Interest in nonsurgical female permanent contraception among men in Portland, Oregon and eastern Maharashtra, India.

OBJECTIVE: We examined the men's attitudes and perceptions toward the concept of female nonsurgical permanent contraception (NSPC) or novel approaches to permanent contraception (PC) that do not require incisions or surgical equipment/hysteroscope. STUDY DESIGN: Cross-sectional survey of married/partnered men in Portland, OR, and rural eastern Maharashtra, India. Descriptive analysis was performed. RESULTS: In India (N=150), most men (80%) anticipated that their partners would undergo PC in the future, compared to 30% in Portland (N=170). About a third (39.6% in India, 82% in Portland) reported being uncomfortable with PC for partners due to the need for surgery. Most men (85% in India, 82% in Portland) expressed a preference for a hypothetical new method of female NSPC over surgery, if safe and effective. CONCLUSION: Most men sampled in two diverse settings expressed interest in NSPC for women. IMPLICATIONS: Men's perceptions of new female contraceptive methods are important to the contraceptive development process. Men may find a safe and effective nonsurgical method of permanent female contraception more acceptable than surgical PC.

Conceptualizing risk and effectiveness: a qualitative study of women's and providers' perceptions of nonsurgical female permanent contraception.

OBJECTIVE: Novel approaches to nonsurgical permanent contraception (NSPC) for women that are low cost and require no incision or hysteroscope/surgical equipment could improve access to, and the acceptability of, permanent contraception (PC). To better understand opportunities and limitations for NSPC approaches, we examined women's and obstetrician-gynecologist (OB/GYN) providers' perceptions of NSPC in Portland, OR. STUDY DESIGN: Semistructured, qualitative interviews were conducted with 40 women recruited from outpatient clinics with purposive sampling, and a focus group was conducted with 9 OB/GYNs in academic and community practice. Transcripts were coded and inductively analyzed with a grounded theory approach. RESULTS: The majority of women identified as white (67%) or Latina (25%). They had a median age of 31.5 years, and median number of children was one. Perspectives on NSPC were closely aligned with women's general attitudes towards PC; over half were considering PC for themselves or partners in the future. Most respondents valued multiple aspects of a nonsurgical approach, with themes of minimizing recovery time, invasiveness and risk and avoiding hormonal contraception. Many assumed that NSPC would be less effective than surgery, however, and felt that a confirmation test would be necessary regardless of the failure rate. Providers welcomed efforts to expand contraceptive choice with NSPC, but would require long-term safety and efficacy data before recommending, and voiced concerns that NSPC's potential relative ease of administration could undermine the inherent seriousness of choosing PC. CONCLUSIONS: Women's and providers' perceptions of NSPC hinged on the ways in which they conceptualized risk and effectiveness. While perceptions were generally favorable, confirmation of safety and effectiveness would be required for a new approach to be accepted. IMPLICATIONS: This hypothesis-generating study elucidates women's and provider's perspectives on new methods of NSPC and contributes to understanding their perceptions of various types of risk. A technique to verify tubal occlusion would be needed for women and providers to accept NSPC.