Effect of Contraception Decisional Aid on Postpartum Contraceptive Choice: A Replicated Time Series Study [20G

Abstract

INTRODUCTION: Contraception after birth is essential to the wellbeing of mothers as well as the health of their future children. The WHO recommends a two to three year inter-pregnancy interval. Decisional aids have helped to assist women with contraceptive decision-making. Our goal was to develop and test an electronic decisional aid to inform pregnant women about options for postpartum contraception. METHODS: We conducted a replicated interrupted time series study. A decisional aid was developed using attributes from Health Belief Model’s behavioral theory. It included detailed and interactive information about reversible and permanent contraceptives. We enrolled a total of 200 pregnant women between 24 to 36 weeks into either the intervention group (received decisional aid) or control group. The primary outcome was to compare contraceptive choice between two groups. The secondary outcome was to assess whether the patient received their contraceptive choice post delivery. RESULTS: Women did not differ in their demographics or contraceptive choice prior to delivery. Of the 200 participants, 56 decided to obtain very effective contraceptives such as intrauterine device and implant postpartum. This was similar across control and intervention groups (p= .697). Post-delivery, the majority of participants received birth control that was of similar or higher efficacy. Women in the intervention group however had less decisional conflict compared to those in control group (p < 0.05). CONCLUSION: The postpartum contraception decisional aid was successful in reducing decisional conflict. There was no significant difference in contraceptive choice or uptake between the intervention and control group.