The value of an extended postnatal program for contraceptive use during the first year postpartum

Abstract

Abstract Objective To investigate if earlier and repeated postpartum care visits (PPCVs) (3 and 7 weeks) compared to a standard visit (7 weeks) would increase early initiation of contraception and contraceptive use at 1‐year postpartum. Design Comparative clinical trial. Setting Six maternity clinics in Gothenburg, Sweden. Population There were 447 women in the intervention group and 511 in the standard group. Methods Comparing standard postpartum care with an intervention model of care. Main Outcome Measures Initiation of contraception and method used. Results From January 2019 to June 2020, 1159, participants were enrolled. Analyses included 958 subjects where the intervention group had higher use of contraception (55.5%) compared to the standard group (48.5%), (95% confidence interval [CI]: 0.4–13.5), p = 0.037. Long‐acting reversible contraceptives were higher among users in the intervention group (56.9%) compared to the standard group (48%), (95% CI: −0.3 to 18.0), p = 0.059. Condom use was higher in the standard group (19%) compared to the intervention group (12.1%), (95% CI: 0.1–13.6), p = 0.047. Contraceptive use 1‐year postpartum was higher in the intervention group (55.7%) compared to the standard group (47.2%), (95% CI: 1.2–15.9), p = 0.023 and more pregnancies were reported in the standard group (7.8%) compared to the intervention group (4.1%), (95% CI: 0.5–7.0), p = 0.040. Conclusion These results indicate the importance of earlier and additional PPCVs to increase early start‐up of contraception and to obtain a higher frequency of contraceptive use 1‐year postpartum to reduce pregnancies close to delivery.

Keywords

• contraception
• gynaecology
• postpartum