Beyond the Patient: Healthcare Providers’ Insights on Partner Engagement in Contraceptive Decision-Making

Abstract

Introduction

Family planning is a dyadic decision influenced by social, cultural, and structural factors. However, contraceptive counseling in perinatal care often centers on pregnant individuals alone, potentially overlooking the critical role of partner involvement. This qualitative study explored healthcare providers’ (HCPs) perceptions of involving partners in perinatal contraceptive education to understand the potential value and challenges of dyadic approaches, guided by the biobehavioral family model (BBFM)

Methods

Ten HCPs (including physicians, nurse practitioners, and community health directors) serving low-income populations in Appalachian Tennessee participated in semi-structured interviews. The interviews focused on their perceptions of the Planning Together intervention, a dyadic workbook designed to integrate contraceptive education with couple communication training for pregnant couples. Interview transcripts were analyzed using thematic analysis.

Results

Four primary themes emerged from the analysis: (1) Strengths and challenges of partner involvement; (2) Importance of couple communication training; (3) Ensuring patient-centeredness; and (4) Continued need for information. Providers endorsed dyadic approaches as valuable for fostering partner buy-in and consistent contraceptive use.

Discussion

Findings underscore the potential of family-centered contraceptive education to improve relational dynamics and health outcomes. However, they also highlight significant logistical (e.g., appointment attendance) and relational barriers that must be addressed. The study indicates a need for HCP training in dyadic communication skills and for e-health literacy interventions to combat misinformation. By demonstrating how relational dynamics shape contraceptive behaviors, this study advances the BBFM and offers practical strategies for integrating partners into perinatal care.

Family planning is an intimate and important decision that is affected by social, cultural, economic, and medical influences (The Lancet, 2017; Johnson et al., 2021; Silumbwe et al., 2020). Much has been studied on promoting family planning and provision during the postpartum phase, but decision-making conversations between the healthcare provider and the pregnant patient are recommended to begin as early as the preconception stage and during prenatal care. Not only are perinatal office visits during or after pregnancy the most consistent access point for contraception education, but contraceptive counseling has also been shown to be most effective when provided during both the prenatal and postpartum stages (Zapata et al., 2015). Access to contraception options and contraception education can be affected by many factors, including geography, cost, insurance, knowledge or lack of knowledge, sociocultural influences, and availability of healthcare; however, contraceptive cost is one of the most frequently reported (ACOG 2015; Auerbach et al. 2023; Newton-Levinson et al. 2024). Low-income patients are more likely to be impacted by these barriers because they may have access to fewer contraceptive choices, more limited insurance coverage, and more prohibitive transportation options (Henderson et al. 2016; Parks & Peipert, 2016). Healthcare providers can identify these barriers and communicate contraceptive information and options in a patient-centered manner, which may lead to increased contraceptive uptake and a positive patient experience (Henderson et al., 2016; Newton-Levinson et al., 2024).

Traditionally, contraception and family planning have been viewed in the context of the pregnant patient in isolation. However, some pregnant-capable people prefer a more family-centered model during this process that involves their partner or support person (Meriggiola & Goulis, 2024). A strong body of international research demonstrates that couple-based interventions that harness partner support are an understudied and important component of postpartum contraceptive usage (Challa et al. 2020; Dixit et al. 2021; Sack et al. 2022), along with other traditionally gender-siloed perinatal health behaviors (e.g., education on obstetric and newborn complications; Midhet & Becker, 2010; Susin & Giugliani, 2008). Sud's overview of dyads in medicine optimization and illness management research demonstrates the value and potential of dyadic research in healthcare overall (2021). Specifically, research considering the perspectives of both partners in the context of health and decision-making can identify interpersonal processes that underpin important healthcare decisions. Studies that focus on the individual patient can only identify individual processes, not interpersonal processes, that underpin important healthcare decisions.

