Postpartum Family Planning in Pediatrics: A Survey of Parental Contraceptive Needs and Health Services Preferences.

Abstract

Infant well-child visits are increasingly being explored as opportunities to address parental postpartum health needs, including those related to reproductive health. To inform potential pediatric clinic-based interventions, this study assessed postpartum contraceptive needs and health services preferences. We surveyed postpartum individuals attending 2-6 month well-child visits at three Northern California pediatric clinics (2019-20). We examined unmet contraceptive need; the acceptability of contraceptive education, counseling, and provision at well-child visits; and sociodemographic and clinical correlates. We conducted univariate and multivariable regression modeling to assess associations between sociodemographic and clinical variables, status of contraceptive need, and acceptability measures. Study participants (n=263) were diverse in terms of race/ethnicity (13% Asian, 9% Black, 37% Latinx, 12% Multi-racial or Other, 29% White), and socioeconomic status. Overall, 25% had unmet contraceptive need. Unmet need was more common among participants who had delivered more recently, were multiparous, or reported ≥1 barrier to obtaining contraception; postpartum visit attendance, education, race, and ethnicity were not associated with unmet need. Most participants deemed the following acceptable in the pediatric clinic: receiving contraceptive information (85%), discussing contraception (86%), and obtaining a contraceptive method (81%). Acceptability of these services was greater among participants with unmet contraceptive need, better self-rated health, and private insurance (all p<.05). A quarter of participants had unmet contraceptive need beyond the early postpartum period. Most considered the pediatric clinic an acceptable place to address contraception, suggesting the pediatric clinic may be a suitable setting for interventions aiming to prevent undesired pregnancies and their sequelae.