Abstract
BackgroundThe postpartum period is an opportune time for contraception adoption, as women have extended interaction with the reproductive healthcare system and therefore more opportunity to learn about and adopt contraceptive methods. This may be especially true for women who experience unintended pregnancy, a key target population for contraceptive programs and programs to eliminate mother-to-child HIV transmission. Among women in Zimbabwe surveyed in 2014, we examined the relationship between pregnancy intention associated with a woman’s most recent pregnancy, and her subsequent postpartum contraceptive use.MethodsIn our analysis we utilized a dataset from a random selection of catchment areas in Zimbabwe to examine the association between pregnancy intention of most recent pregnancy and subsequent postpartum contraceptive use using multinomial logistic regression models. We also explored whether this association differed by women’s HIV status. Finally, we examined the association between pregnancy intention and changes in contraception from the pre- to postpartum periods.ResultsFindings suggest that women who reported that their pregnancy was unintended adopted less modern (all non-traditional) contraceptive methods overall, but adopted long-acting reversible contraception (LARC) more frequently than women reporting an intended pregnancy (OR 1.41; CI 1.18, 1.68). Among HIV-positive women, this relationship was particularly strong (OR 3.12; CI 1.96, 4.97). However, when examining changes in contraceptive use from the pre-pregnancy to the postpartum period, women who had an unintended pregnancy had lower odds of changing to a more effective method postpartum overall (OR 0.71; CI 0.64, 0.79).ConclusionsWe did not find evidence of higher modern method adoption in the postpartum period among women with an unintended pregnancy. However, women who were already on a method in the pre-pregnancy period were catalyzed to move to more effective methods (such as LARC) postpartum. This study provides evidence of low modern (non-traditional) method adoption in general in the postpartum period among a vulnerable sub-population in Zimbabwe (women who experience unintended pregnancy). Simultaneously, however, it shows a relatively greater portion specifically of LARC use among women with an unintended pregnancy. Further research is needed to more closely examine the motivations behind these contraceptive decisions in order to better inform distribution and counseling programs.
Highlights
The postpartum period is an opportune time for contraception adoption, as women have extended interaction with the reproductive healthcare system and more opportunity to learn about and adopt contraceptive methods
Women who reported that their pregnancy was unintended were more likely to be unmarried, to be in the lowest income quartile, to report HIV-positive status, to have a lower educational status, to have access to long-acting reversible contraception (LARC) at the facility in their catchment area and to be using a contraceptive method in the pre-pregnancy period (Tables 1 and 2)
We found that women reporting that their pregnancy was unintended were less likely to adopt some types of modern contraception
Summary
The postpartum period is an opportune time for contraception adoption, as women have extended interaction with the reproductive healthcare system and more opportunity to learn about and adopt contraceptive methods. This may be especially true for women who experience unintended pregnancy, a key target population for contraceptive programs and programs to eliminate mother-to-child HIV transmission. As a result, increasing women’s access to and demand for family planning, including long-acting reversible contraception (LARC) methods that do not rely on daily adherence, is a global priority [8,9,10,11], as it effectively improves women’s health through child spacing [12]. Current evidence from sub-Saharan Africa on modern method use in the postpartum period suggests that there has been improvement in adoption over the years, and overall rates of use remain moderate [16,17,18]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
