Prevalence and associated factors with contraceptive use 1 year after childbirth: a cross-sectional analysis of the pregnancy risk assessment monitoring system

Abstract

Background Contraceptive use after childbirth can reduce risk of unplanned pregnancy. This study estimated the prevalence of contraception use in the 1 year after childbirth. It further examined factors associated with use of the most and moderately effective forms of reversible contraception in the 1-year period after childbirth.Methods This cross-sectional study used Phase 8 data from the Pregnancy Risk Assessment Monitoring System (PRAMS) (2016–2020) in the USA (N=194 032). Prevalence, overall and by type, was estimated nationally, by state and by age. Multinomial logistic regression models estimated associations with the most and moderately effective forms of reversible contraception (vs non-use). The most effective reversible contraception consisted of long-acting reversible contraception (LARC); moderately effective reversible contraception was a combined category of the injection, pill, patch, vaginal ring and diaphragm.Results Moderately effective reversible contraception was the most common method used (24.8%) followed by no contraception (23.9%) and then use of the most effective reversible contraception (17.0%). Variation by age and state in LARC use was demonstrated. Having had a postpartum visit was the factor most strongly associated with LARC use in the 1 year after childbirth (adjusted OR (aOR): 4.96, 95% CI: 4.91 to 5.01). In contrast, being married at the time of the survey was the factor most strongly associated with use of moderately effective reversible contraception (aOR: 1.55, 95% CI: 1.54 to 1.56).Conclusion Higher prevalence of no contraception or less effective forms of birth control presents an opportunity for greater LARC adoption, if preferred, especially at the postpartum visit.