Postpartum Contraceptive Use Research Articles

Prenatal and Postpartum Home Visits and Postpartum Contraceptive Use: A Cross-Sectional Analysis.

Background: The postpartum period is a time of unmet contraceptive need for many women. Home visits by a health care worker during pregnancy or after delivery could increase postpartum contraceptive use and decrease barriers to accessing postpartum care. This study investigated the association between prenatal or postpartum home visits and postpartum contraceptive use using a large sample of U.S. women from 41 states. Subjects and Methods: We conducted a cross-sectional analysis using weighted survey data from the 2012-2015 Phase 7 Pregnancy Risk Assessment and Monitoring Systems Core and Standard Questionnaires. Descriptive statistics and multivariate logistic regression models estimated the association between having a prenatal or postpartum home visit and self-reported postpartum contraceptive use. Results: Of 141,296 women, approximately 21% received prenatal or postpartum home visits and 79% used postpartum contraception. After controlling for sociodemographic, reproductive, and health-related factors, women who received prenatal or postpartum home visits had a higher odds of postpartum contraception use (adjusted odds ratio 1.08, 95% confidence interval 1.02-1.15, p = 0.009). Women who were older, were minority race, had less than a high school education, received inadequate prenatal care, experienced partner abuse during pregnancy, or experienced multiple stressors during pregnancy had a lower odds of postpartum contraception use in adjusted analyses controlling for home visitation. Conclusion: Given the benefits of recommended interpregnancy intervals to both the mother and the baby, adding formal contraceptive counseling and offering a variety of postpartum contraceptive methods in the home could further strengthen home visitation programs in the United States and may support women in achieving their reproductive goals.

Association Between Emotional Intimate Partner Violence Around the Time of Pregnancy and Postpartum Contraceptive Use: Results from the Pregnancy Risk Assessment Monitoring System 2016-2021.

This study assessed the relationships between emotional intimate partner violence (IPV) before, during, and after pregnancy and postpartum contraceptive use. We used 2016-2021 Pregnancy Risk Assessment Monitoring System data from seven sites (n = 30,125). We used multivariable logistic regression to assess indicators of emotional IPV and provider counseling associated with postpartum contraceptive use. Emotional IPV 12 months before, during, and after pregnancy were all significantly associated with reduced odds of postpartum contraceptive use. Strengthening postpartum contraceptive services by integrating IPV prevention into care is an opportunity to improve the health of postpartum people.

Association between physical intimate partner violence and postpartum contraceptive use in the United States-evidence from PRAMS 2016-2021.

Intimate Partner Violence (IPV) continues to be a major global public health concern, impacting physical and psychological well-being of individuals, including their reproductive and sexual health. The objective of this study is to examine the association between physical intimate partner violence and the utilization of contraception during the postpartum period in the United States. This study used data from the CDC's Pregnancy Risk Assessment Monitoring System (PRAMS) survey study phase 8, covering 2016-2021. The sample included 165,204 women reporting physical IPV during pregnancy or 12 months before their last pregnancy and their postpartum contraceptive use. Descriptive, bivariate, and logistic regressions were used to analyze the relationship between IPV and postpartum contraceptive use, adjusting for relevant factors and addressing sampling weights. The study found a 3.2% prevalence of physical IPV, with state variances ranging from 2.2% to 5.5%. Among women who experienced physical IPV, 91.0% used contraception, compared to 94.5% of those who did not experience physical IPV. Experiencing physical IPV significantly decreased the likelihood of using any postpartum contraceptive method by 42% (aOR: 0.58; 95% CI: 0.48-0.70) compared to those who did not experience physical IPV during the same period, after adjusting for covariates. Factors that increased the probability of using contraception during the postpartum period included women's higher educational attainment, being married or cohabitating, being employed anytime during pregnancy, and having an unintended last pregnancy. This study highlights the significant association between physical IPV and reduced use of postpartum contraception in the United States. It calls for the integration of IPV considerations into public health policies and clinical initiatives to improve maternal well-being.

