Patterns of Postpartum Depot Medroxyprogesterone Administration Among Low-Income Mothers

Dozier, Ann; Nelson, Alice; Brownell, Elizabeth; Howard, Cynthia R.; Lawrence, Ruth A.

doi:10.1089/jwh.2012.4016

Cited by 16 publications

(8 citation statements)

References 12 publications

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“…We found that DMPA was the main prescribed contraception at first visit postpartum (67%). This number differs from those found by Dozier et al 11 ; they found that 31.3% of patients in the postpartum period used DMPA, and of these, 62% had received the injection before hospital delivery. This is a particularly favorable strategy for avoiding repeated pregnancy in adolescents because the failure rate of the DMPA method when used perfectly is of 0.2%.…”

Section: Discussioncontrasting

confidence: 82%

Adolescent Contraception Before and After Pregnancy—Choices and Challenges for the Future

Borovac-Pinheiro

Surita

D’Annibale

et al. 2016

Rev Bras Ginecol Obstet

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To determine methods of contraception used by adolescents before and after pregnancy. A cross-sectional study was performed, and data were collected from medical records of all teens in puerperal consultation at the Hospital da Mulher - José Aristodemo Pinotti (Caism), Universidade Estadual de Campinas (CAISM),, between July 2011 and September 2013. The inclusion criterion was being 10 to 19 years old, and the exclusion criterion was having a first consultation 90 days after childbirth. Statistical analyses were performed with averages, standard deviations, percentages, correlations and Fisher's exact tests using the SAS program, version 9.4. A total of 196 adolescents in postpartum consultation were included (44 days after childbirth on average). The majority was older than 14 years (89%), with an average age of 16.2 years, and the most were exclusively breast-feeding (70%). Before pregnancy, the use of any contraceptive methods was mentioned by 74% adolescents; the most frequent use was combined oral contraceptive followed by condom. The main reason for abandoning the use of contraception was the occurrence of an unintended pregnancy (41%), followed by reports of side effects (22%), behavior issues (18%) and desire for pregnancy (16%). A positive correlation was found between the age of the adolescent at the moment of childbirth, the age of menarche (r = 0.3), and the first sexual intercourse (r = 0.419). Vaginal delivery occurred in 76% of the cases. After birth, depot medroxyprogesterone acetate (DMPA) was the contraception method most frequently used (71%), followed by oral contraceptives (11.8%) and intrauterine devices (IUDs, 11.2%). The most prescribed contraceptive method before pregnancy in adolescents who had childbirth was combined oral contraceptives. Many of the study participants had an unintended pregnancy. After childbirth, the most used contraceptive method was DMPA. To improve contraception and reduce the chance of unintended pregnancies among adolescents, we should promote the use of long-acting reversible contraceptives (LARCS).

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Section: Discussioncontrasting

confidence: 82%

Adolescent Contraception Before and After Pregnancy—Choices and Challenges for the Future

Borovac-Pinheiro

Surita

D’Annibale

et al. 2016

Rev Bras Ginecol Obstet

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“…The explanation for this finding is not clear, since all events studied related to the most recent period – five years prior to the survey. In a US study among low income women, use of Depot Medroxyprogesterone Acetate (DMPA) reduced with increasing age of woman [ 34 ]. Another significant demographic factor analyzed was the number of living children.…”

Section: Discussionmentioning

confidence: 99%

Predictors of modern contraceptive use during the postpartum period among women in Uganda: a population-based cross sectional study

