Even if family planning services are otherwise available, many women may lack access because they are not permitted to decide on their own to use family planning. Others may not seek services because the available services have a poor reputation in the community (36, 258). For example, such obstacles as lack of privacy or confidentiality at clinics, or negative attitudes toward certain medical procedures (such as pelvic exams) may deter otherwise motivated women from seeking services (14).

Unnecessary medical requirements discourage some people from seeking family planning, prevent others from choosing their preferred method, and lead still others to discontinue use (180). Removing unnecessary requirements to using family planning safely and effectively can improve access. Such barriers can include overly strict eligibility criteria for certain methods, unnecessary physical examinations, rules requiring frequent follow-up visits, and regulations that prohibit health care personnel other than physicians from delivering family planning services (180). As they review current findings about modern contraceptives, their safety, and their risks, more health care professionals and policy-makers may decide to remove these unnecessary medical barriers to family planning (180, 247, 264, 269).