Effective Birth Control Use among Women at Risk for Unintended Pregnancy in Los Angeles, California

Abstract Context Identifying sociodemographic and health-related risk factors associated with more effective versus less effective birth control use can help to identify barriers to effective birth control use and decrease risk for unintended pregnancy. Methods Data used were from the 2007 Los Angeles County Health Survey. More effective birth control use was assessed among women ages 18 to 49, who were at risk for unintended pregnancy, residing in Los Angeles County. The study population consisted of 849 women. Multivariate associations of more effective birth control use with sociodemographic and health factors were assessed in logistic regression models. All analyses used weighted data. Results Women who used a more effective birth control method at last act of coitus were less likely to be Black (odds ratio [OR], 0.33) or Asian/Pacific Islander (OR, 0.49), have less than a high school education (OR, 0.33), be a smoker (OR, 0.52), and have public insurance (OR, 0.47) than women using a less effective birth control method. They were more likely to have received a pap test (OR, 2.66), describe their health as fair or poor (OR, 2.39), and have a household income of 200% to 299% of the federal poverty level (OR, 2.25) than women using a less effective birth control method. Conclusions Sociodemographic factors, some of which underlie cultural diversity, predict the use of more effective birth control methods and should be considered when providing family planning services and preconception health counseling to unique populations.