Understanding contraceptive choice after discontinuing the contraceptive pill in Germany - a qualitative inquiry

BACKGROUND: Contraception decision-making is a vital aspect of sexual and reproductive health, with individuals weighing various factors when choosing their current contraceptive methods. Method discontinuation is common and should not be viewed as an endpoint but rather as a starting point for selecting the next contraceptive option. However, there is a limited understanding of what former contraceptive pill users seek after discontinuation. METHODS: This study examined the decision-making process and experiences of former oral contraceptive users (N = 19) who transitioned to alternative methods in Germany. We conducted a reflexive thematic analysis. RESULTS: We generated five key themes shaping post-pill contraceptive decisions: (1) prioritization of efficacy and pregnancy prevention, with permanent methods offering psychological relief; (2) reliance on familiarity, particularly with condoms, as a default choice; (3) strong preference for hormone-free options due to concerns over side effects and bodily autonomy; (4) embodied aversion to invasive procedures, such as IUD insertion or complex surgeries; and (5) a growing emphasis on shared responsibility and gender equality in contraception, with calls for greater male involvement and accessible non-hormonal alternatives. These findings underscore the importance of individual experiences, bodily autonomy, and equitable contraceptive access in post-pill decision making. CONCLUSIONS: This study offers valuable insights into the complex nature of contraceptive decision-making, addressing considerations such as long-term health effects, bodily autonomy, and the need for improved contraceptive options.