In addition to recognizing the importance of the dyadic model/partner support system in family planning, provider perspectives need to be understood and incorporated to facilitate effective patient-centered contraceptive education. Physicians, nurses, pharmacists, and community health workers are all potential providers of contraceptive education and counseling. Combining patient-centered interventions with provider perspectives leads to stronger shared decision-making in the healthcare process (Meriggiola & Goulis, 2024; Rivlin & Isley, 2018).

While provider perspectives on contraceptive counseling have been investigated, not much is known about provider perception of partner involvement (Goueth et al., 2023; Manzer et al., 2024). Previous studies have shown the importance of a positive relationship between patients and providers, specifically regarding contraceptive counseling (Dehlendorf et al., 2014; Fox et al., 2018; Schivone & Glish, 2017). However, there are several barriers experienced by providers when striving for patient-centered care, such as available time to provide comprehensive care and build meaningful patient relationships (Manzer et al., 2024). These barriers can become even wider when considering the patienťs partner or family supporter in addition to the pregnant patient. Previous studies have found that both providers and patients place an importance on communication skills during contraceptive counseling (Dehlendorf et al., 2014; Manzer et al., 2024; Meriggiola & Goulis, 2024).

Biopsychosocial models of health, such as the Biobehavioral Family Model (BBFM), theorize that reducing social barriers (i.e., harnessing existing relationship support and optimizing couple communication) can improve health behaviors leading to long-term health benefits (Wood, 2003; Wood, 2017). The Biobehavioral Family Model (BBFM) connects how family relationships impact health outcomes, mediated through biobehavioral reactivity, defined as depression, anxiety, and other health behaviors. Previous BBFM-driven research has shown that high-quality couple communication predicts better long-term health outcomes and health behaviors (Roberson et al., 2018; Priest et al., 2019; Woods et al., 2020). Healthcare providers can apply the BBFM through family-oriented care, which engages supportive family members, such as intimate partners, in appointments and collaborative treatment planning (Wood et al., 2021). These family-oriented interventions can be more meaningful and lead to more specific and supported care. Applying this to contraceptive education, the BBFM framework posits that improved couple communication during family planning decision-making can increase consistent contraceptive use during the postnatal period.

Due to the social, cultural, economic, and medical influences that impact family planning, provider perspectives are a key first step in designing a novel dyadic contraception education intervention. This study population includes providers working in the Tennessee Appalachia area with patients living in urban, suburban, and rural settings. A setting this unique can also present unique barriers. Finances, such as insurance and billing, and transportation were two barriers identified by contraception providers in a neighboring southern state, South Carolina (Mann et al., 2022). However, “very little is known about contraceptive behavior in Appalachia” (Auerbach et al. 2023). Through the lens of the BBFM, this study will investigate provider perspectives on partner involvement in contraceptive education delivered in a perinatal clinical setting and barriers to consistent contraceptive use led by the following research question:

What are the perceptions and considerations of Healthcare Professionals [HCP]s who work in South Central Appalachia, when involving partners in contraceptive education delivered in a perinatal clinical setting?

Method

Self-of-the-Researchers

The authors and researchers are part of an interdisciplinary research team. The perspectives and intentions of the individual authors are presented in Table 1.

Table 1.

Author Positionality

Author	Positionality Statement
Patricia N.E. Roberson	White, cis-gender, straight female from the Southeast. Faculty member with training as a family scientist and marriage and family therapist. My research focuses on the role of family on adult health and developing family-based behavioral health interventions.
Kendall Brady	White, cis-gender, straight female from the Southeast. Medical student committed to family medicine who studies improving healthcare access and reproductive health experiences.
Angela Hiefner	White, cis-gender, straight Christian female from the Midwest. A Marriage and Family Therapist with research interests in women’s health.
Amy Alspaugh	White, cis-gender, straight female from Appalachia. Certified Nurse-Midwife, nurse scientist, and nursing professor who studies improving sexual and reproductive health experiences and midwifery workforce issues.
Alexandria Wilson	White, cis-gender, straight female from Southeast. Medical librarian with faculty assignment who specializes in evidence synthesis, research support, and liaises with the department of OBGYN
Jill Maples	White, cis-gender, straight Christian female from the Midwest. Faculty member with broad research training in translational research, social sciences, and clinical research in women’s health.
Nikki Zite	White, cis-gender, straight Jewish female from the Midwest. OBGYN with subspecialty training in Complex Family Planning who practices full spectrum OBGYN care and conducts contraceptive access research and advocacy.

