Patterns of postpartum depot medroxyprogesterone administration among low-income mothers.

Abstract

Depot medroxyprogesterone acetate (DMPA) is often administered immediately postpartum to reduce the risk of short-interval repeat or unintended pregnancies, but little is known about the actual patterns of postpartum DMPA use. This article examines the patterns of DMPA administered among low-income new mothers in an upstate New York State community. Mothers attending urban pediatric practices (births 2009-2011) completed a mailed survey approximately 5 months after delivery. Among 83 survey items were questions about breastfeeding and timing of DMPA receipt. Unintended pregnancy was reported by 48.8% of the subjects. Their deliveries occurred across four local hospitals. Among the 31.3% of subjects who received postpartum DMPA, 62.6% received it prior to hospital discharge. Those receiving in-hospital DMPA (n=127) were significantly more likely than other mothers to be black, older, urban dwelling, non-high school graduates, multiparous, and planning to formula feed. Administration patterns differed by hospital. This study of postpartum DMPA administration among a convenience sample of low-income mothers demonstrated rates of 26% overall, but there was between-hospital variability. Additional study may identify approaches to ensure timely administration to appropriate candidates.