Contraindications to oral contraceptive use among women in the United States, 1999–2001

ObjectiveThe prescription requirement for oral contraceptives (OCs) is designed to prevent women with contraindications from using OCs, but this system has never been evaluated. This analysis investigates OC use among women who have contraindications.MethodsWe use National Health and Nutrition Examination Survey data to estimate the prevalence of contraindications among OC users and nonusers. We associate OC use with contraindication status, controlling for sociodemographic characteristics and access to health services.ResultsOverall, 16% of fecund women aged 20 to 51 years are contraindicated from OC use. The prevalence of contraindications among current OC users is 6%, as compared to 19% among nonusers. Regression results show that OC use is more strongly associated with age, race, marital status and health insurance coverage than with having a contraindication to OCs.ConclusionThe results suggest that under the prescription requirement, screening for contraindications to OCs may be working, but not perfectly. More research is needed to identify more effective and convenient screening methods.