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Maternal and Child Health Journal

, Volume 21, Issue 9, pp 1744–1752 | Cite as

The Availability and Use of Postpartum LARC in Mexico and Among Hispanics in the United States

  • Joseph E. PotterEmail author
  • Celia Hubert
  • Kari White
Article

Abstract

Objectives In the 1980s, policy makers in Mexico led a national family planning initiative focused, in part, on postpartum IUD use. The transformative impact of this initiative is not well known, and is relevant to current efforts in the United States (US) to increase women’s use of long-acting reversible contraception (LARC). Methods Using six nationally representative surveys, we illustrate the dramatic expansion of postpartum LARC in Mexico and compare recent estimates of LARC use immediately following delivery through 18 months postpartum to estimates from the US. We also examine unmet demand for postpartum LARC among 321 Mexican-origin women interviewed in a prospective study on postpartum contraception in Texas in 2012, and describe differences in the Mexican and US service environments using a case study with one of these women. Results Between 1987 and 2014, postpartum LARC use in Mexico doubled, increasing from 9 to 19 % immediately postpartum and from 13 to 26 % by 18 months following delivery. In the US, <0.1 % of women used an IUD or implant immediately following delivery and only 9 % used one of these methods at 18 months. Among postpartum Mexican-origin women in Texas, 52 % of women wanted to use a LARC method at 6 months following delivery, but only 8 % used one. The case study revealed provider and financial barriers to postpartum LARC use. Conclusions Some of the strategies used by Mexico’s health authorities in the 1980s, including widespread training of physicians in immediate postpartum insertion of IUDs, could facilitate women’s voluntary initiation of postpartum LARC in the US.

Keywords

Mexico Hispanics Immigrants Postpartum contraception Long-acting reversible contraception (LARC) 

Notes

Acknowledgments

This research was supported by a grant from the Susan Thompson Buffett Foundation. Infrastructural support was provided by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R24 042849) to the Population Research Center, University of Texas at Austin. We would like to thank Chloe Dillaway and Natasha Mevs-Korff for superb research assistance. The first author is grateful to Rodolfo Tuirán, Daniel Hernández Franco, and Anibal Faundes for conversations that helped bring the early years of the Mexican family planning program back into focus. 

