Aishat Olatunde1, Safiyah Hosein2,3, Andrew Paoletti2, Alexis Pitcairn-Ramirez2,4, Elizabeth P Gurney2,5. 1. Department of Obstetrics and Gynecology, Einstein Medical Center Philadelphia, Lifter 1614, 5501 Old York Road, Philadelphia, PA, 19141, USA. aishat.olatunde@gmail.com. 2. Department of Obstetrics and Gynecology, Einstein Medical Center Philadelphia, Lifter 1614, 5501 Old York Road, Philadelphia, PA, 19141, USA. 3. Women and Infants Hospital, Brown University, 101 Dudley Street, Providence, RI, 02905, USA. 4. Complete Women's Care, 1951 SW 172nd Avenue, Suite 416, Miramar, FL, 33029, USA. 5. Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, 1695 Eastchester Road, Bronx, NY, 10461, USA.
Abstract
OBJECTIVES: To compare the prevalence of highly effective contraceptive use by 12 weeks postpartum among participants of Centering Pregnancy®, a model of group prenatal care (GPC), and traditional prenatal care (TPC), and to investigate differences in contraceptive method choice by type of prenatal care. METHODS: We performed a retrospective review of all eligible patients who participated in GPC (n = 143) and a random sample of patients participating in TPC (n = 290) who followed up at our institution within 12 weeks of delivery. Our primary outcome was the proportion of participants using a highly effective contraceptive method within 12 weeks postpartum. Contraceptives were classified in tiers (Tier 1, long-acting reversible and permanent contraception; Tier 2, oral contraceptive pills, transdermal patch, vaginal ring, or injection; Tier 3, barrier and fertility awareness methods, withdrawal, spermicide; and no method). Tier 1 and Tier 2 methods were considered highly effective. RESULTS: The prevalence of highly effective contraceptive use by 12 weeks postpartum was 63.6% (91 of 143) and 63.1% (183 of 290) among participants in GPC and TPC, respectively (p = 0.99). We found no difference in Tier 1 versus other method use (adjusted odds ratio (aOR) 1.05, 95% CI 0.95-1.15, p = 0.34) or Tier 2 versus other method use between groups (aOR 0.98, 95% CI 0.89-1.08, p = 0.69), in a multivariable model controlling for demographic and clinical factors. CONCLUSIONS FOR PRACTICE: The prevalence of highly effective contraceptive use at 12 weeks postpartum was not different between GPC and TPC participants in this study. GPC was not associated with increased use of Tier 1 or Tier 2 contraceptive methods.
OBJECTIVES: To compare the prevalence of highly effective contraceptive use by 12 weeks postpartum among participants of Centering Pregnancy®, a model of group prenatal care (GPC), and traditional prenatal care (TPC), and to investigate differences in contraceptive method choice by type of prenatal care. METHODS: We performed a retrospective review of all eligible patients who participated in GPC (n = 143) and a random sample of patients participating in TPC (n = 290) who followed up at our institution within 12 weeks of delivery. Our primary outcome was the proportion of participants using a highly effective contraceptive method within 12 weeks postpartum. Contraceptives were classified in tiers (Tier 1, long-acting reversible and permanent contraception; Tier 2, oral contraceptive pills, transdermal patch, vaginal ring, or injection; Tier 3, barrier and fertility awareness methods, withdrawal, spermicide; and no method). Tier 1 and Tier 2 methods were considered highly effective. RESULTS: The prevalence of highly effective contraceptive use by 12 weeks postpartum was 63.6% (91 of 143) and 63.1% (183 of 290) among participants in GPC and TPC, respectively (p = 0.99). We found no difference in Tier 1 versus other method use (adjusted odds ratio (aOR) 1.05, 95% CI 0.95-1.15, p = 0.34) or Tier 2 versus other method use between groups (aOR 0.98, 95% CI 0.89-1.08, p = 0.69), in a multivariable model controlling for demographic and clinical factors. CONCLUSIONS FOR PRACTICE: The prevalence of highly effective contraceptive use at 12 weeks postpartum was not different between GPC and TPC participants in this study. GPC was not associated with increased use of Tier 1 or Tier 2 contraceptive methods.
Authors: Paul A Harris; Robert Taylor; Robert Thielke; Jonathon Payne; Nathaniel Gonzalez; Jose G Conde Journal: J Biomed Inform Date: 2008-09-30 Impact factor: 6.317
Authors: Ebony B Carter; Lorene A Temming; Jennifer Akin; Susan Fowler; George A Macones; Graham A Colditz; Methodius G Tuuli Journal: Obstet Gynecol Date: 2016-09 Impact factor: 7.661
Authors: Jennifer A Hutcheon; Heidi D Nelson; Reva Stidd; Susan Moskosky; Katherine A Ahrens Journal: Paediatr Perinat Epidemiol Date: 2018-10-12 Impact factor: 3.980
Authors: Katherine A Ahrens; Heidi Nelson; Reva L Stidd; Susan Moskosky; Jennifer A Hutcheon Journal: Paediatr Perinat Epidemiol Date: 2018-10-24 Impact factor: 3.980