Date of Award


Document Type

Open Access Thesis

Degree Name

MS in Physician Assistant Studies (PA)


Physician Assistant Studies

First Advisor

Stephanie Elko


Many barriers to contraceptive use exist in sexually active Nicaraguan women, leading to increasingly high rates of unintended pregnancies among these women. Higher rates of depression, domestic abuse, and unemployment are also seen in this group of women. These women face more complications during pregnancy and receive higher rates of unsafe abortions, impacting the mom and the infant, as well as the community in which they live. Some of the barriers to contraceptive use include lack of access to healthcare, lack of knowledge about contraceptive methods, negative attitudes about contraceptives, providers’ fear of criticism, previous dissatisfaction or contraceptive failure, family history of teen pregnancy, cultural and media-related stigma, and the cultural belief of Machismo. These barriers were identified through literature review and fieldwork completed in Nicaragua. Recognizing these barriers allows interventions to take place to reduce the number of unintended pregnancies and the problems they pose on the woman, infant, and community. While not all barriers can be eliminated, steps can be taken to improve access and education about contraceptive use to allow all women of reproductive age to have a choice about their sexual health.