Issues in contraception: recognizing the reasons for contraceptive non-use and abuse
Tanis, J.L.
Mcn. American Journal of Maternal Child Nursing 2(6): 364-369
1977
ISSN/ISBN: 0361-929X PMID: 411008 Document Number: 381011
The reasons for improper or nonuse of contraceptives fall into 3 basic categories - cultural, social, and educational forces; conflicting priorities; and subconscious motivation. Due to the fact that many of the reasons for improper or nonuse of contraceptives are subconscious, they are less likely to be recognized and acknowledged by the individual. Cultural, social, and educational forces influencing improper or nonuse of contraceptives include poverty, ignorance, fear and anxiety, shame and embarrassment, and the feeling that family planning programs are a form of black genocide. Conflicting priorities influencing the improper or nonuse of contraceptives include denial, guilt, excitement due to risk, spontane ty, loneliness, crisis/pressure, hostility, and the availability of abortion. Included under the category of subconscious motivation are uncertainty in a relationship, sense of loss or grief, coital gamesmanship, sexual identity conflicts, masochism, opportunism, nihilism, and ambivalence. The attitudes of nurses, physicians, and social workers offering the services are very likely to influence whether individuals accept or reject family planning services. Staff may hold negative attitudes toward family planning, toward the poor, and toward sex and may be uncomfortable in their role in family planning because of various educational and personal reasons. Normative-reeducative strategy has been proposed as a means of coping with the nonuse of family planning services. This strategy attempts to modify, influence, persuade, and manipulate through a change agent such as the nurse who works to strengthen the individual's self-awareness, self-understanding, and self-control.