Procedure

To assess HCP perceptions and considerations, this study examined professional feedback on a proposed dyadic contraceptive education intervention called Planning Together. Planning Together includes an interactive educational workbook that includes both contraceptive and couple communication training. The workbook is designed to be completed during pregnancy, a couple’s consultation to review learned material before delivery, and two booster check-ins to promote application postnatally. Part of the Planning Together intervention, an interactive contraceptive education workbook was designed for pregnant couples to learn facts about available contraceptive methods and effective communication strategies before jointly selecting a preferred contraceptive method to use postnatally. We utilized referrals and snowball strategies to recruit ten healthcare professionals familiar with the patient population and/or actively providing contraceptive education in the Appalachian region of Tennessee. We aimed to recruit a variety of healthcare professionals to increase the diversity of perspectives. Following completion of the informed consent and initial demographic survey, each participant was given the proposed workbook to review and provide feedback on the content based on their professional experience with the target population. Next, a semi-structured virtual interview was conducted by a member of the research team to evaluate each HCP's feedback on the program and personal experience providing contraceptive education to low-income patients. The interview guide is provided in Supplemental Material A. All interviews were transcribed using an electronic transcribing software and cross-referenced for accuracy by members of the research team.

This study was approved by our local internal review board (IRB; #5175) for human subject research at the University of Tennessee Health Science Center, College of Medicine, Knoxville. All participants read and signed the IRB-approved informed consent prior to participating in the study.

Participants compliment

Participants consisted of 3 OBGYN Physicians, 1 Family Physician, 1 Maternal Fetal Medicine Fellow, 4 APRNs, and 1 Community Health Program Director. Inclusion criteria was assessed based on experience (1) working with pregnant people and their romantic partner and (2) providing contraceptive education to patients. With a broad range of clinical experience (<1 year-29 years), most participants identified as female (90%), Non-Hispanic/Latino/a (90%), and White (80%). Individual demographic information is detailed in Table 1.

Analysis

Three members of the research team reviewed all transcripts and conducted thematic analysis using ATLAS.ti Web (version 9.18.0) (ARLAS.ti; 2025; Vaismoradi et al., 2013). In the initial review of the transcripts, this analysis team identified emerging codes and themes to develop a coding structure. This coding structure was reviewed and discussed by the full research team to ensure rigor and trustworthiness of the data interpretation (Morse et al., 2002). To best support rigor and trustworthiness in the analysis, the research team was intentionally constructed with both relationship researchers and healthcare professionals for diverse perspectives within the data analysis. The finalized coding structure was then applied to each transcript.

Results

During our interviews with healthcare professionals (HCP) about the Planning Together protocol and workbook, four major themes emerged regarding HCP’s perceptions of partner involvement in perinatal contraceptive education.

