Contraceptive counseling and postpartum contraceptive use

Details

• Alternative Title:
  Am J Obstet Gynecol
• Personal Author:
  Zapata, Lauren B. ; Murtaza, Sarah ; Whiteman, Maura K. ; Jamieson, Denise J. ; Robbins, Cheryl L. ; Marchbanks, Polly A. ; D’Angelo, Denise V. ; Curtis, Kathryn M.
• Description:
  OBJECTIVE
  
  The objective of the study was to examine the associations between prenatal and postpartum contraceptive counseling and postpartum contraceptive use.
  
  STUDY DESIGN
  
  The Pregnancy Risk Assessment Monitoring System 2004–2008 data were analyzed from Missouri, New York state, and New York City (n = 9536). We used multivariable logistic regression to assess the associations between prenatal and postpartum contraceptive counseling and postpartum contraceptive use, defined as any method and more effective methods (sterilization, intrauterine device, or hormonal methods).
  
  RESULTS
  
  The majority of women received prenatal (78%) and postpartum (86%) contraceptive counseling; 72% received both. Compared with those who received no counseling, those counseled during 1 time period (adjusted odds ratio [AOR], 2.10; 95% confidence interval [CI], 1.65–2.67) and both time periods (AOR, 2.33; 95% CI, 1.87–2.89) had significantly increased odds of postpartum use of a more effective contraceptive method (32% vs 49% and 56%, respectively; P for trend < .0001). Results for counseling during both time periods differed by type of health insurance before pregnancy, with greater odds of postpartum use of a more effective method observed for women with no insurance (AOR, 3.51; 95% CI, 2.18–5.66) and Medicaid insurance (AOR, 3.74; 95% CI, 1.98–7.06) than for those with private insurance (AOR, 1.87; 95% CI, 1.44–2.43) before pregnancy. Findings were similar for postpartum use of any contraceptive method, except that no differences by insurance status were detected.
  
  CONCLUSION
  
  The prevalence of postpartum contraceptive use, including the use of more effective methods, was highest when contraceptive counseling was provided during both prenatal and postpartum time periods. Women with Medicaid or no health insurance before pregnancy benefited the most.
  
  
• Subjects:
  Adult Contraception Contraception Behavior Contraceptive Agents, Female Contraceptive Devices, Female Contraceptives, Oral Counseling Female Humans Insurance, Health Intrauterine Devices Logistic Models Medicaid Multivariate Analysis Postnatal Care Pregnancy Prenatal Care Sterilization, Reproductive Young Adult

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• Source:
  Am J Obstet Gynecol. 212(2):171.e1-171.e8.
• Pubmed ID:
  25093946
• Pubmed Central ID:
  PMC4470255
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHS/United States
• Place as Subject:
  United States
• Volume:
  212
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:79dd0d8bc31c84256d3badc4e1989239e2646cddab9a42aebb314f9fc829bca5
• Download URL:
  https://stacks.cdc.gov/view/cdc/31663/cdc_31663_DS1.pdf
• File Type:
  [PDF - 195.93 KB ]