Effect of an Intensive Nurse Home Visiting Program on Postpartum Contraceptive Use and Birth Spacing: A Randomized Controlled Trial.

To evaluate the effect of an intensive nurse home visiting program on postpartum contraceptive use and birth spacing among individuals with a first pregnancy who were eligible for Medicaid insurance in South Carolina. We conducted a nonblinded, randomized controlled trial of the Nurse-Family Partnership (NFP), an established intensive home visiting program that provides prenatal and postpartum home visits through 2 years after childbirth. The trial included patients who were eligible for Medicaid insurance with a first pregnancy at less than 28 weeks of gestation between April 1, 2016, and March 17, 2020, who were followed up through 2 years after childbirth. Participants were randomized 2:1 to NFP compared with standard of care treatment. The primary outcome was a birth interval of less than 21 months between the index pregnancy and a subsequent birth. The secondary outcomes were birth intervals of less than 15 and 24 months, receipt of a contraceptive implant or intrauterine device (IUD) immediately postpartum, any contraceptive use and receipt of a family planning visit (at both 6 weeks and 1 year postpartum), and IUD receipt at 1 year postpartum. We assessed outcomes using linked birth certificate records and Medicaid claims data. A total of 4,932 trial participants (3,295 in the intervention group and 1,637 in the control group) were included in the study analysis. Within 21 months of the study index birth, 11.0% of individuals in the NFP group and 12.2% of the usual care group had a subsequent birth. The NFP did not have a statistically significant effect on birth intervals of less than 21 months (adjusted coefficient -1.1, 95% CI, -2.9 to 0.8). There were no statistically significant differences between the NFP and control groups for any of the study's eight secondary outcomes related to birth spacing and postpartum contraceptive use. Home visits with a registered nurse did not affect postpartum contraceptive use or birth spacing. ClinicalTrials.gov, NCT03360539.

Antenatal Care Interventions to Increase Contraceptive Use Following Birth in Low- and Middle-Income Countries: Systematic Review and Narrative Synthesis.

Health risks associated with short interpregnancy intervals, coupled with women's desires to avoid pregnancy following childbirth, underscore the need for effective postpartum family planning programs. The antenatal period provides an opportunity to intervene; however, evidence is limited on the effectiveness of interventions aimed at reaching women in the antenatal period to increase voluntary postpartum family planning in low- and middle-income countries (LMICs). This systematic review aimed to identify and describe interventions in LMICs that attempted to increase postpartum contraceptive use via contacts with pregnant women in the antenatal period. Studies published from January 2012 to July 2022 were considered if they were conducted in LMICs, evaluated an intervention delivered during the antenatal period, were designed to affect postpartum contraceptive use, were experimental or quasi-experimental, and were published in French or English. The main outcome of interest was postpartum contraceptive use within 1 year after birth, defined as the use of any method of contraception at the time of data collection. We searched EMBASE, Global Health, and Medline and manually searched the reference lists from studies included in the full-text screening. We double-screened 771 records and included 34 reports on 31 unique interventions in the review. Twenty-three studies were published from 2018 on, with 21 studies conducted in sub-Saharan Africa. Approximately half of the study designs (n=16) were randomized controlled trials, and half (n=15) were quasi-experimental. Interventions were heterogeneous. Among the 24 studies that reported on the main outcome of interest, 18 reported a positive intervention effect, with intervention recipients having greater contraceptive use in the first year postpartum. While the studies in this systematic review were heterogeneous, the findings suggest that interventions that included a multifaceted package of initiatives appeared to be most likely to have a positive effect.

