Joseph E Potter1, Kristine Hopkins2, Abigail R A Aiken3, Celia Hubert2, Amanda J Stevenson2, Kari White4, Daniel Grossman5. 1. Population Research Center, University of Texas at Austin, TX, USA. Electronic address: joe@prc.utexas.edu. 2. Population Research Center, University of Texas at Austin, TX, USA. 3. Population Research Center, University of Texas at Austin, TX, USA; LBJ School of Public Affairs, University of Texas at Austin, TX, USA. 4. Health Care Organization and Policy, University of Alabama at Birmingham, AL, USA. 5. Ibis Reproductive Health, Oakland, CA, USA; Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA.
Abstract
OBJECTIVES: We aimed to assess women's contraceptive preferences and use in the first 6 months after delivery. The postpartum period represents a key opportunity for women to learn about and obtain effective contraception, especially since 50% of unintended pregnancies to parous women occur within 2 years of a previous birth. METHODS: We conducted a prospective cohort study of 800 postpartum women recruited from three hospitals in Austin and El Paso, TX. Women aged 18-44 who wanted to delay childbearing for at least 24 months were eligible for the study and completed interviews following delivery and at 3 and 6 months postpartum. Participants were asked about the contraceptive method they were currently using and the method they would prefer to use at 6 months after delivery. RESULTS: At 6 months postpartum, 13% of women were using an intrauterine device or implant, and 17% were sterilized or had a partner who had had a vasectomy. Twenty-four percent were using hormonal methods, and 45% relied on less effective methods, mainly condoms and withdrawal. Yet 44% reported that they would prefer to be using sterilization, and 34% would prefer to be using long-acting reversible contraception (LARC). CONCLUSIONS: This study shows a considerable preference for LARC and permanent methods at 6 months postpartum. However, there is a marked discordance between women's method preference and actual use, indicating substantial unmet demand for highly effective methods of contraception. IMPLICATIONS: In two Texas cities, many more women preferred long-acting and permanent contraceptive methods (LAPM) than were able to access these methods at 6 months postpartum. Women's contraceptive needs could be better met by counseling about all methods, by reducing cost barriers and by making LAPM available at more sites.
OBJECTIVES: We aimed to assess women's contraceptive preferences and use in the first 6 months after delivery. The postpartum period represents a key opportunity for women to learn about and obtain effective contraception, especially since 50% of unintended pregnancies to parous women occur within 2 years of a previous birth. METHODS: We conducted a prospective cohort study of 800 postpartum women recruited from three hospitals in Austin and El Paso, TX. Women aged 18-44 who wanted to delay childbearing for at least 24 months were eligible for the study and completed interviews following delivery and at 3 and 6 months postpartum. Participants were asked about the contraceptive method they were currently using and the method they would prefer to use at 6 months after delivery. RESULTS: At 6 months postpartum, 13% of women were using an intrauterine device or implant, and 17% were sterilized or had a partner who had had a vasectomy. Twenty-four percent were using hormonal methods, and 45% relied on less effective methods, mainly condoms and withdrawal. Yet 44% reported that they would prefer to be using sterilization, and 34% would prefer to be using long-acting reversible contraception (LARC). CONCLUSIONS: This study shows a considerable preference for LARC and permanent methods at 6 months postpartum. However, there is a marked discordance between women's method preference and actual use, indicating substantial unmet demand for highly effective methods of contraception. IMPLICATIONS: In two Texas cities, many more women preferred long-acting and permanent contraceptive methods (LAPM) than were able to access these methods at 6 months postpartum. Women's contraceptive needs could be better met by counseling about all methods, by reducing cost barriers and by making LAPM available at more sites.
Authors: Brooke Winner; Jeffrey F Peipert; Qiuhong Zhao; Christina Buckel; Tessa Madden; Jenifer E Allsworth; Gina M Secura Journal: N Engl J Med Date: 2012-05-24 Impact factor: 91.245
Authors: Kate Coleman-Minahan; Chloe H Dillaway; Caitlin Canfield; Daniela M Kuhn; Katherine S Strandberg; Joseph E Potter Journal: Perspect Sex Reprod Health Date: 2018-12-03
Authors: Kristine Hopkins; Kari White; Fran Linkin; Celia Hubert; Daniel Grossman; Joseph E Potter Journal: Perspect Sex Reprod Health Date: 2015-01-30
Authors: Joseph E Potter; Kate Coleman-Minahan; Kari White; Daniel A Powers; Chloe Dillaway; Amanda J Stevenson; Kristine Hopkins; Daniel Grossman Journal: Obstet Gynecol Date: 2017-08 Impact factor: 7.661
Authors: Kavita Shah Arora; Barbara Wilkinson; Emily Verbus; Mary Montague; Jane Morris; Mustafa Ascha; Brian M Mercer Journal: Contraception Date: 2018-02-25 Impact factor: 3.375