postpartum contraception
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PLoS Medicine ◽  
2022 ◽  
Vol 19 (1) ◽  
pp. e1003878
Author(s):  
Nicole K. Richards ◽  
Christopher P. Morley ◽  
Martha A. Wojtowycz ◽  
Erin Bevec ◽  
Brooke A. Levandowski

Background Postpartum contraception prevents unintended pregnancies and short interpregnancy intervals. The Pregnancy Risk Assessment Monitoring System (PRAMS) collects population-based data on postpartum contraception nonuse and reasons for not using postpartum contraception. In addition to quantitative questions, PRAMS collects open-text responses that are typically left unused by secondary quantitative analyses. However, abundant preexisting open-text data can serve as a resource for improving quantitative measurement accuracy and qualitatively uncovering unexpected responses. We used PRAMS survey questions to explore unprompted reasons for not using postpartum contraception and offer insight into the validity of categorical responses. Methods and findings We used 31,208 categorical 2012 PRAMS survey responses from postpartum women in the US to calculate original prevalences of postpartum contraception use and nonuse and reasons for contraception nonuse. A content analysis of open-text responses systematically recoded data to mitigate survey bias and ensure consistency, resulting in adjusted prevalence calculations and identification of other nonuse themes. Recoded contraception nonuse slightly differed from original reports (21.5% versus 19.4%). Both calculations showed that many respondents reporting nonuse may be at a low risk for pregnancy due to factors like tubal ligation or abstinence. Most frequent nonuse reasons were not wanting to use birth control (27.1%) and side effect concerns (25.0%). Other open-text responses showed common themes of infertility, and breastfeeding as contraception. Comparing quantitative and qualitative responses revealed contradicting information, suggesting respondent misinterpretation and confusion surrounding the term “pregnancy prevention.” Though this analysis may be limited by manual coding error and researcher biases, we avoided coding exhaustion via 1-hour coding periods and validated reliability through intercoder kappa scores. Conclusions In this study, we observed that respondents reporting contraception nonuse often described other methods of pregnancy prevention and contraception barriers that were not included in categorical response options. Open-text responses shed light on a more comprehensive list of pregnancy prevention methods and nonuse options. Our findings contribute to survey questions that can lead to more accurate depiction of postpartum contraceptive behavior. Additionally, future use of these qualitative methods may be used to improve other health behavior survey development and resulting data.


Author(s):  
Justine M. Keller ◽  
Jessica A. Norton ◽  
Fan Zhang ◽  
Rachel Paul ◽  
Tessa Madden ◽  
...  

Objective To evaluate whether participation in CenteringPregnancy group prenatal care is associated with decreased risk of an interpregnancy interval (IPI) ≤6 months. Study Design We conducted a retrospective cohort study of women enrolled in Missouri Medicaid from 2007 to 2014 using maternal Medicaid data linked to infant birth certificate records. Inclusion criteria were women ≥11 years old, ≥1 viable singleton delivery during the study period, residency in St. Louis city or county, and ≥2 prenatal visits. The primary outcome was an IPI ≤6 months. Secondary outcomes included IPI ≤12 months, IPI ≤18 months, postpartum long-acting reversible contraception (LARC) uptake, and postpartum LARC or depot medroxyprogesterone acetate (DMPA) uptake. Data were analyzed using descriptive statistics and logistic regression. Backward stepwise logistic regression was used to adjust for potential confounders including maternal age, race, obesity, nulliparity, marital status, diabetes, hypertension, prior preterm birth, and maternal education. Results Of the 54,968 pregnancies meeting inclusion criteria, 1,550 (3%) participated in CenteringPregnancy. CenteringPregnancy participants were less likely to have an IPI ≤6 months (adjusted odds ratio [aOR]: 0.61; 95% confidence interval [CI]: 0.47–0.79) and an IPI ≤12 months (aOR: 0.74; 95% CI: 0.62–0.87). However, there was no difference for an IPI ≤18 months (aOR: 0.89; 95% CI: 0.77–1.13). Women in CenteringPregnancy were more likely to use LARC for postpartum contraception (aOR: 1.37; 95% CI: 1.20–1.57). Conclusion Participation in CenteringPregnancy is associated with a significant decrease in an IPI ≤6 and ≤12 months and a significant increase in postpartum LARC uptake among women enrolled in Missouri Medicaid compared with women in traditional prenatal care. Key Points


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nivedita Roy ◽  
Priyanka Adhikary ◽  
Rita Kabra ◽  
James Kiarie ◽  
Gitau Mburu ◽  
...  

