Abstract
INTRODUCTION: Postpartum contraception planning is important for preventing short-interval pregnancies especially in populations at increased risk for adverse pregnancy and birth outcomes, such as those with gestational diabetes. This study evaluated the effect of antenatal contraception education on postpartum contraception plans and actual postpartum contraceptive use in patients with pregnancy hyperglycemia. METHODS: This pilot two-arm randomized controlled trial (Project Wellness, NCT04209348) assigned patients to receive contraception education (intervention, n=10) or standard-of-care (control, n=9). Postpartum contraceptive plans were assessed pre- and post-intervention. Contraceptive effectiveness was assessed pre- and post-intervention and 3 months postpartum. The primary outcome was a change in contraceptive plan from pre to post intervention (yes/no). The secondary outcome was contraceptive effectiveness; categorized as: 1) none, 2) least effective, 3) moderately effective, and 4) most effective methods. Fisher's exact test compared differences in contraceptive plans between groups and Mann–Whitney U test compared contraceptive effectiveness. RESULTS: Among participants in the contraception education group, 90% (n=9) changed their postpartum contraceptive plan after intervention, compared to 33.3% (n=3) in the control group (P=.02). Contraceptive effectiveness was significantly higher in the contraception education group immediately post-intervention (P=.045) and at 3 months postpartum (P=.030), compared to the control group. CONCLUSION: Structured education and planning for postpartum contraception may increase use of highly effective contraceptive methods in the early postpartum period to optimize family planning goals and decrease short interval births. Further research should evaluate satisfaction with contraception education and planning, and longer-term contraceptive use.
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