Postpartum intentions on contraceptive use and method choice among breastfeeding women

Abstract

Objectives: Few postpartum women use long-acting contraceptives and those who use less effective methods have increased rates of unintended pregnancy. Little is known about postpartum contraception intentions among breastfeeding women. Our objectives were to assess contraceptive intentions, measure the extent of prenatal contraceptive counseling and identify correlates of both among postpartum women who were planning to breastfeed. Methods: We conducted a cross-sectional study using a convenience sample of 100 breastfeeding women following delivery before their discharge at a large university hospital in 2015. We used logistic regression to assess three outcomes of interest: intention to use contraceptives before 6 months postpartum, report of receiving counseling on postpartum contraception during prenatal care and consideration of the effects of contraceptive methods on the breastfeeding dyad when choosing a postpartum method. Results: Most women (91%) intended to use contraceptives. Prior history of no use was the sole factor related to not intending to use a method. The most commonly cited reason (35%) for the intended choice of method was convenience. Surprisingly, few women (21%) reported considering the effects of a method on the breastfeeding dyad when choosing a postpartum contraceptive method. Nearly half of women reported never discussing postpartum contraception with their health care provider during prenatal care. In the multivariate analysis, receiving public assistance was the only factor that remained statistically significantly associated with reporting the receipt of contraception counseling during prenatal care. Conclusions: Although most women intended to use contraceptives, prenatal counseling on postpartum contraception is inadequate.