Theme 1: Strengths and Challenges with Partner Involvement

Eight of the ten HCPs described strengths and/or challenges with partner involvement in discussions about contraception and family planning with. Five of the ten highlighted partner involvement as a particular strength of the intervention, noting that this dyadic approach is valuable and supports contraceptive decision-making. They described the dyadic approach as supporting their work as HCPs, and the patients and partners they serve, in multiple ways. First, one HCP shared that the partner's presence in the prenatal visit makes it easier to introduce the topic of contraception and the available options: “Iťs a lot easier to introduce these sorts of things and talk about it, you know, and so I do feel like when [partners] come all the time, iťs been a lot easier to talk about things” (HCP4). Second, others described partner involvement as bolstering the support available to the patient as they navigate the decision-making process. One HCP stated, “I love the partner aspect. I think thaťs really smart. And I think that also helps people come to their conclusion and feel good about their choices, too” (HCP1). Others described partner involvement as helping to shift the dominant narrative that contraception is primarily the pregnant partner's responsibility, and moving toward a norm of shared responsibility, collaboration, and aligning family planning goals:

And I think that especially right now, we need to highlight the fact that contraceptive access benefits everyone. … This is your life, too. You know, this is not just the life of someone you care about. Iťs your life, too. Iťs your contraceptive plan, because the two of you are having sex. And I think that we need to get men bought in on having a contraceptive plan, and if they're not with a partner, then, of course the contraceptive plan is condoms for most, and vasectomy, and I donť know, cross fingers. But when you're in a relationship, shifting that dialogue to like, this is also your contraceptive plan. This is your family planning plan. (HCP6)

Though there was agreement about the value of partner involvement, five HCPs shared that partner presence is infrequent at visits, which could serve as a challenge. One mentioned that “partners typically come to the first visit and the anatomy scan, but not necessarily all the rest of the visits, unless there's an ultrasound,” and “even fewer partners come to the postpartum visit,” so partners may miss the visits in which contraception is discussed (HCP4). Another acknowledged the barriers couples may face in attending appointments together:

I donť get a lot of dads in the room for my patients. And thaťs not to say that dads arenť involved at home necessarily. But I just donť know if I know how successful, you know, it would be for my patients, or whether when you consider childcare and working, and like all this stuff, if there would be a time limitation, particularly for my specific population at an FQHC. (HCP10)

Lastly, 3 HCPs described the important challenge of considering relational and power dynamics. HCP3 recommended “[encouraging] them that this is a decision of the couple. Probably in this meeting, being aware if there are any power imbalances. But yeah, because sometimes iťs like, maybe they reach a decision. And maybe just one person made the decision.” Others highlighted the value of joint decision-making between partners, but acknowledged caution around male partners dominating the decision-making:

I kind of see it happen both ways. Sometimes iťs a great conversation between the patient and the partner when they're at the visits, and we all three can talk about it and give an opinion. You know, they'll each give their opinion on what they prefer. And then sometimes I see them, and you can just see the woman kind of shut down and not say anything, and you can tell she has opinions, but then just goes with whatever he says. (HCP8)

Overall, healthcare providers strongly valued the dyadic approach for its role in facilitating conversations, building patient support, and promoting shared responsibility in family planning. However, they identified a key challenge: partners are frequently absent from visits where contraception is discussed. Additionally, providers noted the need to navigate relational dynamics carefully to ensure their approach supports, rather than undermines, collaborative and equitable couple decision-making.

Theme 2: Importance of Couple Communication Training

Five of the ten HCPs described ways in which the couple communication training proposed in the Planning Together workbook may be important beyond contraceptive decision-making and extend to parenting and other relationships as well. They shared that these strategies “could be applied to all sorts of conversations” (HCP9) and that “these things are so important to be positive with your kids, too” (HCP2). Another described the broader impact on couples that this communication training can have:

If they're willing to do it, iťs good for life. Not just talking about birth control, but iťs helpful communication just in general. So I do think that is helpful, because I feel like a lot of our population doesnť have a lot of support, and maybe havenť had, like, someone to show them what good communication looks like or what even a healthy relationship is. So I know thaťs not what you guys are trying to do. Iťs really about birth control. But I think that it helps in a lot of other areas in their lives. (HCP5)

Healthcare providers perceived the couple communication training as a valuable and transferable skill set. They emphasized that the strategies extend beyond the immediate goal of contraceptive decision-making, offering couples tools that can improve communication in broader contexts, such as parenting and general relationship health, which may be particularly impactful for populations with limited prior exposure to models of healthy communication.