Abstract Background Postpartum family planning (PPFP) helps women space childbirths, increase exclusive breastfeeding and prevent unintended pregnancies, leading to reduction in maternal, infant and child morbidities and mortality. Unmet need of family planning is highest among women in the postpartum period due to lack of knowledge, cultural and religious barriers, access barriers and low antenatal care service utilization. However, in spite of low prevalence of postpartum family planning practices, birth-to-birth interval is reportedly high in Delhi, India. This study explores the postpartum contraception practices and the relationship between use of postpartum contraception and subsequent child linear growth. Methods This is a mixed method cohort study on PPFP and is nested within an ongoing “Women and Infants Integrated Interventions for Growth Study” (WINGS). Married women aged 18–30 years who have delivered a live baby are recruited for quantitative interviews at 6 weeks, 6, 12, and 24 months postpartum. In-depth interviews are conducted with a randomly selected sub-sample of women at each of the four time points, 35 husbands and 20 local service providers to understand their perspectives on PPFP practices. Discussion The findings from the study will provide useful insights into couples’ contraception preferences and choice of contraception, modern and traditional, initiation time and the effect of birth spacing and contraception use on subsequent linear growth of the child. This knowledge will be of significant public health relevance and will help in designing appropriate interventions for appropriate postpartum contraception use and delivery strategies. The study aims to work address the Sexual and Reproductive Health and Rights goal of promoting reproductive health, voluntary and safe sexual and reproductive choices for women. Trial registration Trial registration number: CTRI/2020/03/023954.


2021 ◽  
Vol 29 (3) ◽  
pp. 124
Author(s):  
Junita Indarti ◽  
Lucas Christiawan ◽  
Dalri Suhartomo ◽  
Caroline Caroline ◽  
Ditha Loho

HIGHLIGHT1. As maternal mortality rate (MMR) is still high, there should be ways to reduce the rate, one of which is the prevention of conception through contraceptive methods. 2. A descriptive study was conducted to all patients giving birth in a national hospital between 2016 to 2019 covering data on the patients, including age, parity, the origin of referral, and type of contraception.3. Most patients who gave birth in the hospital had postpartum contraception, especially permanent contraception and long-term contraception. ABSTRACTObjectives: The maternal mortality rate in Indonesia is one of the highest in the world at 305 out of 100.000 live birth. One of the best ways to reduce MMR is conception prevention through contraceptive methods. According to 2018 Demographic and Health Survey, Indonesia’s Contraceptive Prevalence Rate is as low as 57%, not even reaching the 2015 Millenium Development Goals target of 65%. We conducted a study on postpartum contraceptive use in Dr. Cipto Mangunkusumo National Central General Hospital (RSCM) to see the use of contraception in RSCM so that it can be an example of how contraception is used in RSCM for patients who give birth here.Materials and Methods: A descriptive study was conducted from all patients giving birth in RSCM from 2016 until 2019, data including patient data, consisting of patient age, parity, the origin of referral, and type of contraception, are input from the medical recordResults: There were 5,596 deliveries, consisting of 3,785 C-sections and 1,811 vaginal deliveries. As much as 5332 (95.3%) of subjects had postpartum contraception, 725 (13.67%) of which received tubectomy, and most of which received long-term contraceptive methods (IUD 4414 (82.78%) and implant 44 (0.82%)). As many as 1.065 subjects were more than 35 years of age, 6,2% of which did not use any postpartum contraception. As many as 984 subjects were RSCM bookcases, 6,9% of which did not use any postpartum contraception.Conclusion: Most patients giving birth in RSCM had postpartum contraception, especially permanent contraception and long-term contraception. The contraception profile in RSCM alone can neither describe nor represent the condition and distribution of contraceptive methods in Indonesia because RSCM is a national referral and medical education center whose cases are relatively more complex.


2021 ◽  
Vol 4 (2) ◽  
pp. 150
Author(s):  
Alfi Syifa Darmastuti ◽  
Kasiati Kasiati ◽  
Muhammad Ardian Cahya Laksana ◽  
Linda Dewanti

Abstract Background: The use of postpartum contraception is ideally used after delivery under 42 days. Data obtained from the BKKBN of East Java Province, the achievement of unmet need in Surabaya is 13.31% of the unmet need target of 10.44%. The Balanced Counseling Strategy is a family planning counseling method that is practical, interactive, client-friendly, and encourages the client’s active participation. The purpose of this research is to know the effect of using BCS on improving the knowledge and attitudes of pregnant women about family planning. Method: In this quasy experimental research, pre-post with control group designed was implemented. Quota sampling is used to choose responden. Questionaire is used for research instrument. Data analysis used Paired t-test, Wilcoxon Signed Rank Test and Mann-Whitney Test. Results: Thirty nine of pregnant women are studied.  The intervention group has increased knowledge scored 16,64 (p-value = 0,003) though the control  group score 5.11 (p-value = 0,030) that is showed that there is significant different between two grups with p-value 0,045. The intervention group has increased attitudes scored 1,95 (p-value = 0,003) though the control  group 0,11 (p-value = 0,650) that is showed that there is significant different between two grups with p-value 0,015.  Conclusion: Counseling using Balanced Counseling Strategy can increase knowledge and attitude of pregnant women about family planning and more effective than pregnancy-class methods at Tanah Kalikedinding of Public Health 2019. 


