Abstract
Objective
Despite the importance of contraception for pregnancy planning in females with chronic
conditions, little is known about contraception use in those with two or more chronic
conditions—i.e., multimorbidity. We examined contraception use among females with
multimorbidity, one chronic condition, and no identified chronic conditions.
Study design
We used data from the 2015 to 2016 Canadian Community Health Survey on 15 to 49-year-old
females at risk of unintended pregnancy (n = 12,741), comparing females with ≥2 chronic
conditions (21.3%) and one chronic condition (27.7%) to those with no identified chronic
conditions (51.0%). We used modified Poisson regression to derive adjusted prevalence
ratios (aPR) for any contraception vs no contraception, and multinomial logistic regression
to derive adjusted odds ratios (aOR) for highly effective, moderately effective, and
no contraception vs less effective contraception.
Results
Compared to females with no identified chronic conditions, those with multimorbidity
were less likely to use any contraception (aPR 0.93, 95% CI 0.89 − 0.98). Females
with multimorbidity were more likely than those with no identified chronic conditions
to use no contraception (aOR 1.29, 95% CI 1.13 − 1.46), with little to no difference
in the use of highly (aOR 1.08, 95% CI 0.91 − 1.29) or moderately effective contraception
(aOR 0.98, 95% CI 0.86 − 1.13), vs less effective contraception. There were no differences
between females with one chronic condition and no identified chronic conditions.
Conclusion
The lower overall rate of contraception use in females with multimorbidity reflects
a need for more attention to family planning in this population, with prompt and convenient
access to highly effective options.
Implications
Females with multimorbidity were less likely than those with no identified chronic
conditions to use any contraception, and no more likely to use highly or moderately
effective versus less effective contraception. Individuals with multimorbidity could
benefit from attention to family planning, with prompt and convenient access to highly
effective options.
Keywords
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Article info
Publication history
Published online: July 27, 2021
Accepted:
July 17,
2021
Received in revised form:
July 16,
2021
Received:
January 22,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
