Short Interval Between Pregnancies

OBJECTIVE To evaluate the associations between postpartum contraception and having a recent preterm birth. STUDY DESIGN Population-based data from the Pregnancy Risk Assessment Monitoring System in nine states were used to estimate postpartum use of highly or moderately effective contraception (sterilization, intrauterine device, implants, shots, pills, patch, and ring) and user-independent contraception (sterilization, implants, and intrauterine device) among women with recent live births (2009–2011). We assessed differences in contraception by gestational age (≤27, 28–33, or 34–36 weeks versus term [≥37 weeks]) and modeled the associations using multivariable logistic regression with weighted data. RESULTS A higher percentage of women with recent extreme preterm birth (≤27 weeks) reported using no postpartum method (31%) compared with all other women (15%–16%). Women delivering extreme preterm infants had decreased odds of using highly or moderately effective methods (adjusted odds ratio [aOR]=0.5, 95% confidence interval [CI]: 0.4 – 0.6) and user-independent methods (aOR=0.5, 95% CI: 0.4 – 0.7) compared with women having term births. Wanting to get pregnant was more frequently reported as a reason for contraceptive non-use by women with an extreme preterm birth overall (45%) compared with all other women (15%–18%, p<.0001). Infant death occurred in 41% of extreme preterm births and over half (54%) of these mothers reported wanting to become pregnant as the reason for contraceptive non-use. CONCLUSIONS During contraceptive counseling with women who had recent preterm births, providers should address optimal pregnancy interval, and consider that women with recent extreme preterm birth, particularly those whose infants died, may not use contraception because they want to get pregnant.

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Postpartum contraceptive use among women with a recent preterm birth

Robbins

Farr

Zapata

et al. 2015

American Journal of Obstetrics and Gynecology

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Interpregnancy care

Johnson

Gee

2015

Seminars in Perinatology

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The aim of interconception care is to provide women who have had a prior adverse pregnancy outcome with optimal care in order to reduce risks that may affect the woman׳s health and any future birth she may choose to have. National recommendations call for action, and evidence supports specific clinical interventions. The need for interconception care is documented in national and state survey and surveillance data. Chronic diseases and behavioral risks affect the health of millions of U.S. women of childbearing age. Interconception care demonstration projects have used a "disease management" approach that includes medical care and case management. The increasing use of postpartum visits, as a gateway to interconception interventions, is essential. The Affordable Care Act emphasis on preventive services and expanded health coverage for women offers new opportunities to finance interconception care. Improved and enhanced clinical practices, along with the engagement of women, in interconception care have the potential to improve birth outcomes and reduce disparities.

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Association of Postpartum Predischarge Depot-Medroxyprogesterone Acetate with In-Hospital Breastfeeding Initiation

Chen

Wysong

Hong

et al. 2016

Breastfeeding Medicine

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ppDMPA receipt was independently associated with decreased rates of breastfeeding initiation. Although more AA mothers received ppDMPA than non-AA, the association of ppDMPA with breastfeeding noninitiation was stronger in non-AA than in AA mothers. Future research should examine this question prospectively to ascertain if there is a cause-effect relationship and should address both physiological effects and social perceptions.

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Short Interval Between Pregnancies

Abstract: females. Obstet Gynecol 2012;119:772-9.) of a single-dose emergency contraceptive demonstrated young women's ability to appropriately select and correctly use the emergency contraceptive. This post hoc analysis examined the safety of the emergency contraceptive in various age subgroups.

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Postpartum contraceptive use among women with a recent preterm birth

Postpartum contraceptive use among women with a recent preterm birth

Interpregnancy care

Association of Postpartum Predischarge Depot-Medroxyprogesterone Acetate with In-Hospital Breastfeeding Initiation

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