The Prevalence of Postpartum Contraception Use among Teenage Mothers at Vajira Hospital, Thailand

OBJECTIVES: To determine the prevalence of postpartum contraception use among teenage mothers and to identify the factors influencing both postpartum contraception use and loss to postpartum follow-up at the Faculty of Medicine Vajira Hospital in Thailand.METHODS: Four hundred and seventy-five participants were randomly selected from 1,060 Thai teenage pregnant that gave birth at the Faculty of Medicine Vajira Hospital between 1 January 2017 and 31 December 2020 and were scheduled postpartum visits. The clinical factors associated with postpartum contraception use and loss to postpartum follow-up were studied using multiple logistic regression analysis.RESULTS: A total of 451 participants remained after excluding criteria. Of these, 212 participants did not follow-up on their postpartum visits, leaving the limitation to summarize the true prevalence of postpartum contraception use of the total population. However, of the 232 participants who visited postpartum follow-ups, the prevalence of contraceptive use was 95.8%. Married status was the only factor associated with higher postpartum contraceptive use (odds ratio (OR) 12.81 [3.38-48.64]). Age 18 years and older (ORadj1.71 [1.16-2.53]), absence of previous contraceptive use (ORadj1.91 [1.29-2.80]), and total antenatal care visits fewer than 8 (ORadj 1.61 [1.07-2.42]) were significantly related with loss to postpartum follow-ups.CONCLUSION: The prevalence of contraceptive use was high among teenage mothers who had follow-up postpartum visits. However, this population also had a high loss rate of postpartum visits. Interventions and close monitoring should be considered to evaluated further for effective adolescent reproductive services.

Impact of Janani Suraksha Yojana on Postpartum Contraception: Evidence from Two Selected Districts in Assam

This study explores the association between the receipt of JSY benefits and postpartum contraception use among reproductive-aged women in Assam who belong to the age group 18-49 years. The study is exclusively based on primary data collected from a sample of 260 reproductive-aged women residing in the two districts of Assam viz., Jorhat and Cachar. Surveyed women considered in the study were those who had experienced at least one live birth within the two years preceding the survey. Sample respondents were divided into two groups: those who received JSY benefits and those who did not. A binary logistic regression model is used to quantify the effect of JSY on postpartum counselling and postpartum contraception. The study findings reveal a positive impact of JSY on women’s postpartum contraception adoption within the study area. The possibility of receiving counselling on postpartum contraception and adopting postpartum contraceptives was 13.89 times and 14.94 times greater for those respondents who did not benefit from the JSY. The study reveals that JSY not only promotes institutional childbirth but also enhances postpartum contraceptive counselling and the adoption of postpartum contraceptive methods among the beneficiary women.

FACTORS ASSOCIATED POST-PARTUM CONTRACEPTION PLANNING

The problem of stunting that occurs in Indonesia is caused by one of the sensitive factors, namely bad parenting. Improper parenting can occur in mothers whose children are born too close together (<2 years). Postpartum contraception can also be a solution for those who are "4 too” The achievement of postpartum family planning services in Sarirejo District (65.12%) has not met the target (70%). This study aims to analyze the effect of age, number of children, level of education and knowledge of postpartum family planning plans for pregnant women in Sarirejo District. This type of analytic observational research with cross sectional design. The research subjects were all pregnant women in Sarirejo District in April 2023 with a total sample of 77 respondents. The results showed that the variables Age (p=0.001), Number of Children (p=0.001) and Knowledge (p=0.001) were related to postpartum contraceptive plans. Meanwhile, education level only at senior high school level (p=0.001) has an influence on postnatal contraceptive use plans. The conclusion is that postpartum contraceptive use increases with increasing maternal age, increases with increasing number of children, increases with maternal education and increasing knowledge. There is a need to increase understanding and knowledge of pregnant women about the importance of postnatal family planning through counseling and collaboration with village midwives.

Does reversible postpartum contraception reduce the risk of pregnancy condition recurrence? A longitudinal claims-based study from Maine

