Abstract
Objectives
To compare the prevalence of highly effective contraceptive use by 12 weeks postpartum among participants of Centering Pregnancy®, a model of group prenatal care (GPC), and traditional prenatal care (TPC), and to investigate differences in contraceptive method choice by type of prenatal care.
Methods
We performed a retrospective review of all eligible patients who participated in GPC (n = 143) and a random sample of patients participating in TPC (n = 290) who followed up at our institution within 12 weeks of delivery. Our primary outcome was the proportion of participants using a highly effective contraceptive method within 12 weeks postpartum. Contraceptives were classified in tiers (Tier 1, long-acting reversible and permanent contraception; Tier 2, oral contraceptive pills, transdermal patch, vaginal ring, or injection; Tier 3, barrier and fertility awareness methods, withdrawal, spermicide; and no method). Tier 1 and Tier 2 methods were considered highly effective.
Results
The prevalence of highly effective contraceptive use by 12 weeks postpartum was 63.6% (91 of 143) and 63.1% (183 of 290) among participants in GPC and TPC, respectively (p = 0.99). We found no difference in Tier 1 versus other method use (adjusted odds ratio (aOR) 1.05, 95% CI 0.95–1.15, p = 0.34) or Tier 2 versus other method use between groups (aOR 0.98, 95% CI 0.89–1.08, p = 0.69), in a multivariable model controlling for demographic and clinical factors.
Conclusions for Practice
The prevalence of highly effective contraceptive use at 12 weeks postpartum was not different between GPC and TPC participants in this study. GPC was not associated with increased use of Tier 1 or Tier 2 contraceptive methods.
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Data Availability
Data has not been deposited into a repository but is available upon request.
Code Availability
Code is available upon request.
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Acknowledgements
The authors would like to thank Sarita Sonalkar, MD, MPH, Erika Levi, MD, MPH, and Elizabeth Micks, MD, MPH, for reviewing this manuscript.
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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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AO and EPG conceived and designed the study. APR provided background for the study. AO and SH performed data collection, which was supervised by EPG. EPG provided statistical advice and the data was analyzed by AP. AO drafted the manuscript and all the authors contributed substantially to its revision. AO takes responsibility for the paper as a whole.
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No author has a commercial or proprietary interest in any drug, device, or equipment mentioned in the article. EPG was Nexplanon trainer for Merck at the time of the study. The other authors declare they have no conflict of interest.
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The Institutional Review Board at our institution approved all study activities.
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Olatunde, A., Hosein, S., Paoletti, A. et al. Impact of Group Prenatal Care on Contraceptive Use at Twelve Weeks Postpartum. Matern Child Health J 26, 1559–1566 (2022). https://doi.org/10.1007/s10995-022-03394-6
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DOI: https://doi.org/10.1007/s10995-022-03394-6