A Survey of Mothersʼ Comfort Discussing Contraception with Infant Providers at Well-Child Visits

Fagan, E. Blake; Rodman, Emily; Sorensen, Elizabeth A.; Landis, Suzanne E.; Colvin, Gaye

doi:10.1097/smj.0b013e318197fae4

Cited by 22 publications

(11 citation statements)

References 13 publications

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“…Similar results are found in the present research that the advice on FP during ANC/PNC sessions has improved both contraceptive behavior outcomes. Advice during PNC is found to be more effective followed by, advice received during ANC to improve contraceptive behavior as found in previous studies [ 65 – 68 ]. This has a programmatic implications that advice on FP during PNC and ANC visits should be promoted with more efforts to increase contraceptive use and to reduce unmet need for FP.…”

Section: Discussionsupporting

confidence: 74%

Assessing the Impact of Family Planning Advice on Unmet Need and Contraceptive Use among Currently Married Women in Uttar Pradesh, India

Yadav

Dhillon²

2015

PLoS ONE

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BackgroundCounseling/advice is one of the key interventions to promote family planning (FP) in developing countries, including India. It helps to improve the quality of care and reduce maternal deaths. This paper investigates the continuity of maternal health (MH) service utilization from antenatal care to post-natal care and the impact this service utilization has on contraceptive use and on meeting the demand for family planning among currently married women in rural Uttar Pradesh, India.Methods and FindingsThe study assesses the impact of FP advice on unmet need and contraceptive use by adopting the propensity score matching method. It uses data from the District Level Household Survey (DLHS) (2007–08) that covered 76,147 currently married women (CMW) in the age group 15–44 years in Uttar Pradesh. Results show that the utilization of MH services [Antenatal care (ANC), institutional delivery, Postnatal care (PNC)] and FP advice during ANC and PNC has led to increase in current use of contraception by 3.7% (p<.01), 7.3% (p<.01) and 6.8% (p<.01), respectively. However, a greater utilization of these services has not translated into a reduction of unmet need for contraception at a similar manner.ConclusionMH service utilization including FP advice is more effective in increasing current use of spacing methods as compared to limiting methods. Findings support the need for “effective FP advice” interventions to reduce unintended births and unmet need. However, women from Scheduled Caste/Scheduled Tribe communities are less likely to receive MH services. Thus, efforts are required to ensure that currently married women across socio-economic backgrounds have equal opportunity to receive MH services and information on contraceptive use to meet the demand for family planning methods.

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Section: Discussionsupporting

confidence: 74%

Assessing the Impact of Family Planning Advice on Unmet Need and Contraceptive Use among Currently Married Women in Uttar Pradesh, India

Yadav

Dhillon²

2015

PLoS ONE

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“…One such approach is the co-location (broadly defined) of postpartum contraceptive services with the Well-Baby-Visit. A study by Fagan et al [ 9 ] found that 75 % of women reported they would be very/somewhat likely to use a contraceptive prescription provided by their infants’ physician. Additionally, a study conducted at UIC Hospital [ 22 ] found that 83 % of postpartum women surveyed at the WBV reported they were comfortable discussing contraception at the WBV, and 84 % stated they would accept contraceptive advice at the WBV.…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, the timing of the recommended four to six-week postpartum visit in the U.S. is not based on current evidence about women’s sexual activity after pregnancy or the need for timely postpartum contraception; thus, over half of women are at risk for a rapid repeat pregnancy [ 11 ]. Few studies examine women’s preferences for postpartum care [ 9 , 21 , 22 , 31 , 43 ]; however, there is ample evidence that the postpartum visit is underutilized [ 4 , 5 , 7 , 17 , 27 , 30 , 41 , 42 , 44 ]. For example, among women in Illinois who are Medicaid recipients, fewer than 60 % receive a postpartum visit according to the Healthcare Effectiveness Data and Information Set [HEDIS] measure for postpartum care [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Understanding Factors Associated with Postpartum Visit Attendance and Contraception Choices: Listening to Low-Income Postpartum Women and Health Care Providers