PurposeTo estimate the effect of reversible postpartum contraception use on the risk of recurrent pregnancy condition in the subsequent pregnancy and if this effect was mediated through lengthening the interpregnancy interval (IPI). MethodsWe used data from the Maine Health Data Organization's Maine All Payer Claims dataset. Our study population was Maine women with a livebirth index pregnancy between 2007 and 2019 that was followed by a subsequent pregnancy starting within 60 months of index pregnancy delivery. We examined recurrence of three pregnancy conditions, separately, in groups that were not mutually exclusive: prenatal depression, hypertensive disorders of pregnancy (HDP), and gestational diabetes (GDM). Effective reversible postpartum contraception use was defined as any intrauterine device, implant, or moderately effective method (pills, patch, ring, injectable) initiated within 60 days of delivery. Short IPI was defined as ≤ 12 months. We used log-binomial regression models to estimate risk ratios and 95 % confidence intervals, adjusting for potential confounders. ResultsApproximately 41 % (11,448/28,056) of women initiated reversible contraception within 60 days of delivery, the prevalence of short IPI was 26 %, and the risk of pregnancy condition recurrence ranged from 38 % for HDP to 55 % for prenatal depression. Reversible contraception initiation within 60 days of delivery was not associated with recurrence of the pregnancy condition in the subsequent pregnancy (aRR ranged from 0.97 to 1.00); however, it was associated with lower risk of short IPI (aRR ranged from 0.67 to 0.74). Conclusion(s)Although initiation of postpartum reversible contraception within 60 days of delivery lengthens the IPI, our findings suggest that it does not reduce the risk of prenatal depression, HDP, or GDM recurrence. This indicates a missed opportunity for providing evidence-based healthcare and health interventions in the intrapartum period to reduce the risk of recurrence.

A EFEKTIFITAS KONSELING DENGAN MENGGUNAKAN ALAT BANTU PENGAMBILAN KEPUTUSAN BER-KB (ABPK) PADA IBU HAMIL DALAM PENGGUNAAN KB PASCA PERSALINAN (KBPP)

Unintended pregnancy occurs because of too late postpartum contraceptive use. The intervention can be done is provide family planning counseling at pregnancy. One of the tools in family planning counseling is ABPK. This study was aimed to identify the effectiveness of ABPK when postpartum family planning counseling in trimester III pregnant to decision making in postpartum contraceptive use. This study Posttest only control research design. Sample technique with proportional stratified random sampling with the inclusion and exclusion criteria. The results of the bivariate analysis showed that there were insignificant differences proportion of contraceptive methods selected, both in group 29-32 weeks / early third trimester (p 0.474), group 33-36 weeks/ middle third trimester (p value 0.791) and group 37-40 weeks / final third trimester (p 0, 316). There was a significant difference in the timing of family planning use at group 29-32 weeks / early third trimester (p 0.001) and there was no difference in the timing of family planning use at group 33-36 weeks / middle third trimester (p 0, 118) and group 37-40 weeks / final third trimester (p 0, 070). This finding suggests that the use ABPK in postpartum family planning counseling has not been statistically effective in decision making chose contracepsion. Therefore, a postpartum family planning counseling model can be developed aspect of the media, subject or frequency of counseling during pregnancy.

Maternal Contraception Education Increases the Use of Highly Effective Contraceptive Methods Postpartum [ID 2683527

INTRODUCTION: Postpartum contraception planning is important for preventing short-interval pregnancies especially in populations at increased risk for adverse pregnancy and birth outcomes, such as those with gestational diabetes. This study evaluated the effect of antenatal contraception education on postpartum contraception plans and actual postpartum contraceptive use in patients with pregnancy hyperglycemia. METHODS: This pilot two-arm randomized controlled trial (Project Wellness, NCT04209348) assigned patients to receive contraception education (intervention, n=10) or standard-of-care (control, n=9). Postpartum contraceptive plans were assessed pre- and post-intervention. Contraceptive effectiveness was assessed pre- and post-intervention and 3 months postpartum. The primary outcome was a change in contraceptive plan from pre to post intervention (yes/no). The secondary outcome was contraceptive effectiveness; categorized as: 1) none, 2) least effective, 3) moderately effective, and 4) most effective methods. Fisher's exact test compared differences in contraceptive plans between groups and Mann–Whitney U test compared contraceptive effectiveness. RESULTS: Among participants in the contraception education group, 90% (n=9) changed their postpartum contraceptive plan after intervention, compared to 33.3% (n=3) in the control group (P=.02). Contraceptive effectiveness was significantly higher in the contraception education group immediately post-intervention (P=.045) and at 3 months postpartum (P=.030), compared to the control group. CONCLUSION: Structured education and planning for postpartum contraception may increase use of highly effective contraceptive methods in the early postpartum period to optimize family planning goals and decrease short interval births. Further research should evaluate satisfaction with contraception education and planning, and longer-term contraceptive use.