et al. 2015

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BackgroundThe rationale for promotion of family planning (FP) to delay conception after a recent birth is a best practice that can lead to optimal maternal and child health outcomes. Uptake of postpartum family planning (PPFP) remains low in sub-Saharan Africa. However, little is known about how pregnant women arrive at their decisions to adopt PPFP.MethodsWe used 3298 women of reproductive ages 15–49 from the 2011 UDHS dataset, who had a birth in the 5 years preceding the survey. We then applied both descriptive analyses comprising Pearson’s chi-square test and later a binary logistic regression model to analyze the relative contribution of the various predictors of uptake of modern contraceptives during the postpartum period.ResultsMore than a quarter (28%) of the women used modern family planning during the postpartum period in Uganda. PPFP was significantly associated with primary or higher education (OR=1.96; 95% CI=1.43-2.68; OR=2.73; 95% CI=1.88-3.97 respectively); richest wealth status (OR=2.64; 95% CI=1.81-3.86); protestant religion (OR=1.27; 95% CI=1.05-1.54) and age of woman (OR=0.97, 95% CI=0.95-0.99). In addition, PPFP was associated with number of surviving children (OR=1.09; 95 % CI=1.03-1.16); exposure to media (OR=1.30; 95% CI=1.05-1.61); skilled birth attendance (OR=1.39; 95% CI=1.12-1.17); and 1–2 days timing of post-delivery care (OR=1.68; 95% CI=1.14-2.47).ConclusionsIncreasing reproductive health education and information among postpartum women especially those who are disadvantaged, those with no education and the poor would significantly improve PPFP in Uganda.

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“…A study in Nepal revealed that more than one-quarter of women who gave birth in the last five years became pregnant within 24 months of giving birth and 52% had an unmet need for family planning within 24 months postpartum [10]. The rationale for promotion of family planning to delay conception after a recent birth is a best practice that can lead to optimal maternal and child health outcomes [5, 8, 11, 12]. On the contrary, short inter-pregnancy intervals can result in negative health outcomes such as maternal anaemia, low birth weight and neonatal and infant mortality [8, 13, 14].…”

Section: Introductionmentioning

confidence: 99%

Postpartum family planning utilization in Burundi and Rwanda: a comparative analysis of population based cross-sectional data

Rutaremwa¹,

Kabagenyi²

2018

Pan Afr Med J

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IntroductionPromotion of modern family planning is a major policy action for Africa to harness the demographic dividend. Family planning is an important public health intervention for maternal and child health.MethodsAnalysis was based on data from Demographic and Health Surveys conducted in 2010 on samples of women from Burundi (3396) and Rwanda (4670). Descriptive and multivariate logistic regression analyses to examine the contribution and comparison of the various predictors of uptake of modern contraceptives during the postpartum period (PPFP) in the two countries were carried out using STATA statistical software.ResultsDescriptive findings show only 20% of the samples of women in Burundi used while more than half of the women (51%) were using PPFP. Utilization of PPFP was significantly associated with primary (OR = 1.3, 95% CI = 1.1-1.6) and higher education (OR = 2.2, 95% CI = 1.6-3.1) in Burundi. Similarly in Rwanda increased use of PPFP in primary was (OR = 1.4, 95% CI = 1.2-1.6) while secondary education (OR = 1.6, 95% CI = 1.2-2.1). Protestant women were less likely to use PPFP in both Burundi (OR = 0.75, 95% CI = 0.6-0.9) and Rwanda (OR = 0.69, 95% CI = 0.6-0.8). Other significant variables in the regression models of both countries included wealth status, age of woman, number of living children and exposure to media. Professional birth delivery assistance was significant only in Rwanda.ConclusionEnhancing postpartum contraceptive use should target women with low education, low wealth status, and that the media has an important role to play in this transformation. Policies and programs must be put in place to ensure that the rural urban differences are eradicated.

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Patterns of Postpartum Depot Medroxyprogesterone Administration Among Low-Income Mothers

Abstract: This study of postpartum DMPA administration among a convenience sample of low-income mothers demonstrated rates of 26% overall, but there was between-hospital variability. Additional study may identify approaches to ensure timely administration to appropriate candidates.

Cited by 16 publications

References 12 publications

Adolescent Contraception Before and After Pregnancy—Choices and Challenges for the Future

Adolescent Contraception Before and After Pregnancy—Choices and Challenges for the Future

Predictors of modern contraceptive use during the postpartum period among women in Uganda: a population-based cross sectional study

Postpartum family planning utilization in Burundi and Rwanda: a comparative analysis of population based cross-sectional data

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