References

  1. Aiken, A. R., Creinin, M., Kaunitz, A. M., et al. (2014). Global fee prohibits postpartum provision of the most effective reversible methods. Contraception, 90(5), 466–467.CrossRefPubMedPubMedCentralGoogle Scholar
  2. American College of Obstetricians and Gynecologists. (2011). Practice Bulletin No. 121: Long-acting reversible contraception: Implants and intrauterine devices. Obstetrics and Gynecology, 118, 184–196.CrossRefGoogle Scholar
  3. Aznar, R., Lara, R., & Giner, J. (1985). Investigacion Biomedica. In Martinez-Manautou J. (Ed.), La Revolucion Demografica en Mexico 1970–1980 (pp. 105–129). Mexico: Insituto Mexicano de Seguro Social.Google Scholar
  4. Bertrand, J. T., Sullivan, T. M., Knowles, E. A., et al. (2014). Contraceptive method skew and shifts in method mix in low- and middle-income countries. International Perspectives on Sexual and Reproductive Health, 40(3), 144–153.CrossRefPubMedGoogle Scholar
  5. Biggs, M. A., Harper, C. C., Malvin, J., et al. (2014). Factors influencing the provision of long-acting reversible contraception in California. Obstetrics and Gynecology, 123(3), 593–602. doi: 10.1097/AOG.0000000000000137.CrossRefPubMedGoogle Scholar
  6. Boonstra, H., Duran, V., Gamble, V. N., et al. (2000). The ‘boom and bust phenomenon’: The hopes, dreams and broken promises of the contraceptive revolution. Contraception, 61(1), 9–25.CrossRefPubMedGoogle Scholar
  7. Bronfman, M., López, E., & Tuirán, R. (1986). Práctica anticonceptiva y clases sociales en México: la experiencia reciente. Estudios demográficos y urbanos, 1(2), 165–203.CrossRefPubMedGoogle Scholar
  8. Cleland, J., & Shah, I. H. (2014). Postpartum and post abortion contraception: A synthesis of the evidence. Seminar on promoting postpartum and post-abortion family planning-challenges and opportunities. Cochin: IUSSP.Google Scholar
  9. Gomez, A. M., Fuentes, L., & Allina, A. (2014). Women or LARC first? Reproductive autonomy and the promotion of long-acting reversible contraceptive methods. Perspectives on Sexual and Reproductive Health, 46(3), 171–175. doi: 10.1363/46e1614.CrossRefPubMedPubMedCentralGoogle Scholar
  10. Guttmacher Institute. (2013). Laws affecting reproductive health and rights: 2013 state policy review. New York: Guttmacher Institute.Google Scholar
  11. Hubacher, D. (2002). The checkered history and bright future of intrauterine contraception in the United States. Perspectives on Sexual and Reproductive Health, 34(2), 98–103.CrossRefPubMedGoogle Scholar
  12. Hurt, W. G. (1974). Septic pregnancy associated with Dalkon Shield intrauterine device. Obstetrics and Gynecology, 44(4), 491–495.PubMedGoogle Scholar
  13. Jaccobson, J. L. (2000). Transforming family planning programmes: Towards a framework for advancing the reproductive rights agenda. Reproductive Health Matters, 8(15), 21–32.CrossRefGoogle Scholar
  14. Kavanaugh, M. L., Jerman, J., & Finer, L. B. (2015). Changes in use of long-acting reversible contraceptive methods among U.S. women, 2009–2012. Obstetrics and Gynecology, 126(5), 917–927.CrossRefPubMedPubMedCentralGoogle Scholar
  15. Luchowski, A. T., Anderson, B. L., Power, M. L., et al. (2014). Obstetrician-gynecologists and contraception: Practice and opinions about the use of IUDs in nulliparous women, adolescents and other patient populations. Contraception, 89(6), 572–577. doi: 10.1016/j.contraception.2014.02.008.CrossRefPubMedGoogle Scholar
  16. Martinez-Manautou, J. (Ed.). (1985). La Revolucion Demografica en Mexico 1970–1980. Mexico: Instituto Mexicano de Seguro Social.Google Scholar
  17. Moniz, M. H., Chang, T., Davis, M. M., et al. (2016). Medicaid administrator experiences with the implementation of immediate postpartum long-acting reversible contraception. Women’s Health Issues, 26(3), 313–320.CrossRefPubMedGoogle Scholar
  18. Moniz, M. H., Dalton, V. K., Davis, M. M., et al. (2015). Characterization of Medicaid policy for immediate postpartum contraception. Contraception, 92(6), 523–531.CrossRefPubMedGoogle Scholar
  19. Newton, J., Harper, M., & Chan, K. K. (1977). Immediate post-placental insertion of intrauterine contraceptive devices. Lancet, 2(8032), 272–274.CrossRefPubMedGoogle Scholar
  20. Ogburn, J. A., Espey, E., & Stonehocker, J. (2005). Barriers to intrauterine device insertion in postpartum women. Contraception, 72(6), 426–429. doi: 10.1016/j.contraception.2005.05.016.CrossRefPubMedGoogle Scholar
  21. Potter, J. E. (1999). The persistence of outmoded contraceptive regimes: The cases of Mexico and Brazil. Population and Development Review, 25(4), 703.CrossRefGoogle Scholar
  22. Potter, J. E., & Alba, F. (1986). Population and development in Mexico since 1940: An interpretation. Population and Development Review, 12(1), 47–75.CrossRefGoogle Scholar
  23. Potter, J. E., Hopkins, K., Aiken, A. R., et al. (2014). Unmet demand for highly effective postpartum contraception in Texas. Contraception, 90(5), 488–495.CrossRefPubMedPubMedCentralGoogle Scholar
  24. Potter, J. E., Mojarro, O., & Nunez, L. (1987). The influence of health care on contraceptive acceptance in rural Mexico. Studies in Family Planning, 18(3), 144–156.CrossRefPubMedGoogle Scholar
  25. Singh, R. H., Rogers, R. G., Leeman, L., et al. (2014). Postpartum contraceptive choices among ethnically diverse women in New Mexico. Contraception, 89(6), 512–515. doi: 10.1016/j.contraception.2013.12.017.CrossRefPubMedPubMedCentralGoogle Scholar
  26. Teal, S. B. (2014). Postpartum contraception: Optimizing interpregnancy intervals. Contraception, 89(6), 487–488.CrossRefPubMedGoogle Scholar
  27. Trussell, J. (2011). Contraceptive failure in the United States. Contraception, 83(5), 397–404.CrossRefPubMedPubMedCentralGoogle Scholar
  28. Werth, S. R., Secura, G. M., Broughton, H. O., et al. (2015). Contraceptive continuation in Hispanic women. American Journal of Obstetrics and Gynecology, 312(3), e1–e8. doi: 10.1016/j.ajog.2014.09.003.Google Scholar
  29. White, K., Grossman, D., Hopkins, K., et al. (2012). Cutting family planning in Texas. New England Journal of Medicine, 367(13), 1179–1181.CrossRefPubMedPubMedCentralGoogle Scholar
  30. White, K., Hopkins, K., Aiken, A. R. A., et al. (2015). The impact of reproductive health legislation on family planning clinic services in Texas. American Journal of Public Health, 105(5), 851–858. doi: 10.2105/AJPH.2014.302515.CrossRefPubMedPubMedCentralGoogle Scholar
  31. White, K., Teal, S. B., & Potter, J. E. (2015). Contraception after delivery and short interpregnancy intervals among women in the United States. Obstetrics and Gynecology, 125(6), 1471–1477.CrossRefPubMedPubMedCentralGoogle Scholar
  32. World Health Organization. (2013). Programming strategies for postpartum family planning. Geneva: World Health Organization.Google Scholar
  33. Zatuchni, G. I. (1968). International postpartum family planning program: Report on an action-research demonstration study. American Journal of Obstetrics and Gynecology, 100(7), 1028–1041.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Population Research CenterUniversity of Texas at AustinAustinUSA
  2. 2.National Institute of Public HealthMexicoMexico
  3. 3.Health Care Organization and PolicyUniversity of Alabama at BirminghamBirminghamUSA

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