Factors associated with contraceptive use among postpartum women with substance use disorder

Principles of care for pregnant and parenting people with substance use disorder: the obstetrician gynecologist perspective

“…Contraceptive use, particularly the more effective LARC methods, among persons with SUD is lower ( 138 , 139 ), however current data suggests that lower uptake of reproductive health services in this population is complex. A recent study found an association between increased postpartum contraceptive use and increased prenatal care visits, OBGYN buprenorphine prescribing and increased postpartum visits ( 140 ). Furthermore, HCV infection is rapidly increasing among reproductive-aged persons with injection drug use ( 141 ) leading to an ACOG recommendation for universal HCV screening in pregnancy ( 142 ).…”

Contraceptive uptake in postpartum people with and without opioid use disorder and opioid use with co-occurring substance use

“…While postpartum contraception uptake is effective in optimizing interpregnancy intervals, prior research using Pennsylvania Medicaid data has shown that overall postpartum contraception uptake is low in the 90 days after delivery for women with OUD, with 74.5 % not starting any method, 18.1 % receiving an effective method (oral contraceptive pill, patch, vaginal ring, or progesterone injection), and 7.4 % receiving a highly-effective method (long-acting reversible contraception including intrauterine devices or implants and permanent sterilization procedures) ( Krans et al, 2018 ). Furthermore, to the best of our knowledge, there are few clinical studies evaluating how postpartum contraception uptake may be impacted by the use of multiple substances, specifically opioids in addition to non-opioid substances such as alcohol, methamphetamines/cocaine, and sedative/hypnotics, with the majority of papers focused on individuals with single addictive disorders rather than OUD and co-occurring disorders ( Krans et al, 2018 , Shelton et al, 2022 , Stone et al, 2020 ). This is important as the opioid overdose crisis in the US has evolved to become an epidemic of co-occurring disorders, with opioids most commonly misused with other drugs like alcohol, methamphetamines, cocaine, and sedatives rather than alone ( Lin and Saitz, 2021 , Mattson et al, 2021 ).…”