Effect of Group Prenatal Care on Contraceptive Use at Twelve Weeks Postpartum [5H

Abstract

INTRODUCTION: We compared the prevalence of contraceptive use by 12 weeks postpartum among women who participated in group prenatal care (GPC) vs. traditional prenatal care (TPC) and investigated differences in contraceptive method choice by type of prenatal care. METHODS: We performed a retrospective review of patients who received GPC or TPC and followed up within 12 weeks of delivery, between January 1 and December 31, 2017, at our institution, after receiving IRB approval. Postpartum contraceptive methods were analyzed by effectiveness (Tier 1, long-acting reversible contraception and sterilization; Tier 2, hormonal methods; Tier 3, barrier and fertility awareness methods, withdrawal, spermicide; and no method) using Chi-square and multivariate logistic regression. RESULTS: 122 participants in GPC and 121 in TPC were included. The prevalence of any contraceptive use by 12 weeks postpartum was 70.5% and 68.6% for GPC and TPC, respectively (P=.75). After controlling for demographic and clinical factors, there was no difference in Tier 1 versus other contraceptive use (aOR 0.92, 95% CI 0.81-1.07, P=.31). Participants in GPC were significantly more likely to select Tier 2 contraceptive methods (aOR 1.19, 95% CI 1.03-1.36, P=.02), and attendance at each additional GPC visit increased the odds of selecting a Tier 2 method (aOR 1.02, 95% CI 1.00-1.04, P=.03). CONCLUSION: There was no difference in the prevalence of contraceptive use at 12 weeks postpartum among women who received group compared to traditional prenatal care in this study. Participation in GPC was associated with increased use of Tier 2 contraceptive methods in a dose-dependent fashion, regardless of sociodemographics.