Women’s and healthcare providers’ experiences of contraceptive counselling: a qualitative systematic review

Abstract

Background: Persistent inequalities shape women’s access to and experiences of contraceptive care. Improving care quality requires a clearer understanding of women-provider interactions. This study aimed to synthesise women’s and healthcare providers’ experiences of contraceptive counselling. Methods: This qualitative systematic review with inductive thematic synthesis followed the JBI methodology. Eligible studies in English, Portuguese, or Spanish published from database inception to 16 June 2025 were identified in CINAHL Ultimate, MedicLatina, MEDLINE Ultimate, the Psychology and Behavioral Sciences Collection, and Scopus. An initial limited search, development of search terms, and comprehensive databases searches were undertaken; the PRISMA flow diagram summarised study selection. Two reviewers independently appraised quality using the JBI Critical Appraisal Checklist for Qualitative Research, and extracted data on study objectives, design, setting, participants, and main themes using a standardised form. Results: Nine studies met the inclusion criteria. Six explored women’s experiences, two examined healthcare providers’ experiences, and one addressed both. Three overarching themes emerged: Contraceptive Engagement, Woman-Provider Relationship, and Decision-Making Process. Women and healthcare providers identified economic constraints, religious beliefs, and information gaps as common obstacles to contraceptive engagement. Healthcare providers emphasised woman-centred care, aligning with women’s preference for non-judgemental, proactive, and respectful counselling. The decision-making process was the most prominent theme, with informed and respected decisions serving as central facilitators. Conclusion: High-quality counselling requires recognising women’s needs and adopting empowerment strategies. Integrating these insights into services and expanding counselling delivered by trained healthcare providers are essential to improve access and quality. Further research should inform education and training programmes.