Continuous Medicaid Eligibility During the COVID-19 Pandemic and Postpartum Coverage, Health Care, and Outcomes

Pursuant to the Families First Coronavirus Response Act (FFCRA), continuous Medicaid eligibility during the COVID-19 public health emergency (PHE) created a de facto national extension of pregnancy Medicaid eligibility beyond 60 days postpartum. To evaluate the association of continuous Medicaid eligibility with postpartum health insurance, health care use, breastfeeding, and depressive symptoms. This cohort study using a generalized difference-in-differences design included 21 states with continuous prepolicy (2017-2019) and postpolicy (2020-2021) participation in the Pregnancy Risk Assessment Monitoring System (PRAMS). State-level change in Medicaid income eligibility after 60 days postpartum associated with the FFCRA measured as a percent of the federal poverty level (FPL; ie, the difference in 2020 income eligibility thresholds for pregnant people and low-income adults/parents). Health insurance, postpartum visit attendance, contraceptive use (any effective method; long-acting reversible contraceptives), any breastfeeding and depressive symptoms at the time of the PRAMS survey (mean [SD], 4 [1.3] months postpartum). The sample included 47 716 PRAMS respondents (64.4% aged <30 years; 18.9% Hispanic, 26.2% non-Hispanic Black, 36.3% non-Hispanic White, and 18.6% other race or ethnicity) with a Medicaid-paid birth. Based on adjusted estimates, a 100% FPL increase in postpartum Medicaid eligibility was associated with a 5.1 percentage point (pp) increase in reported postpartum Medicaid enrollment, no change in commercial coverage, and a 6.6 pp decline in uninsurance. This represents a 40% reduction in postpartum uninsurance after a Medicaid-paid birth compared with the prepolicy baseline of 16.7%. In subgroup analyses by race and ethnicity, uninsurance reductions were observed only among White and Black non-Hispanic individuals; Hispanic individuals had no change. No policy-associated changes were observed in other outcomes. In this cohort study, continuous Medicaid eligibility during the COVID-19 PHE was associated with significantly reduced postpartum uninsurance for people with Medicaid-paid births, but was not associated with postpartum visit attendance, contraception use, breastfeeding, or depressive symptoms at approximately 4 months postpartum. These findings, though limited to the context of the COVID-19 PHE, may offer preliminary insight regarding the potential impact of post-pandemic postpartum Medicaid eligibility extensions. Collection of longer-term and more comprehensive follow-up data on postpartum health care and health will be critical to evaluating the effect of ongoing postpartum policy interventions.

How does person-centered maternity care relate to postpartum contraceptive counseling and use? Evidence from a longitudinal study of women delivering at health facilities in Ethiopia

ObjectivesThis study examines the relationship between integrated, person-centered maternity care (PCMC), the provision of postpartum family planning (PPFP) services, and postpartum contraceptive use among women delivering at health facilities in Ethiopia. Study designWe analyze 2019–2021 longitudinal data from a representative sample of pregnant and recently postpartum women in Ethiopia. This study examines baseline, 6-week, and 6-month survey data collected from women who delivered at a health facility. ResultsMaternity patients who reported more person-centered care were more likely to be counseled on postpartum contraceptive methods before discharge. Overall, 27.5% of women delivering in a health facility received family planning counseling before discharge, ranging from 15.2% in the lowest PCMC quintile to 36.3% in the highest PCMC quintile. The receipt of PPFP counseling was associated with increased odds of postpartum contraceptive use. ConclusionsFindings suggest dimensions of quality care are interlinked, and person-centered care is associated with greater integration of recommended PPFP services into predischarge procedures. However, even among women who report relatively high levels of person-centered care, our results highlight that family planning is not routinely discussed prior to discharge from delivery, and very few women receive a contraceptive method or referral prior to discharge. ImplicationsWhile most postpartum women report they wish to limit or space future pregnancies, the uptake of modern contraceptive methods in the postpartum period is low. As women increasingly opt to deliver in health facilities, further integration of family planning services into predischarge procedures within maternity care can improve contraceptive access. Data statementThe data used in these analyses were collected as part of the PMA Ethiopia study. Data are publicly available at https://www.pmadata.org/data/request-access-datasets.

