Michele O'Shea1, Roya Zandi2, Natasha Kamat2, Kristina Warner3, Sarah Collins4, Margaret Mueller4, Kimberly Kenton4, Christina Lewicky-Gaupp4. 1. Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Duke University, NC, Durham, USA. michele.oshea@duke.edu. 2. Feinberg School of Medicine, Northwestern University, IL, Chicago, USA. 3. Department of Obstetrics and Gynecology, Northwestern University, IL, Chicago, USA. 4. Division of Female Pelvic Medicine and Reconstructive Surgery, Northwestern University, IL, Chicago, USA.
Abstract
INTRODUCTION AND HYPOTHESIS: Our primary objective was to compare rates of contraceptive use among postpartum heterosexual primiparous women with and without obstetric anal sphincter injury (OASIS). The secondary objective was to compare fertility desires among women with and without OASIS. METHODS: This was a planned secondary analysis of a prospective cohort study of postpartum sexual function among primiparous postpartum women. Women with a history of vaginal delivery with and without OASIS completed online surveys at baseline and 3 months postpartum. RESULTS: Sixty-nine women completed baseline and 3-month surveys. Forty-one percent of women with OASIS and 36% without OASIS were not using contraception at 3 months postpartum. One-third of women in either group reported using at least moderately effective contraception (P = 0.9), defined as using hormonal contraception or an intrauterine contraceptive device, and excluding condoms. Most women with OASIS (54%) desired to wait 1 to 2 years before attempting another pregnancy. One fifth of women with and without OASIS desired another pregnancy within the next year (P = 0.4). CONCLUSIONS: A minority of postpartum primiparous women in the present cohort reported using moderately effective contraception 3 months postpartum, regardless of whether they sustained OASIS. The discrepancy between current contraceptive use and desired birth spacing suggests an unmet contraceptive need within our population and an opportunity for improved contraceptive counseling consistent with patients' family planning goals, as well as national and international guidelines on birth spacing. Larger prospective studies are needed to further understand the unmet contraceptive need among women with OASIS.
INTRODUCTION AND HYPOTHESIS: Our primary objective was to compare rates of contraceptive use among postpartum heterosexual primiparous women with and without obstetric anal sphincter injury (OASIS). The secondary objective was to compare fertility desires among women with and without OASIS. METHODS: This was a planned secondary analysis of a prospective cohort study of postpartum sexual function among primiparous postpartum women. Women with a history of vaginal delivery with and without OASIS completed online surveys at baseline and 3 months postpartum. RESULTS: Sixty-nine women completed baseline and 3-month surveys. Forty-one percent of women with OASIS and 36% without OASIS were not using contraception at 3 months postpartum. One-third of women in either group reported using at least moderately effective contraception (P = 0.9), defined as using hormonal contraception or an intrauterine contraceptive device, and excluding condoms. Most women with OASIS (54%) desired to wait 1 to 2 years before attempting another pregnancy. One fifth of women with and without OASIS desired another pregnancy within the next year (P = 0.4). CONCLUSIONS: A minority of postpartum primiparous women in the present cohort reported using moderately effective contraception 3 months postpartum, regardless of whether they sustained OASIS. The discrepancy between current contraceptive use and desired birth spacing suggests an unmet contraceptive need within our population and an opportunity for improved contraceptive counseling consistent with patients' family planning goals, as well as national and international guidelines on birth spacing. Larger prospective studies are needed to further understand the unmet contraceptive need among women with OASIS.
Authors: Christina Lewicky-Gaupp; Alix Leader-Cramer; Lisa L Johnson; Kimberly Kenton; Dana R Gossett Journal: Obstet Gynecol Date: 2015-05 Impact factor: 7.661
Authors: Alix Leader-Cramer; Kimberly Kenton; Bhumy Davé; Dana R Gossett; Margaret Mueller; Christina Lewicky-Gaupp Journal: J Sex Med Date: 2016-08-03 Impact factor: 3.802
Authors: Olga Ramm; Victoria G Woo; Yun-Yi Hung; Hsuan-Chih Chen; Miranda L Ritterman Weintraub Journal: Obstet Gynecol Date: 2018-02 Impact factor: 7.661