures, unclear booking processes, and lack of appointment availability. Many participants welcomed the flexibility and convenience of remote contraceptive services. However, telephone appointments posed challenges for those at school or living with parents, and some described them as rushed and inconducive to asking questions or raising concerns. Those accessing contraception for the first time or nearing menopause felt they were unable to access sufficient support and guidance during the pandemic. Some participants voiced concerns around the lasting effects of COVID-19 on appointment availability and inadequate service delivery. Conclusions and implications Women’s experiences of accessing contraceptive services in England since March 2020 are diverse. While remote services were suitable for some, COVID-19 restrictions unequally impacted women depending on their chosen contraceptive method and life stage. Policy must consider how individual needs are met and in-depth support provided if a more remote model of service delivery becomes routine practice longer term.