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  • Title: Is enhanced, structured prenatal counseling in third trimester associated with postpartum contraceptive uptake?
    Author: Korn E, Yan X, Schmidt-Swartz J, Rahimi S, Moon F, Dinglas C.
    Journal: Sex Reprod Healthc; 2023 Mar; 35():100818. PubMed ID: 36739823.
    Abstract:
    INTRODUCTION: Contraception is key for maternal well-being in the postpartum period. This study aims to evaluate the impact of prenatal counseling on postpartum contraception uptake. METHODS: This cohort study assessed pregnant patients who received their prenatal care at our outpatient obstetrics clinic in 2021-2022. The intervention group received counseling at their 28- and 36-week prenatal visits with a language-congruent paper handout and a review of methods by the provider. The non-intervention group was seen in the outpatient clinic prior to implementation. Intervention patients were surveyed on postpartum days 1-3 to evaluate recollection of counseling and intent to start contraception. Data on uptake and type of contraception chosen was collected for both groups at 6- and 12-weeks postpartum. Our primary outcome was uptake of any type of contraception at the 6-week postpartum visit. RESULTS: A total of 126 patients over two five-month intervals (64 intervention and 62 non-intervention) were included in analysis. Baseline patient characteristics were similar between the groups, including predominance of public insurance. Groups differed by race/ethnicity, with higher rates of Hispanic patients in the intervention group. Patients in the intervention group had higher contraception uptake within six weeks of delivery (OR 2.61, p = 0.0287). Forty-three patients in the intervention group desired postpartum contraception (including permanent methods, such as tubal ligation), although only 21 (48.8 %) received their desired method. There were no differences in method chosen between the non-intervention and intervention groups (p = 0.15). CONCLUSIONS: Structured prenatal counseling regarding contraceptive options can improve the timely initiation of contraception.
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