Postpartum contraception

Cooper, Michelle; Cameron, Sharon

doi:10.1111/tog.12494

Cited by 30 publications

(5 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The provision of contraception within 12 months postpartum is a key intervention in the prevention of short birth intervals and associated consequences 2. Yet, this study identified most (60.2%) women were not provided with government-subsidised hormonal PPC during this time.…”

Section: Discussionmentioning

confidence: 83%

“…The WHO recommends birth intervals of 2–3 years,1 as shorter intervals increase the risk of adverse maternal and infant outcomes including preterm birth, low birth weight and infant mortality 2 3. Unintended pregnancy is also associated with poorer maternal and infant outcomes, such as lower breastfeeding rates, maternal depression, preterm birth and low birth weight,2 4 and exposes women to obstetric risks arising from undesired fertility, unsafe abortions, inadequate birth intervals and pregnancies in high-risk groups 5 6. Because sexual activity and fertility can resume shortly after childbirth, there is a risk of pregnancy during the first 12 months postpartum unless contraception is initiated 2.…”

Section: Introductionmentioning

confidence: 99%

“…Unintended pregnancy is also associated with poorer maternal and infant outcomes, such as lower breastfeeding rates, maternal depression, preterm birth and low birth weight,2 4 and exposes women to obstetric risks arising from undesired fertility, unsafe abortions, inadequate birth intervals and pregnancies in high-risk groups 5 6. Because sexual activity and fertility can resume shortly after childbirth, there is a risk of pregnancy during the first 12 months postpartum unless contraception is initiated 2. Further, low breastfeeding rates globally in the first 6 months after birth limit natural contraception 7.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Patterns in the provision of government-subsidised hormonal postpartum contraception in Queensland, Australia between 2012 and 2018: a population-based cohort study

Carrandi¹,

Bull²,

Hu³

et al. 2023

BMJ Sex Reprod Health

View full text Add to dashboard Cite

BackgroundShort birth intervals and unintended pregnancy are associated with poorer maternal and infant outcomes. There is a risk of pregnancy during the immediate postpartum period unless contraception is initiated. This retrospective cohort study aimed to capture the current patterns of hormonal contraceptive provision within 12 months postpartum in a high-income country.MethodsWe used a linked administrative dataset comprising all women who gave birth in Queensland, Australia between 1 July 2012 and 30 June 2018 (n=339 265 pregnancies). We described our cohort by whether they were provided with government-subsidised hormonal contraception within 12 months postpartum. The associations between hormonal postpartum contraceptive provision and demographic and clinical characteristics were examined using univariate and multivariate logistic regression and presented in terms of crude and adjusted odds ratios with 95% confidence intervals.ResultsA majority of women (60.2%) were not provided with government-subsidised hormonal postpartum contraception within 12 months postpartum. Women who were younger (<25 years), were overweight or obese, smoked, were born in Australia, were non-Indigenous, gave birth in a public hospital, or were in the lowest socioeconomic status group were more likely to be provided with postpartum contraception after adjusting for other covariates, compared with their counterparts.ConclusionsStrategies to increase the provision and uptake of contraception in the immediate postpartum period are needed to prevent short birth intervals and unintended pregnancy and ensure women’s fertility intentions are enacted. Ongoing research is needed to examine the factors influencing women’s access to contraceptive services and, further, the types of contraception provided.

show abstract

Section: Discussionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Patterns in the provision of government-subsidised hormonal postpartum contraception in Queensland, Australia between 2012 and 2018: a population-based cohort study

Carrandi¹,

Bull²,

Hu³

et al. 2023

BMJ Sex Reprod Health

View full text Add to dashboard Cite

show abstract

“…There has been a trend to promote LARC options to women in the immediate postpartum period. 48 There may be an underlying funding reason or beneficent concerns about the risk of a future pregnancy or short inter-pregnancy intervals. However, care needs to be taken to ensure that the woman has the capacity, freedom and information to make these decisions at the material time.…”

Section: Timingmentioning

confidence: 99%

The ethics of state-sponsored and clinical promotion of long-acting reversible contraception

Wale

Rowlands

2020

BMJ Sex Reprod Health

View full text Add to dashboard Cite

ObjectivesTo review ethical aspects of the promotion and provision of long-acting reversible contraception (LARC). Specifically, to examine (1) the tension between informational exchange and the active promotion of LARC methods to new and existing contraceptive users by healthcare professionals; and (2) the distinct ethical issues arising from the promotion of LARC methods by state-sponsored actors and healthcare professionals.MethodsNarrative review and ethical analysis.FindingsThere is an ethical difference between raising awareness/informational provision and actively promoting or prioritising specific contraceptive methods. It matters whether the policy choice is made, or the promotional activity about contraception is undertaken, by individual healthcare professionals at a local level or by more remote state-sponsored actors, because the relationship between the promoter and the (potential) contraceptive user is of a different kind. Imposing a dual responsibility upon healthcare professionals for raising awareness/informational exchange and the active promotion of LARC creates an unnecessary tension and barrier for the delivery of patient-centred care.ConclusionsThis review highlights the need for ethical reflection on the central role of the promoting agent and the distinction between facilitating informational awareness and active promotion of LARC. LARC methods should not be prioritised in isolation and without regard to the wider implications of public promotion. A balanced narrative and information-sharing programme that respects the individual interests of each contraceptive user is called for, especially in direct professional/service user relationships. No assumption should be made that user decision-making will necessarily be determined and influenced solely by the relative effectiveness of the contraceptive method.

show abstract

“…Unintended pregnancies can adversely affect maternal and child physical and psychological health (Gipson et al 2008), and short interpregnancy intervals (<12-18 months) are similarly associated with increased risk of adverse maternal, infant and child health outcomes compared to births after 18 months (Kozuki et al 2013;Ahrens et al 2019). Access to contraception in the postpartum period can reduce unintended pregnancies and short interpregnancy intervals and support pregnancy planning and birth spacing (Cooper and Cameron 2018a).…”

Section: Introductionmentioning

confidence: 99%