Education for contraceptive use by women after childbirth

Lopez, Laureen M; Hiller, Janet E.; Grimes, David A.; Chen, Mario

doi:10.1002/14651858.cd001863.pub3

Cited by 44 publications

(33 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Planners aligned strategies with target increases in service coverage. Target setting was based on past demonstrated achievements in coverage in the country and local expertise as global literature shows no consistent patterns in the coverage levels attained by various strategies [29-31] and context and implementation are heavily influential [32,33]. To improve reliability, a ceiling was set for projected met need in line with the highest achievement of the region in which the study site was placed (based on Demographic Health Survey (DHS) data) to avoid excessively optimistic estimates by local planners.…”

Section: Methodsmentioning

confidence: 99%

Context-specific, evidence-based planning for scale-up of family planning services to increase progress to MDG 5: health systems research

et al. 2012

View full text Add to dashboard Cite

BackgroundUnmet need for family planning is responsible for 7.4 million disability-adjusted life years and 30% of the maternity-related disease burden. An estimated 35% of births are unintended and some 200 million couples state a desire to delay pregnancy or cease fertility but are not using contraception. Unmet need is higher among the poorest, lesser educated, rural residents and women under 19 years. The barriers to, and successful strategies for, satisfying all demand for modern contraceptives are heavily influenced by context. Successfully overcoming this to increase the uptake of family planning is estimated to reduce the risk of maternal death by up to 58% as well as contribute to poverty reduction, women’s empowerment and educational, social and economic participation, national development and environmental protection.MethodsTo strengthen health systems for delivery of context-specific, equity-focused reproductive, maternal, newborn and child health services (RMNCH), the Investment Case study was applied in the Asia-Pacific region. Staff of local and central government and non-government organisations analysed data indicative of health service delivery through a supply–demand oriented framework to identify constraints to RMNCH scale-up. Planners developed contextualised strategies and the projected coverage increases were modelled for estimates of marginal impact on maternal mortality and costs over a five year period.ResultsIn Indonesia, Philippines and Nepal the constraints behind incomplete coverage of family planning services included: weaknesses in commodities logistic management; geographical inaccessibility; limitations in health worker skills and numbers; legislation; and religious and cultural ideologies. Planned activities included: streamlining supply systems; establishment of Community Health Teams for integrated RMNCH services; local recruitment of staff and refresher training; task-shifting; and follow-up cards. Modelling showed varying marginal impact and costs for each setting with potential for significant reductions in the maternal mortality rate; up to 28% (25.1-30.7) over five years, costing up to a marginal USD 1.34 (1.32-1.35) per capita in the first year.ConclusionLocal health planners are in a prime position to devise feasible context-specific activities to overcome constraints and increase met need for family planning to accelerate progress towards MDG 5.

show abstract

Section: Methodsmentioning

confidence: 99%

Context-specific, evidence-based planning for scale-up of family planning services to increase progress to MDG 5: health systems research

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Limited evidence suggests that some educational interventions can increase uptake of contraception-including the most effective methods-after childbirth. 45,46 In Scotland, information given by midwives at an antenatal visit has been part of the pathway of a successful initiative to increase LARC uptake after delivery. 47 Peri-abortion information-giving alone does not appear to influence uptake of LARC or risk of further unplanned pregnancy; 48 it should be part of a pathway to facilitate access to and initiation of contraception.…”

Section: Lessons For Improving Provision Of Contraception After Prementioning

confidence: 99%

Contraception after pregnancy

Glasier

Bhattacharya

Evers

et al. 2019

Acta Obstet Gynecol Scand

View full text Add to dashboard Cite

Whatever the outcome, pregnancy provides the opportunity to offer effective contraception to couples motivated to avoid another pregnancy. This narrative review summarizes the evidence for health providers, drawing attention to current guidelines on which contraceptive methods can be used, and when they should be started after pregnancy, whatever its outcome. Fertility returns within 1 month of the end of pregnancy unless breastfeeding occurs. Breastfeeding, which itself suppresses fertility after childbirth, influences both when contraception should start and what methods can be used. Without breastfeeding, effective contraception should be started as soon as possible if another pregnancy is to be avoided. Interpregnancy intervals of at least 6 months after miscarriage and 1‐2 years after childbirth have long been recommended by the World Health Organization in order to reduce the chance of adverse pregnancy outcome. Recent research suggests that this may not be necessary, at least for healthy women <35 years old. Most contraceptive methods can be used after pregnancy regardless of the outcome. Because of an increased risk of venous thromboembolism associated with estrogen‐containing contraceptives, initiation of these methods should be delayed until 6 weeks after childbirth. More research is required to settle the questions over the use of combined hormonal contraception during breastfeeding, the use of injectable progestin‐only contraceptives before 6 weeks after childbirth, and the use of both hormonal and intrauterine contraception after gestational trophoblastic disease. The potential impact on the risk of ectopic pregnancy of certain contraceptive methods often confuses healthcare providers. The challenges involved in providing effective, seamless service provision of contraception after pregnancy are numerous, even in industrialized countries. Nevertheless, the clear benefits demonstrate that it is worth the effort.

show abstract

“…Provider proficiency in carrying out comprehensive education and counseling on postpartum contraception is particularly important in settings where literacy rates are low [12]. In a systematic review, Lopez et al [13] indicated that education on postpartum contraceptive use is associated with increased contraception use and a reduction in the occurrence of unplanned pregnancies. They further found that both short-term and multiple-contact educational interventions had positive effects on rates of postpartum contraceptive use [13].…”

Section: Introductionmentioning

confidence: 99%