Abstract
Background
Short interpregnancy intervals lead to adverse perinatal outcomes and could be prevented
with increased use of long-acting reversible contraception (LARC) in the postpartum
period. The primary objective of this study was to assess which baseline characteristics
are associated with the intent to use LARC among postpartum women.
Study Design
This study was a substudy of baseline data from a randomized controlled trial. Eight
hundred women completed a pre-intervention survey of demographics and reproductive
health history and intentions. We estimated adjusted relative risks (RRs) of intent
to use LARC for baseline characteristics of interest.
Results
Three hundred three postpartum women (38%) intended to use LARC. Two out of 10 baseline
characteristics were significantly associated with intent to use LARC: not trying
for pregnancy at time of conception [adjusted RR, 1.6; 95% confidence interval (CI),
1.2���2.1] and no desire for another pregnancy within 2 years (adjusted RR, 1.9; 95%
CI, 1.2���2.8).
Conclusions
High interest in LARC exists among postpartum women, particularly among women with
a recent unintended pregnancy and women who do not desire pregnancy for at least 2
years. Past and future pregnancy intentions should be incorporated into future models
and frameworks that evaluate postpartum contraceptive choice. Educational intervention
studies are also needed to assess if LARC interest can be increased among postpartum
women who are less likely to intend to use LARC but at risk for future adverse perinatal
outcomes.
Keywords
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References
- Birth spacing and risk of adverse perinatal outcomes: a meta-analysis.JAMA. 2006; 295: 1809-1823
U.S. Department of Health and Human Services. Office of Disease Prevention and Health Promotion. Healthy People 2020. Washington, DC. Available at: http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=13. Accessed June 8, 2012.
- The postpartum period, breastfeeding, and contraception.in: Speroff L. Darney P.D. A Clinical Guide for Contraception. 4th ed. Lippincott, Williams & Wilkins, Philadelphia2005: 317
- Choosing a contraceptive: efficacy, safety, and personal considerations.in: Hatcher R.A. Contraceptive Technology. 19th ed. Ardent Media, New York2007: 24
- Increasing use of contraceptive implants and intrauterine devices to reduce unintended pregnancy. ACOG Committee Opinion No. 450.Obstet Gynecol. 2009; 114: 1434-1438
- Factors associated with choosing a long-acting reversible contraceptive method amongst postpartum women in an urban teaching hospital.Contraception. 2010; 82 ([abstract]): 197
- Postpartum use of long-acting reversible contraception in a military treatment facility.J Wom Health. 2012; 21: 388-392
- Research electronic data capture (REDCap)���a metadata-driven methodology and workflow process for providing translational research informatics support.J Biomed Inform. 2009; 42: 377-381
- A modified Poisson regression approach to prospective studies with binary data.Am J Epidemiol. 2004; 159: 702-706
- Overestimation of risk ratios by odds ratios in trials and cohort studies: alternatives to logistic regression.CMAJ. 2012; 184: 895-899
Verbiest S. The postpartum visit: an overlooked opportunity for prevention. A dissertation submitted to the faculty of the University of North Carolina at Chapel Hill in partial fulfillment of the requirements for the degree of Doctorate in Public Health in the Department of Health Policy and Management, 2008.
- Regression modeling strategies: with applications to linear models, logistic regression, and survival analysis.Springer, New York2001
- Factors in contraceptive method choice in Bangladesh: goals, competence, evaluation and access.Contraception. 2002; : 357-364
- Breaking the barrier: the Health Belief Model and patient perceptions regarding contraception.Contraception. 2011; : 453-458
- The Health Belief Model can guide modern contraceptive behavior research and practice.J Midwifery Womens Health. 2012; 57: 74-81
- Use of contraception in the United States: 1982���2008. National Center for Health Statistics.Vital Health Stat. 2010; 23: 1-44
- Lack of insurance and parity influence choice between long-acting reversible contraception and sterilization in women postpregnancy.Contraception. 2012; 86: 42-47
- Postpartum initiation of highly effective contraception.Contraception. 2011; 84 ([abstract]): 343
Article info
Publication history
Published online: November 19, 2012
Accepted:
October 10,
2012
Received in revised form:
October 8,
2012
Received:
July 19,
2012
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
