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.
Keywords
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Article info
Publication history
Published online: July 03, 2014
Accepted:
June 25,
2014
Received in revised form:
June 24,
2014
Received:
June 23,
2014
Footnotes
☆Financial disclosure: The authors have no conflicts of interest or competing financial interests to declare.
☆☆Funding acknowledgement: This project was supported by a grant from an anonymous foundation and a National Institute of Child Health and Human Development (NICHD) center grant (5 R24 HD042849) awarded to the Population Research Center at the University of Texas at Austin. ARAA is supported by an NICHD Individual Predoctoral Fellowship (F31 HD079182-01).
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
