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Contraceptive Counseling in the Postpartum Period: Could Pediatricians Have a Role?

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Abstract

Introduction

Unplanned pregnancies lead to adverse health outcomes and contribute to economic burdens. A lack of continuity and consistency in immediate postpartum care may be a contributor. The most frequent postpartum medical encounters occur with the child’s pediatric health care provider, which represents an opportunity to discuss postpartum contraception. Therefore, our objective was to evaluate postpartum family planning knowledge and behavior in women, and to assess the potential acceptability of a pediatrician-delivered intervention to improve knowledge of and convenient access to contraception among postpartum women.

Methods

This was a non-interventional pilot study that employed survey and interview methodology.

Results

Women attending pediatric visits for their newborn or infant (N = 346) were surveyed; 35 were interviewed. On average, respondents were 27 years old (SD = 6), 6 months postpartum (SD = 5), and resumed sex 8 weeks after delivery (SD = 6). Of those who had resumed sex, 68% were not using contraception at the time. However, only 18% of survey respondents wanted to have another child. Few exhibited accurate knowledge of birth spacing or long acting reversible contraception. Most interviewees (86%) supported the idea of pediatricians providing contraceptive counseling. Concerns identified included whether it was “allowable” and pediatrician’s lack of knowledge of complex maternal health histories.

Discussion

This study highlights a gap between contraceptive need and provision in postpartum women. However, the findings suggest women’s willingness to engage in conversations with their child’s pediatrician about family planning. Future research should assess the feasibility and impact of integrating postpartum counseling into pediatric visits.

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Acknowledgement

This project was funded through a grant from the Abdul Latif Jameel Poverty Action Lab (J-PAL).

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Authors and Affiliations

  1. Department of Pediatrics, University of Kansas School of Medicine-Wichita, 3243 E Murdock, Suite 602, Wichita, KS, 67208, USA

    Kari Harris, Siddharthan Sivamurthy, Hafsa Mohiuddin, Amanda Aguila Gonzalez, Thuy Bui & Carolyn Ahlers-Schmidt

  2. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Building 1, Room 1217, Boston, MA, 02115, USA

    Kathryn Andrews, Jessica Cohen & Margaret McConnell

  3. Center for Research for Infant Birth and Survival, 3243 E Murdock, Suite 602, Wichita, KS, 67208, USA

    Carolyn Ahlers-Schmidt

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  1. Kari Harris
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  2. Siddharthan Sivamurthy
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  3. Hafsa Mohiuddin
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  4. Amanda Aguila Gonzalez
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  9. Carolyn Ahlers-Schmidt
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Correspondence to Carolyn Ahlers-Schmidt.

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Harris, K., Sivamurthy, S., Mohiuddin, H. et al. Contraceptive Counseling in the Postpartum Period: Could Pediatricians Have a Role?. Matern Child Health J 24, 923–931 (2020). https://doi.org/10.1007/s10995-020-02947-x

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