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Is Effective Contraceptive Use Conceived Prenatally in Florida? The Association Between Prenatal Contraceptive Counseling and Postpartum Contraceptive Use

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Abstract

The objective of this study is to describe the prevalence of postpartum contraceptive use among women experiencing a live birth in Florida in 2004–2005. To examine the association between family planning counseling during prenatal care visits and the use of effective contraceptive methods among postpartum women. Matched data from Florida PRAMS and Vital Statistics were used (n = 3,962). Weighted logistic regression was used to determine the association between prenatal family planning counseling and effective postpartum contraceptive use. Odds ratios were adjusted for use of contraception prior to pregnancy, well-baby checkup, race, ethnicity, nativity, education, marital status, poverty level, stress before or during pregnancy, and parity. Women who reported discussing family planning with their prenatal care provider were more likely to use effective contraception postpartum (AOR: 1.5, 1.1–2.0) compared to women who did not report a discussion. Women who used contraception prior to pregnancy (AOR: 2.3, 1.7–3.2) and women who experienced no stress before or during pregnancy (AOR: 2.0, 1.2–3.4) were also more likely to use contraception in the postpartum period. A significant interaction was identified between family planning counseling during prenatal visits and maternal education. Stratum specific odds ratios for women who received prenatal family planning counseling were significant for women with less than high school education (AOR: 2.5, 1.3–5.1) and for women with high school education (AOR: 2.0, 1.2–3.4). Women reporting family planning counseling during prenatal care were more likely to use effective contraception postpartum. While women with high school or less than high school education levels benefited from prenatal family planning counseling, the greatest benefit was observed for women with less than high school education. Integrating family planning counseling into prenatal care may increase the use of effective contraceptive methods among postpartum women.

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Abbreviations

PRAMS:

Pregnancy risk assessment monitoring system

FDA:

Food and drug administration

WIC:

Special supplemental nutrition program for women, infants and children

OR:

Odds ratio

AOR:

Adjusted odds ratio

95% CI:

95% confidence interval

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Acknowledgments

The authors thank Dr. Deb Rosenberg for her statistical and analytical contributions and the CDC-PRAMS grant support number 5UR6DP000541-05 who made possible the 2004 and 2005 surveys.

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Authors and Affiliations

  1. Maternal and Child Heath Practice and Analysis Unit, Division of Family Health Services, Florida Department of Health, Tallahassee, FL, USA

    Leticia E. Hernandez, William M. Sappenfield & David Goodman

  2. Community Health Systems Group, Altarum Institute, Ann Arbor, MI, USA

    Jennifer Pooler

Authors
  1. Leticia E. Hernandez
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  2. William M. Sappenfield
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  3. David Goodman
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  4. Jennifer Pooler
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Correspondence to Leticia E. Hernandez.

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Hernandez, L.E., Sappenfield, W.M., Goodman, D. et al. Is Effective Contraceptive Use Conceived Prenatally in Florida? The Association Between Prenatal Contraceptive Counseling and Postpartum Contraceptive Use. Matern Child Health J 16, 423–429 (2012). https://doi.org/10.1007/s10995-010-0738-9

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  • DOI: https://doi.org/10.1007/s10995-010-0738-9

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