Henderson¹,

Stumbras

Caskey³

et al. 2016

Matern Child Health J

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Background While there is considerable variability with respect to attendance at the postpartum visit, not much is known about women’s preferences with respect to postpartum care. Likewise, there is also limited information on providers’ practices regarding the postpartum visit and care including the delivery of contraception. To understand and address deficits in the delivery and utilization of postpartum care, we examined the perceptions of low-income postpartum women with respect to barriers to and preferences for the timing and location of the postpartum visit and receipt of contraception. We also examined providers’ current prenatal and postnatal care practices for promoting the use of postpartum care and their attitudes toward alternative approaches for delivering contraceptive services in the postpartum period. Methods Qualitative face-to-face interviews were completed with 20 postpartum women and in-depth qualitative phone interviews were completed with 12 health care providers who had regular contact with postpartum women. Interviews were coded using Atlas.ti software and themes were identified. Results Women believed that receiving care during the postpartum period was an important resource for monitoring physical and mental health and also strongly supported the provision of contraception earlier than the 6-week postpartum visit. Providers reported barriers to women’s use of postpartum care on the patient, provider, and system levels. However, providers were receptive to exploring new clinical practices that may widen the reach of postpartum care and increase access to postpartum contraception. Conclusion Approaches that increase the flexibility and convenience of postpartum care and the delivery of postpartum contraception may increase the likelihood that women will take advantage of essential postpartum services.

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“…Previous studies in pediatric practices also found high maternal receptivity to health advice at well-child visits. 20,[28][29][30][31][32][33][34][35] This association suggests that well-child visits are an underused opportunity to address maternal risks for poor subsequent birth outcomes. The ICC approach we explored is consistent with recommendations by the American Academy of Pediatrics, which strongly advocates screening for maternal conditions such as smoking and depression at well-child visits.…”

mentioning

confidence: 99%

Interconception Care for Mothers During Well-Child Visits With Family Physicians: An IMPLICIT Network Study

Rosener

Barr

Frayne

et al. 2016

The Annals of Family Medicine

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PURPOSE Interconception care (ICC) is recommended to improve birth outcomes by targeting maternal risk factors, but little is known about its implementation. We evaluated the frequency and nature of ICC delivered to mothers at well-child visits and maternal receptivity to these practices. METHODSWe surveyed a convenience sample of mothers accompanying their child to well-child visits at family medicine academic practices in the IMPLICIT (Interventions to Minimize Preterm and Low Birth Weight Infants Through Continuous Improvement Techniques) Network. Health history, behaviors, and the frequency of the child's physician addressing maternal depression, tobacco use, family planning, and folic acid supplementation were assessed, along with maternal receptivity to advice.RESULTS Three-quarters of the 658 respondents shared a medical home with their child. Overall, 17% of respondents reported a previous preterm birth, 19% reported a history of depression, 25% were smoking, 26% were not using contraception, and 58% were not taking folic acid. Regarding advice, 80% of mothers who smoked were counseled to quit, 59% reported depression screening, 71% discussed contraception, and 44% discussed folic acid. Screening for depression and family planning was more likely when the mother and child shared a medical home (P <.05). Most mothers, nearly 95%, were willing to accept health advice from their child's physician regardless of whether a medical home was shared (P >.05).CONCLUSIONS Family physicians provide key elements of ICC at well-child visits, and mothers are highly receptive to advice from their child's physician even if they receive primary care elsewhere. Routine integration of ICC at these visits may provide an opportunity to reduce maternal risk factors for adverse subsequent birth outcomes. 2016;14:350-355. doi: 10.1370/afm.1933. Ann Fam Med INTRODUCTIONI nterconception care (ICC) is defined as care provided to mothers between pregnancies to improve health outcomes for women, newborns, and children.1 It includes interventions that modify risk factors in order to promote healthy outcomes of subsequent pregnancies.2 In 2006, the Centers for Disease Control and Prevention Work Group and Select Panel on Preconception Care recommended risk assessment and intervention in the interconception period, especially for women with previous adverse birth outcomes.3 ICC recommendations regarding maternal depression, tobacco use, folic acid supplementation, and family planning are supported by evidence suggesting that addressing these factors reduces poor birth outcomes. [4][5][6][7][8][9][10][11][12][13][14] ICC has been broadly advocated but not widely implemented. 15,16 Barriers include limited access to health care between pregnancies, maternal focus on their infant to the exclusion of their own personal health needs, 351inadequate knowledge of ICC among clinicians, and lack of an established ICC model. Continuity of care with the same primary care clinician or practice over time has been associated with improved ou...

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A Survey of Mothersʼ Comfort Discussing Contraception with Infant Providers at Well-Child Visits

Cited by 22 publications

References 13 publications

Assessing the Impact of Family Planning Advice on Unmet Need and Contraceptive Use among Currently Married Women in Uttar Pradesh, India

Assessing the Impact of Family Planning Advice on Unmet Need and Contraceptive Use among Currently Married Women in Uttar Pradesh, India

Understanding Factors Associated with Postpartum Visit Attendance and Contraception Choices: Listening to Low-Income Postpartum Women and Health Care Providers

Interconception Care for Mothers During Well-Child Visits With Family Physicians: An IMPLICIT Network Study

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