Initiating an Intrauterine Device: How Adolescent and Young Adult Women Exercise Autonomy in the Decision-Making Process

This study explores how adolescent and young adult (AYA) women exercise their autonomy when making the decision to use an intrauterine device (IUD). The study team interviewed 42 AYA women participating in a longitudinal study of AYA women’s experiences during the first year of IUD use conducted within 30 days of IUD placement. I found young women’s exercise of autonomy lays on a spectrum. I describe four profiles reflecting independent, relational, shared, and deferential decision-making power. Autonomy was enacted differently depending on if the young woman wanted to share decision-making and who the young woman chose to include in the decision-making process. This study highlights important role of social referents, including friends, family, partners, and medical professionals, in supporting AYA women’s autonomy when considering an IUD. Medical providers should seek information on contraceptive justice approaches so they may assist AYA women with contraceptive decision-making in a collaborative, not coercive, process.