Pregnancy Desirability and Motivational Readiness for Postpartum Contraceptive Use: Findings from Population-Based Surveys in Eight Sub-Saharan African Countries.

This study examined the associations between pregnancy intention and motivational readiness for postpartum contraceptive use. Data for this cross-sectional analysis were derived from nationally representative surveys of the Performance Monitoring and Accountability 2020 (PMA2020) project conducted in eight sub-Saharan African countries. Participants included 9488 nonpregnant women of reproductive age (15-49 years) who had given birth in the last 2 years. Weighted multinomial logistic regression analyses were performed to estimate the odds ratios (OR) and their corresponding 95% confidence intervals (CIs) of the associations of motivational readiness for contraceptive adoption categorized as precontemplation, contemplation, and post-action with pregnancy intention. After adjusting for confounding factors, the findings revealed that women in Côte d'Ivoire and Nigeria who had mistimed pregnancies had significantly higher odds of being in the contemplation vs. precontemplation stage compared to those who had intended pregnancies. Similarly, women who had unwanted pregnancies in Ethiopia were also more likely to be in the contemplation stage. Furthermore, significant differences were observed for women in Burkina Faso, Côte d'Ivoire, and Nigeria regarding the association between mistimed pregnancies and being in the post-action stage. For women who had unwanted pregnancies, this association was significant only in Nigeria. Additionally, the odds of being in the contemplation stage, compared to the post-action stage, for women who had unwanted pregnancies were significantly higher in Ethiopia and Nigeria. These results indicate that recent unintended pregnancies in specific sub-Saharan African countries may motivate women to take action to prevent future unintended pregnancies. The findings underscore the importance of tailored and context-specific approaches in family-planning programs based on the stage of motivational readiness.

The determinants of postpartum contraceptive use in Nigeria.

Postpartum contraception is vital for maternal and child health, and reduces the risk of infant mortality. The Health Belief Model (HBM) is a widely accepted framework for exploring health behaviors, such as contraceptive use. Therefore, this study aimed to investigate the factors influencing postpartum contraceptive use in Nigeria and to contextualize the findings within the framework of the HBM. This study was a secondary analysis of cross-sectional data collected from the Demographic Health Survey conducted in Nigeria (NDHS). In total, 28,041 women were included in this study. Self-reported contraceptive use was the outcome, while the explanatory variables included maternal age, place of residence, region of residence, religion, marital status, educational level, household wealth quintiles, knowledge of the ovulatory cycle, decision-maker for health care, and distance to health care facilities. Descriptive statistics and multivariate logistic regression were used to summarize and identify factors influencing postpartum contraceptive use. The HBM was used to discuss the main findings. The prevalence of postpartum contraceptive use in Nigeria is 27%. Our findings showed that the odds of using contraceptives during the postpartum period were higher among women who knew their ovulation cycles, lived in urban areas in the southern region, had no distance barriers to health care, and were 25-49 years old. Education, wealth, and marital status also increase the odds of contraceptive use. However, women who lived in the northeast and northwest regions or shared decision-making with their partners had lower odds. This study highlights the need for region-specific and age-focused interventions to increase contraceptive use in Nigeria. Additionally, increasing accessibility and affordability of contraceptives for younger and economically disadvantaged women, along with promoting women's autonomy in decision-making, can further enhance contraceptive use across Nigeria.

Intention to Use Postpartum Contraceptive and Its Determinants in Sub-Saharan Africa: Systematic Review and Meta-Analysis.

