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Most U.S. Women Report Using Postpartum Contraceptives


 

The majority (88%) of postpartum women reported current use of at least one form of contraception, based on an analysis of data from more than 43,000 women.

Reducing the percentage of births within a year of a previous birth among women in the United States is one of the Center's for Disease Control and Prevention's Healthy People 2010 goals. Use of effective contraceptive methods after a recent pregnancy can help prevent unintended pregnancies, ensure adequate birth spacing, and reduce adverse maternal and infant outcomes, according to Maura Whiteman, Ph.D., and colleagues at the CDC.

The researchers reviewed data from the CDC's Pregnancy Risk Assessment Monitoring System from 2004 to 2006 from New York City and 12 states. The postpartum period was defined as 2–9 months after giving birth. The report is the first population-based study to examine differences in postpartum contraceptive use based on maternal characteristics (MMWR 2009;58:821–6).

Overall, 62% of of 43,887 postpartum women reported using highly effective contraceptive methods (such as sterilization, IUD, pill, patch, or ring).

Another 20% reported using moderately effective methods (such as condoms) and 6% reported using less effective methods (such as the rhythm method, sponge, or diaphragm), while 12% reported no postpartum contraception, they reported.

Women who were least likely to use at least one method of contraception included those who had no prenatal care, women aged 35 years and older, women who said they wanted to get pregnant sooner, and women who identified themselves as Asian/Pacific Islander.

Highly effective postpartum contraception use by age ranged from a low of 53% among women aged 35 and older to a high of 73% among women younger than 20 years.

When the data were broken down by race, highly effective postpartum contraception use ranged from a low of 35% among Asian/Pacific Islanders to a high of 71% among black women and American Indian/Alaska Native women.

In addition, women with Medicaid coverage prior to pregnancy were more likely to use highly effective contraception postpartum than women without Medicaid, while women with no prenatal care were less likely to use highly effective contraception postpartum than those who had any prenatal care.

The study was limited by several factors, including the use of self- reports, a lack of data from all parts of the United States, and a lack of data on several additional contraceptive methods such as spermicides, emergency contraception, and lactational amenorrhea.

But the results can help clinicians identify women who need more information about postpartum contraception, the researchers noted.

“Health care providers should consider encouraging postpartum women to use highly effective contraceptive methods to increase the proportion of pregnancies that are intended and promote healthy birth spacing,” they said.

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