Theme 3: Ensuring Patient-Centeredness

Four of the ten HCPs mentioned the importance of considering each patienťs/couple's context when discussing contraception planning during pregnancy. These HCPs emphasized aligning their goals with each patienťs or couple's goals for family planning, how contraception decisions are made, and ensuring alignment between a particular contraceptive method and lifestyle considerations (e.g., ability or desire to take a pill every day or follow up every three months for a Depo shot). Regarding decision-making, HCP3 highlighted the role of culture: “There are cultures in which some other people tend to want to be part of the decision-making process. … So, I think we need to consider the other factors that they might find as a factor that affects their decision.” HCP10 recommended “just kind of letting them lead with their goals. And then, although of course iťs their decision. But you know, then I can kind of cater the ways that I talk about this in terms of what their goals are.” HCP6 felt that this approach “is the best way to get people kind of talking and listening and having a conversation instead of just getting a prescription, and then you just cross your fingers on your patienťs behalf.”

Two HCPs described acknowledging the current pregnancy as a critical component of patient-centered contraceptive discussions during pregnancy. HCP4 described creating a frame for contraceptive conversations that addresses future family planning without detracting from couples' experiences of their current pregnancy:

I think you want to be, you know, make sure you are acknowledging the current pregnancy. Because I think some patients are like, 'I just have to think about this baby. I'll think about that later.' So I think, yeah, just making sure that iťs not all focused on later, like, 'What can we do to make me not pregnant?' Again, you know, focus more on, 'Okay, what can we do to help you enjoy this baby in time when you want future babies?' (HCP4)

Two HCPs also emphasized the importance of considering contraception as the patienťs decision, versus the provider's decision. HCP1 described how a more “paternalistic” or directive approach can interfere with a patienťs or couple's success with contraception:

I almost feel as though, if we are pressuring people into making a decision, or we're convincing someone to try something that maybe they're not actually excited about, or that they donť actually think is right for their body, but they're just saying yes, because their doctor told them to. Then, I think that greatly impacts the consistency of use and greatly impacts how the patient feels about their overall contraceptive plan. So I think for me, the times whenever a patient has been consistent and has been excited about their contraceptive method has been the times when they've come to their conclusions on their own. I've given them knowledge, and I've helped them reach their conclusion. But they've come to their conclusion on their own. (HCP1)

Healthcare providers emphasized that patient-centeredness in contraceptive counseling requires a tailored, non-directive approach. This involves prioritizing the patienťs/couple's goals, cultural context, and lifestyle over provider preference, and framing future planning in a way that respectfully acknowledges their current pregnancy to foster genuine engagement and consistent contraceptive use.

Theme 4: Continued Importance of Information

In discussions about the content of couples-based contraceptive conversations, all ten HCPs described perceptions of the importance of information-sharing in terms of not only details about each contraceptive method, but also for dispelling myths that arise from various sources of information and normalizing switching methods when needed. The information-sharing can help patients “feel empowered” (HCP2) in their contraceptive decision-making. The HCPs highlighted several key pieces of information that can empower patients, including the pros and cons to various methods, what patients can expect with a method in terms of placement or side effects, what is normal and what is not after starting a new method, clear details on how the method is used and maintained over time, and visual tools to convey size and material.

