Globally, injectable contraception is among the most popular modern methods, but the need to return to a facility for re-injection every 3 months can reduce DMPA continuation rates. Subcutaneous DMPA (DMPA-SC) is a low-dose formulation that non-medical personnel can administer. The study sought to determine women’s interest in self-administration of DMPA-SC from 13 family planning clinics and six abortion clinics in the U.S. and to understand whether self-injection can overcome barriers to access.
Overall, 21% of women reported interest in self-administration, particularly if they were currently using or had previously used DMPA. Women reporting difficulty obtaining or refilling a prescription were twice as likely to report interest in DMPA-SC compared to women with no difficulty. Interest was driven by a desire to reduce return visits to facilities for repeat injections. Family planning providers should consider the option of self-administration of DMPA-SC for women who may have difficulty returning for repeat injections to reduce late injections and improve continuation. Private health insurance plans, Medicaid, and other insurance companies must weigh higher costs of DMPA-SC against potential benefits in cost-savings of fewer return visits, improvement in contraceptive continuation, and reduction in the unintended pregnancy rate.
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