DETERMINANTS OF CONTRACEPTIVE USE AMONG WOMEN OF REPRODUCTIVE AGE IN GREAT-BRITAIN AND GERMANY .2. PSYCHOLOGICAL-FACTORS

Psychological determinants of contraceptive use were investigated in G reat Britain and Germany, using national data obtained in 1992. It was hypothesised that current contraceptive use among sexually active, fe rtile women aged 15-45 was related to their attitude towards the vario us contraceptive methods, social influences, perceptions of being able to use a method correctly and consistently, a correct estimation of f ertility, and communication with their partner. Effects of age and cou ntry were also taken into account. The attitude of respondents towards the various contraceptive methods was ambivalent and no method was se en as ideal. On medical methods (OCs, IUDs and sterilisation) many res pondents expressed doubts as to their safety for health. Social influe nces most frequently concerned the use of OCs. Respondents considered themselves able to use oral contraceptives correctly, but expressed ge neral fear about intrauterine devices and sterilisation, and many wome n believed they were not able to use condoms and periodic abstinence c onsistently. Multifactorial analyses revealed that current contracepti ve use was principally determined by social influences, attitude and s elf-efficacy with respect to medical methods. Age and country, and, fo r use of unreliable methods, fertility awareness also played a role. C ommunication with the partner was less relevant. Contraceptive choice (and the use of non-medical methods) depended greatly on encouragement to use and being in favour of medical methods. A lack of social suppo rt for use of medical methods and a negative attitude towards them was related to higher use rates of condoms, periodic abstinence, withdraw al and reliance on 'luck'. In the case of withdrawal and/or no method, underestimation of fertility played an additional role. Contraceptive choice appears to be determined more by a general like or dislike of medical methods rather than on a weighing of the merits of individual available methods.