"I Just Don't Think I Can Deal:" Contraceptive Method Acceptability, Dealbreakers, and Women's Embodied Sense of Self

Introduction For many cisgender women, bodily experiences and perceptions of contraceptive acceptability (or, whether or not they feel they can use certain methods) are intimately linked. However, we need more information regarding how women's understandings of their embodied selves relate to contraceptive "dealbreakers"-or, characteristics of contraceptive methods that lead women to reject certain methods. Methods Between 2018 and 2020, we conducted 30 semi-structured interviews with cisgender women enrolled in a contraceptive initiative study. We used a process of thematic analysis, including initial open coding followed by focused coding, to identify themes related to women's contraceptive dealbreakers. Results We found that women's method dealbreakers revolved around three key circumstances: (1) a lack of trust that methods would help women prevent pregnancy and maintain bodily autonomy, (2) if methods disrupted a predictable monthly menstrual cycle, and (3) when methods prevented women from having the kind of sex lives they wanted. Conclusions Rather than prioritize efficacy above all else, we find that women's negotiation of their contraceptive dealbreakers reveals nuanced decision-making informed by the continued importance of embodied womanhood. Women's experiences with their bodies inform contraceptive acceptance, tolerance, and enthusiasm about different methods. Our findings have important implications for contraceptive counseling, method research and development, and contraceptive equity.