Four of the HCPs shared that these conversations require dispelling many myths about contraceptive methods, and 7 HCPs described perceived challenges related to the sources from which patients obtain information about contraception. HCP6 shared about the difficulty of addressing incorrect information while maintaining a patient/couple-centered perspective, particularly within contexts of distrust toward healthcare providers:

So thaťs been one of the challenges that I've had is threading the needle between trying to reassure them that these things arenť likely to happen and talk to them about the data and talk to them about why it may seem that way. But also not making them feel like their fears arenť valid or making them feel stupid, because all of these incorrect messages are also paired with, and doctors donť care, and doctors donť listen, and doctors arenť gonna tell you the truth. (HCP6)

The HCPs shared that their patients obtain contraceptive information from family and friends, Google, and particularly social media. HCP9 described social media as “a powerful force in so many people's lives” that is “really hard to counter.” For many of these HCPs, attending to these sources of information plays a large role in their contraceptive conversations with patients:

There are patients who come in after Googling things and getting on social media and watching TikTok. They come in, and they have concerns about, you know about, for example, with an IUD, if iťs painful, there's a lot of word of mouth where patients tend to say, 'Well, I've heard this, or I've read this, that this can cause problems or complications.' And so yes, I have experienced that in my practice, where people have come in and have had, or been given misinformation. Usually based on word of mouth from their friends or from social media. (HCP7)

Lastly, two of the HCPs emphasized the value in clarifying for patients that switching contraceptive methods is not only acceptable, but normal. During these conversations, HCPs can create space for partners to revisit their chosen contraceptive method with each other and with their provider:

One thing that I'm thinking about is leaving the door open in terms of iťs not because you made a decision that there is no way back. Make sure that you leave the conversation open, and that you build trust with your partner. Saying, 'You know what, I'm having double thoughts about that. I would like to revisit that.' (HCP3)

Healthcare providers underscored that effective contraceptive counseling must prioritize comprehensive, clear information-sharing to empower patients. This involves actively countering prevalent myths often sourced from social media and personal networks, and normalizing the idea that contraceptive methods can be changed, thereby fostering adaptability and trust in the decision-making process.

Discussion

Quality contraceptive education access is an integral part of family planning, particularly for low-income couples who may have fewer resources to access their preferred contraceptive method compared to more affluent couples. In addition to socioeconomic barriers to contraceptive education access, research also points to male romantic partners as a barrier to consistent contraceptive use, because of a lack of contraceptive knowledge (Anaman-Torgbor et al., 2025). Given that a consistent access point to contraceptive education for adults is during perinatal office visits during or after pregnancy, the present study sought to identify perceptions and considerations of Healthcare Providers [HCPs] regarding romantic partners' involvement in contraceptive education delivered in this setting. The four themes we identified may have important clinical and research implications to (1) inform HCPs training to include family-centered communication skills; (2) identify access points to expand couple and parenting communication education; (3) adopt E-health literacy education programs for patients and families; and (4) inform future research to examine the role of family members in patient-centered care.

Eight of the 10 HCPs identified strengths and challenges with involving partners in contraceptive education and decision-making. Notably, several HCPs identified challenges with partner involvement that may be addressed through couple and family communication training for HCPs. Basic family-centered communication skills may be critical for HCPs who may navigate challenging relationship power dynamics between partners when making healthcare decisions, as explained by HCP8. After all, couples may struggle with differing values, fears, or priorities regarding contraception decision-making, and basic family-centered communication skills may provide the HCPs with tools to facilitate constructive dialogue, active listening, and empathy to ensure that both parties feel heard. Additionally, HCPs were concerned that many romantic partners do not attend appointments, making joint couple contraceptive education and decision-making challenging. Through engaging the partner via family-centered communication skills, HCPs can foster a sense of teamwork and help partners align their goals, leading to joint buy-in in their contraceptive decision-making. Such buy-in by a romantic partner may lead to more consistent appointment attendance and ultimately consistent use of the couple's desired contraceptive method. Therefore, these family-centered communication skills may be an important skill for perinatal HCPs who are the primary resource for adults to access contraceptive education.