2021 ◽  
Vol 4 (8) ◽  
pp. e2118912
Author(s):  
Maria I. Rodriguez ◽  
Menolly Kaufman ◽  
Stephan Lindner ◽  
Aaron B. Caughey ◽  
Ana Lopez DeFede ◽  
...  

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e048048
Author(s):  
Jacqueline Powell ◽  
Evelyn Fuentes-Rivera ◽  
Blair Darney

ObjectiveWe tested whether women who reported high-risk pregnancies or deliveries were more likely to receive immediate postpartum contraception prior to discharge compared with normal-risk women in Mexico.MethodsThis is a retrospective study using the National Health and Nutrition Survey. We classified women as high-risk based on reported complications in pregnancy and delivery. We used multivariable logistic regression to test the association of high-risk status and receipt of postpartum contraception (any modern method and Tier one methods) prior to discharge.ResultsOur sample included 5030 deliveries (population N=3 923 657). Overall, 19.1% of the sample were high risk. Over 60% of women in the high-risk and normal-risk group received immediate postpartum contraception, but a greater proportion of high-risk women received a method (67% vs 61% normal risk; p<0.001). However, in multivariable models, there were no significant differences in receipt of any modern method or tier 1 method by risk group.ConclusionWomen with high-risk pregnancies were not more likely to receive postpartum contraception than the normal-risk group, once accounting for sociodemographic and clinical factors. Prenatal and postpartum contraception counselling should address the health effects of high-risk pregnancies and interpregnancy intervals to improve maternal health outcomes.


2021 ◽  
Vol 59 (239) ◽  
Author(s):  
Mukta Singh Bhandari ◽  
Suresh Kayastha

Introduction: Contraception plays a key role in preventing unwanted births. It also decreases pregnancy and childbirth-related morbidities and mortalities, but many women don't use contraception particularly in the postpartum period. The main objective of this study was to find out the prevalence of contraception use among postpartum women in a municipality. Methods: A descriptive cross-sectional study was conducted among married women of reproductive age in Dhulikhel municipality of Kavrepalanchok from January to September 2019. Ethical approval was obtained from Institutional Review Committee and permission was taken from Dhulikhel Municipality before the study. The sample size was 332. A convenience sampling method was used. A semi-structured questionnaire pre-tested in Panauti municipality was used. Data entry and analysis were done using Statistical Package for Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated for descriptive analysis. Results: Out of total 332 women, 146 (40%) (34.73-45.26 at 95% Confidence Interval) used postpartum contraception. Injectable/Depot was used by 61 (42%) women. Total 97 (52%) of the non-users intended to use contraception in the future. The most common reason for contraception use was women not wanting the next child soon 91 (62%) and reason for non-use was feeling contraception as unnecessary 73 (39%). Conclusions: The use of postpartum contraception was poor, and only half of the non-users intended to use contraception in the future. Thus, contraception use should be encouraged during all possible contact times, and counselling should be made universal to improve postpartum contraception services' uptake.


Author(s):  
Priya G. Dhameliya ◽  
Parul T. Shah ◽  
Shlok V. Patel ◽  
Dhanvi J. Deliwala ◽  
Kinjal Kotahri

Background: Depot medroxyprogesterone (DMPA) injection 150 mg intramuscular was used in postpartum women for contraception in this study, once every 3 months. The aim of the study acceptance and compliance of DMPA, observe side effects related to usage of DMPA and establish its effectiveness as a postpartum contraception method.Methods: This is a prospective study carried out at Obstetrics and Gynaecology department over a period of 9 months and follow up was done. Only patients of full term normal delivery and Lower segment caesarean section (LSCS) were included. They were counselled properly and after their willingness for enrolment they were included in study after taken consent.Results: Out of 50 cases selected maximum patients, 48% were in the age group of 26 to 30, 38% were from lower socioeconomic class. Amenorrhoea and irregular spotting were found in 68% and 42%respectively. There was no case of failure of this contraceptive method in this study.Conclusions: DMPA is an effective and safe method of contraception in lactating period. Proper counselling will increase acceptance of DMPA. Awareness in patients regarding its benefits as compared to other contraceptive methods. 


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