Contraceptive choices of overweight and obese women in a publically funded hospital: possible clinical implications

Contraception. 2012 Aug;86(2):122-6. doi: 10.1016/j.contraception.2011.12.004. Epub 2012 Mar 28.


Background: Despite the growing obesity epidemic in the United States, family planning for overweight and obese women has been understudied. The aim of this study was to describe the contraception methods selected by normal weight, overweight and obese women.

Study design: We retrospectively reviewed 7262 charts of women who underwent first trimester surgical termination of pregnancy at the John H. Stroger, Jr. Hospital of Cook County between January 1, 2008, and January 1, 2010. We analyzed the relationship between body mass index (BMI) and choice of contraceptive method, after adjusting for age, race, smoking and level of education.

Results: When compared to patients with BMI <25 kg/m², overweight (BMI 25-29.9 kg/m²) and obese patients (BMI ≥30 kg/m²) were more likely to select the intrauterine device (OR 1.3, 95% CI 1.28-1.32 for overweight; OR 1.6, 95% CI 1.59-1.61 for obese), contraceptive ring (OR 1.4, 95% CI 1.28-1.52 for overweight; OR 1.6, 95% CI 1.57-1.63 for obese) and tubal ligation (OR 1.5 95% CI 1.44-1.62 for overweight; OR 2.9, 95% CI 2.79-3.01 for obese). They were less likely to choose injectable contraception (OR 0.7, 95% CI 0.59-0.81 for overweight; OR 0.52, 95% CI 0.48-0.56 for obese). There was no relationship between BMI and choice of condoms, oral contraceptive pills and implantable methods.

Conclusion: In our population, the contraceptive choices of overweight and obese women differed from those of normal weight women. These differences in contraceptive selection are important to recognize in light of the potential effect of BMI on the safety and efficacy of different contraceptive methods. Further research is needed to evaluate the contraceptive preferences, risks and benefits for overweight and obese women.

MeSH terms

  • Abortion, Induced / economics
  • Adult
  • Body Mass Index
  • Chicago
  • Choice Behavior*
  • Contraception Behavior*
  • Contraceptive Devices, Female / economics
  • Contraceptive Devices, Female / statistics & numerical data
  • Family Planning Services / economics
  • Female
  • Health Behavior*
  • Hospitals, County* / economics
  • Humans
  • Intrauterine Devices / economics
  • Intrauterine Devices / statistics & numerical data
  • Medical Records
  • Obesity / complications*
  • Obesity / economics
  • Overweight / complications*
  • Overweight / economics
  • Pregnancy
  • Pregnancy Complications / economics
  • Pregnancy Complications / prevention & control*
  • Pregnancy Trimester, First
  • Retrospective Studies
  • Sterilization, Tubal / statistics & numerical data
  • Young Adult