Contraceptive autonomy of adolescents and young adults in the U.S. South: The influence of healthcare providers, partners, and parents

A growing body of research describes coercive experiences in contraceptive care in the clinic setting, a phenomenon that disproportionately constrains the contraceptive autonomy of women who are young, low-income, Black, or Latinx. Less research has examined how other social influences may constrain contraceptive use and decision-making. We examine contraceptive autonomy across three domains of interpersonal influence (healthcare providers, sexual partners, and parents) and by race (Black vs. White). Between July-September 2023, we surveyed 1207 Black and White adolescents and young adults (AYAs) assigned female at birth living in five southern states. Over half of all respondents reported feeling social pressure related to their contraceptive use. More respondents spoke with a sexual partner or healthcare provider than with a parent about contraception, but those who did speak with a parent were most likely to report contraceptive pressure. Furthermore, respondents who reported social pressure were less likely to be using their preferred method of contraception. Black (vs. White) AYAs were less likely to have conversations with healthcare providers and sexual partners about contraception; more likely to report social pressure across all interpersonal domains; and less likely to be using their preferred method. By examining social pressures beyond the clinic setting, findings reveal the multifaceted and socially patterned ways that bodily autonomy is constrained for AYAs assigned female at birth and how this is magnified for Black AYAs.