Nonuse of contraceptive methods, use of less effective methods, and incorrect and inconsistent use of methods underlie the high frequency of unintended pregnancy. In addition, racial and ethnic differences in contraceptive use contribute to disparities in unintended pregnancy. While use of contraception is influenced by a complex set of factors, including access to medical care and the influence of social networks, providers have the potential to positively influence women's ability to use contraception during health care visits, especially as all non-barrier methods of contraception require either a prescription or a medical procedure. Optimizing this counseling is one approach to helping women of all race/ethnicities and socioeconomic strata to improve their ability to plan pregnancies.

In this review, we present what is known about contraceptive counseling, including how it is performed and what is known about what works, and doesn't work, in this area of health communication. We will draw on literature from other areas of health communication to inform this discussion while acknowledging the unique nature of family planning counseling. Specifically, we recognize that providing this counseling is complicated by the fact that providers and patients must not only consider the medical issues involved in method selection – such as the presence or absence of contraindications to methods and differences in method efficacy – but also consider issues that are intensely personal, including relationship influences on contraceptive use, attitudes towards side effects, and desire (or lack of desire) for future fertility. In addition, there is a need to take in consideration the history in which some family planning providers were involved in coercive efforts to limit vulnerable women's fertility when providing this counseling. Together, these factors result in the provider's role in method selection having the potential to be perceived of differently – by both the patient and the provider – then it would be in other medical decisions.