Patient-Reported Outcomes of Peripartum Contraceptive Care Quality [29I

Abstract

INTRODUCTION: Patient-reported outcomes are underutilized in peripartum populations. Little is known about the patient experience of care, and some studies raise concern that care is not always respectful nor patient-centered. We evaluated patient-reported outcomes of peripartum contraceptive care to guide future quality improvement efforts. METHODS: We conducted a cross-sectional, online survey at a tertiary care center in September/October 2018 using two convenience samples: pregnant women (32+ weeks gestation) and postpartum women (4-8 weeks postpartum). We evaluated patient contraceptive care experiences at prenatal visits (pregnant sample) and during childbirth hospitalizations and postpartum visits (postpartum sample). We used the validated, 4-item Patient-Centered Contraceptive Counseling [PCCC] measure (positive score, all items rated excellent), analyzing data with descriptive statistics. RESULTS: We included 117 pregnant patients (response rate 49.5%) and 84 postpartum patients (response rate 43.8%). Participants were largely white (87.1%), aged 25-35 years (66.7%), college graduates (77.6%), and wanting to avoid pregnancy for 2 or more years (63.2%). Positive PCCC scores varied across practice settings (prenatal visit, 66.7%, childbirth hospitalization, 45.2%, postpartum visit, 68.8%). On individual PCCC items, “Excellent” ratings were least common for “my provider gave me enough information to make the best decision about my birth control method” (prenatal visit, 68.9%, childbirth hospitalization, 50.6%, postpartum visit, 69.1%), and “my provider let me say what mattered to me about my birth control method” (prenatal visit, 78.8%, childbirth hospitalization, 63.1%, postpartum visit, 76.3%). CONCLUSION: Findings suggest opportunities to improve patient-centeredness in peripartum contraceptive care, with a goal of providing adequate information and respecting patient preferences and priorities.