Couple communication training for the couples was also identified by providers as important. Many providers identified that teaching couples communication skills about a specific topic (e.g., contraceptive decision-making) would naturally extend to parenting and other relationships. In fact, research suggests that healthy couple communication patterns are linked to long-term relationship stability, mental and physical health (Gottman & Levenson, 2002; Priest et al., 2019; Roberson & Fincham, 2018; Roberson et al., 2018; Robles et al., 2014), and in some cases, better financial stability (Fan & Babiarz, 2019; Teachman & Paasch, 1994). However, access to couples therapy to acquire such skills is often not available for couples without sufficient financial resources or insurance, and therapy resources are often not accessible outside of urban areas (Hubbard & Anderson, 2022). Therefore, perinatal appointments that couples attend together could be an important access point for couple communication education that might imbue couples with resiliency strategies, such as effective problem-solving, to overcome future financial and parenting stressors that often cause relationship dissolution and mental stress.

A consistent concern across HCPs was individual and couple contraceptive misinformation through social media. The ability to “seek, find, understand, and apprise health information from electronic sources,” including social media (Norman and Skinner, 2006), is termed “e-health literacy.” Traditional health literacy focuses on an individual's ability to obtain and process health information (often provided by medical professionals). However, e-health literacy requires the additional skills of information and media literacy (i.e., knowing if the source of the information is credible and being able to detect bias in the source provider) and computer literacy (i.e., having the skills necessary to use computer software and hardware required to access health information). E-health literacy for evaluating contraceptive information may be particularly critical given our unfettered access to health information on social media. Education programs to improve e-health literacy may be a crucial aspect of sex education curricula in high schools for minors and primary care clinics for adults.

Ensuring patient-centered care for contraceptive education, as noted by several HCPs, is imperative to safeguard the autonomy necessary to promote the health and well-being of women (Dehlendorf et al., 2016; Pew Research Center, 2025). At the same time, we know that consistent contraceptive use of preferred methods relies on engaging their male sexual partner in the decision-making process (Adelekan et al., 2014; Institute for Reproductive Health, 2013; Kraft et al., 2014). Currently, contraceptive education programs in the US place the burden of contraceptive decision-making and planning on the person who is capable of becoming pregnant (Yee et al., 2015) but have demonstrated minimal effectiveness (Pazol et al., 2015; Whitaker et al., 2014). A strong body of international research demonstrates that couple-based education that harnesses partner support is an important but understudied component of postpartum contraceptive use (Challa et al., 2020; Dixit et al., 2021; Sack et al., 2022), indicating a potential educational method for improving family planning in the US moving forward. Seemingly, the path forward to improving family planning must thread the needle between ensuring patient-centered care and couple-informed strategies to ensure partner “buy-in.” This may be particularly challenging in the context of medical privacy rules, such as the Health Insurance Portability and Accountability (HIPAA) Act of 1996, and well-documented gendered power dynamics and violence associated with family planning negotiations (Bergmann & Stockman, 2015).

Limitations

The findings of this study should be understood in the context of three important limitations. First, the themes were identified from interviews designed to understand providers' opinions of a couple-based contraceptive education program. Also, these data were collected cross-sectionally, so identified themes may reflect HCPs’ recent interactions with patients and not the stability of themes or perceptions over time. We attempted to minimize the impact of these limitations by achieving data saturation and ensuring participants had a variety of professional perspectives and length of experience.

Conclusion

In conclusion, this study highlights the potentially important role of couple-based contraceptive education in improving family planning outcomes, particularly for low-income couples. The findings underscore the potential importance of HCP training in family-centered communication skills, expanded access to couple communication education, and e-health literacy programs to combat contraceptive misinformation. While patient-centered care remains paramount, integrating partner engagement strategies—without compromising autonomy—could enhance consistent contraceptive use, relationship quality, and ultimately better maternal and family long-term health. However, challenges such as community resource limitations and gendered power dynamics must be addressed to implement these couple-based contraceptive education effectively while ensuring patient privacy is maintained. Future research should explore couple-based contraceptive education the US, building on existing international evidence, to develop equitable, holistic, and scalable approaches to effective contraceptive education.