Abstract

Background

Women receiving treatment for opioid use disorder have low levels of contraception use and high rates of unintended pregnancies, abortion and children being adopted or fostered. This paper aims to understand the relationship between contraceptive choice and power amongst women receiving Opioid Replacement Therapy (ORT).

Methods

During 2016/17, semi-structured interviews were undertaken with 40 women (aged 22–49 years) receiving ORT in the South of England. Data relating to the latent concept of power were inductively coded and analysed via Iterative Categorisation.

Findings

Power manifested itself through six interconnected ‘fields’: i. ‘information about fertility and contraception’; ii. ‘access to contraception’; iii. ‘relationships with professionals and services’; iv. ‘relationships with male partners’; v. ‘relationships with sex work clients’; and vi. ‘life priorities and preferences’. Each field comprised examples of women’s powerlessness and empowerment. Even when women appeared to have limited power or control, they sometimes managed to assert themselves.

Conclusions

Power in relation to contraceptive choice is multi-faceted and multi-directional, operating at both individual and structural levels. Informed decision-making depends on the provision of clear, non-judgemental information and advice alongside easy access to contraceptive options. Additional strategies to empower women to make contraceptive choices and prevent unplanned pregnancies are recommended.

中文翻译：

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接受阿片类药物替代疗法的女性的避孕选择和效力：定性研究

摘要

背景

接受阿片类药物使用障碍治疗的妇女避孕药具使用率低，意外怀孕、流产和儿童被收养或寄养的比例很高。本文旨在了解接受阿片类药物替代疗法 (ORT) 的女性的避孕选择与效力之间的关系。

方法

2016/17 年期间，对在英格兰南部接受 ORT 的 40 名女性（22-49 岁）进行了半结构化访谈。与潜在的权力概念相关的数据通过迭代分类进行归纳编码和分析。

发现

权力通过六个相互关联的“领域”表现出来：i。“关于生育和避孕的信息”；二. “获得避孕药具”；三. “与专业人士和服务的关系”；四. “与男性伴侣的关系”；v. “与性工作客户的关系”；和六。“生活的优先事项和偏好”。每个领域都包含妇女无能为力和赋权的例子。即使女性的权力或控制力似乎有限，她们有时也会设法坚持自己的立场。

结论

与避孕选择相关的权力是多方面和多方向的，在个人和结构层面发挥作用。知情决策取决于提供明确的、非判断性的信息和建议，以及易于获得的避孕选择。建议采取其他策略，使妇女能够做出避孕选择并防止意外怀孕。