The postpartum period is a critical moment for the delivery of family planning services. However, the utilization of family planning among women in sub-Saharan Africa is not optimal. Therefore, the current study aims to assess the intention to use postpartum contraception and its related determinants in the sub-Saharan African setting. This study utilized a comprehensive search strategy that involved searching several databases, including PubMed, Scopus, EMBASE, Science Direct, Google Scholar, and online research institutional repository homes. Data extraction was performed using Microsoft Excel, and statistical analysis was conducted using STATA software (version 14). To assess publication bias, a forest plot, Begg's rank test, and Egger's regression test were employed. Heterogeneity was evaluated using the I2 statistic, and an overall estimated analysis was conducted. In addition, sensitivity analysis was performed to examine the impact of each study on the overall estimate. Meta-regression analysis was conducted to identify potential sources of heterogeneity. Finally, the pooled odds ratio (OR) for associated factors was calculated. After reviewing 1,321 articles, 14 studies were deemed eligible for inclusion in this meta-analysis. The final analysis comprised a total of 39,936 study participants. The overall intention to use postpartum contraception in sub-Saharan Africa was found to be 62.21% (95% confidence interval [CI]: 55.532-68.875). In subgroup analysis, the highest prevalence of intention was observed in Ethiopia (66.71%; 95% CI: 50.36-83.05), while the lowest prevalence was reported in Ghana (59.39%; 95% CI: 50.22-68.57). The intention to use contraception was found to be 67.22% (95% CI: 62.37-72.07) and 54.53% (95% CI: 46.61-62.45) for institutional and community-based studies, respectively. Maternal educational status (OR = 1.22; 95% CI: 1.09-1.38) and husbands' approval of contraceptive use (OR = 2.395; 95% CI: 1.256-4.567) were identified as predictors of intention to use postpartum contraception. In conclusion, the results of our study show a comparatively low intention toward the use of postpartum contraception, in contrast to findings reported in other countries. As such, we recommend that stakeholders prioritize maternal education and encourage male partner involvement in family planning decisions.

Knowledge and perception with intention in the selection of postpartum intrauterine contraceptive device in third trimester pregnant women

Family Planning Program was one strategy to reduce the risk of maternal death. The first year postpartum was the most important time for contraceptive use. The percentage of intrauterine contraceptive device(IUCD) usage was still low compared to other contraceptive methods. The aim of this study was to know the relationship of knowledge and perception with intention in the selection of postpartum intrauterine contraceptive device(PPICD) in third trimester pregnant women. This study was an analytic observational study with a cross-sectional design. The study was conducted in June 2022. Data for pregnant women in the third trimester of July 2021 - August 2021 at the Dadirejo Public Health Center are 72 people. This research uses total sampling. The research instrument is a questionnaire. Data analysis in this study was univariate, bivariate (Chi-square and likelihood) and multivariate (logistical regression) analysis. The proportion of postpartum contraceptive use was 52%. Knowledge level (p=0.000), perception (p=0.000) was related to the intention to use the PPIUCD. The variable that most influenced the intention to use the PPIUCD was the level of knowledge OR 15.315 (95% CI 3.337-69.4531; p=0.000). Knowledge level is the most dominant factor.

Contraceptive Intentions and Use throughout the Extended Postpartum Period: A Panel Study in Ethiopia.

The postpartum period is an ideal time for women to access contraception, but the prevalence of postpartum contraceptive use remains low in sub-Saharan Africa. To better understand the gap between women's desires to space or limit births and their contraceptive behaviors, intention to use contraception has been proposed as a person-centered measure of contraceptive demand. Using data from a panel study of Ethiopian women aged 15-49 who were interviewed at six weeks, six months, and one year postpartum, we examined the dynamics of contraceptive intention in the first year postpartum and its relationship with contraceptive use. Contraceptive intention fluctuated considerably in the year after childbirth. At six weeks, 60.9 percent of women intended to use a contraceptive method in the next year; 23.2% did not. By one year, less than half (43.5 percent) were using a method, and those who had no intention to use doubled (44.5 percent). Women who developed or sustained their intention to use a method in the postpartum period were more likely to adopt a method by one year than those who did not, showing that contraceptive intention is a strong predictor of use and has the potential to inform person-centered reproductive health programming in the extended postpartum period.

