Article Text

Download PDFPDF
Views and experiences of long-acting reversible contraception among ethnic minorities in high-income countries: a systematic review of qualitative studies
  1. Sumayyah Ahmed,
  2. Abigail McLoughlin Dymond,
  3. Michele Correa,
  4. Merlin L Willcox
  1. Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, University of Southampton Faculty of Medicine, Southampton, UK
  1. Correspondence to Sumayyah Ahmed, School of Primary Care, University of Southampton Faculty of Medicine, Southampton, UK; sa8g19{at}


Ethnic minorities in high-income countries have higher rates of unintended pregnancies but are less likely to use highly efficacious long-acting reversible contraception (LARC). The reasons for this are unclear.

Aim To understand the views and experiences of ethnic minorities within high-income countries about LARC.

Methodology Medline, CINAHL, EMBASE and Sociological Abstracts were searched systematically to find qualitative articles about views on LARC. Titles and abstracts were screened to select qualitative studies about LARC whose participants were mainly from ethnic minorities in high-income countries. Quality assessment was conducted using the Critical Appraisal Skills Programme (CASP) tool. Thematic synthesis was conducted.

Results Seventeen studies (19 articles) met the inclusion criteria, 14 of which were from the USA (227 participants identified as Latina, 222 Black, 15 multiracial, 4 Asian). Two studies included 32 Chinese women in the UK and Australia and one included 20 Aboriginal women in Australia. Factors influencing uptake of LARC included side effects, convenience, and perceived efficacy of LARC compared with other methods; women’s ideas, concerns and expectations; and external influences (partner, family/friends, health professionals and society). Convenience of LARC, control over reproductive decisions, and desire to prevent pregnancy were the main facilitators. Barriers included specific cultural concerns about irregular bleeding, concerns about racial discrimination, and family/friends having negative views on LARC.

Conclusions Ethnic minority women often have additional needs and concerns about LARC compared with the White majority. Further research is needed to develop and evaluate customised respectful counselling on contraception options for ethnic minority women and their partners.

  • long-acting reversible contraception
  • qualitative research

Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study.

View Full Text


  • Contributors SA is the guarantor of this article and responsible for the overall content. The study was conceived and planned by MLW and SA. Under the guidance and instruction of MLW, SA and AMD conceptualised and conducted the initial literature search, and jointly screened the search results. SA conducted the data extraction and thematic analysis of findings from 15 papers, with supervision and input from MLW. MC screened and conducted data extraction and thematic analysis of four additional references, under the supervision of MLW. SA wrote the original draft, and all authors reviewed and revised the draft. MC, SA and MLW edited the manuscript to incorporate the peer reviewers’ feedback. All authors read and approved the final version.

  • Funding MLW’s salary was funded by the National Institute for Health and Care Research (NIHR) (grant NIHR302412). The authors did not receive a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.