Postpartum contraception usage in immigrants compared with non-immigrants in Buffalo, NY

ObjectivesThe purpose of this study was to compare rates of postpartum contraception use in immigrant populations in Buffalo, NY compared with non-immigrant populations. The study also explores rates of specific birth control selection amongst those who did choose to employ postpartum contraception. Study designA retrospective chart review was conducted comparing the rate of postpartum contraceptive use in 132 immigrant individuals with that of 134 non-immigrant individuals, as measured by the documented intent or refusal to initiate any contraceptive method within the first three months postpartum. Patients were from clinics affiliated with the Women and Children’s Hospital of Buffalo (WCHOB) who delivered during the years 2015–2016. The immigrant patients were chosen from the top ten immigrant countries of origin who delivered at WCHOB at the time. ResultsAfter controlling for factors of maternal age, gestational age at time of delivery, and gravidity and parity, the immigrant group was more likely to decline postpartum contraception in the first three months postpartum compared with the non-immigrant group (25.8% vs 6.7%, p < 0.001). Immigrants were more likely to select a barrier method (p = 0.036) and decided to employ contraception more remotely from delivery when compared with non-immigrant individuals (p < 0.001). Amongst the immigrant cohort, there was no statistically significant difference in methods chosen based on broad geographic areas of origin. ConclusionsImmigrant obstetric populations in Buffalo are less likely to employ postpartum contraception compared with non-immigrant populations. The factors influencing this are multifactorial; however, this information can inform care for both immigrant and non-immigrant patients.

The effect of maternal educational status, antenatal care and resumption of menses on postpartum contraceptive use in Ethiopia: systematic review and meta-analysis

The postpartum period is a crucial starting point for the delivery of family planning services. To date, there are numerous primary studies in Ethiopia on postpartum contraceptive use and related factors. However, the results of key variables are inconsistent, making it difficult to use the results to advance the service dimensions of postpartum contraceptive use in the country. Therefore, this systematic review and meta-analysis was required to summarize this inconsistency and compile the best available evidence on the impact of maternal educational status, antenatal care and menstrual resumption on postpartum contraceptive use in Ethiopia. PubMed, Google Scholar, Scopus, Science Direct, and the repositories of online research institutes were searched. Data were extracted with Microsoft Excel and analyzed with the statistical software STATA (version 14). Data on the study area, design, population, sample size, and observed frequency were extracted using the Joanna Briggs Institute tool. To obtain the pooled effect size, a meta-analysis was performed using a weighted inverse variance random effects model. Cochran's Q X2 test, and I2 statistics were used to test for heterogeneity, estimate the total quantity, and measure the variability attributed to heterogeneity. A mixed-effects meta-regression analysis was performed to identify possible sources of heterogeneity. To examine publication bias, the Eggers regression test and the Beggs correlation test were used at a p-value threshold of 0.001. Of the 654 articles reviewed, 18 studies met the inclusion criteria and were included in this meta-analysis. Overall, the final analysis includes 11,263 study participants. In Ethiopia, postpartum contraceptive use correlated significantly with maternal educational status (OR = 3.121:95% CI 2.127–4.115), antenatal care follow-up (OR = 3.286; 95% CI 2.353–4.220), and return of the mother's menses (OR = 3.492; 95% CI 1.843–6.615). A uniform meta-regression was performed based on publication year (p = 0.821), sample size (p = 0.989), and city of residence (p = 0.104), which revealed that none of these factors are significant. The use of postpartum contraceptives was found to be better among mothers who are educated, attended antenatal appointments, and resumed their menstrual cycle. Based on our research, we strongly recommended that antenatal care use and maternal educational accessibility need to improve. For family planning professionals, removing barriers to menstruation resumption should be a key priority.