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Effectiveness of Postpartum Contraceptive Choices

Am J Obstet Gynecol; ePub 2017 Feb 28; Brunson, et al

Long-acting reversible contraception is highly effective for postpartum women who wish to retain fertility but avoid early repeat pregnancy, a recent study found. This retrospective cohort study included 373,840 women (median age 27 years at time of delivery) enrolled in the US military healthcare system experiencing a total of 450,875 postpartum intervals during the study period between October 2010 and March 2015. Women were analyzed based on the most effective contraceptive method initiative during the first 6 months postpartum, even if subsequently discontinued. Researchers found:

  • Postpartum contraceptive methods initiated included self or partner sterilization (7%), intrauterine device (13.5%), etonogestrel implant (3.4%), depot medroxyprogesterone acetate (2.5%), and pill, patch, ring (36.8%).
  • 36.7% of women did not initiative a prescription method.
  • The estimated short interdelivery interval rate was 17.4% but varied with contraceptive method.
  • Use of an intrauterine device reduced the hazard of a subsequent delivery (aHR, 0.19) as did etonogestrel-implant (aHR, 0.21) when compared with non-use of any prescription contraceptive, while pill, patch, ring had less effect (aHR, 0.80).

Citation:

Brunson MR, Klein DA, Olsen CH, Weir L, Roberts TA. Postpartum contraception: Initiation and effectiveness in a large universal healthcare system. [Published online ahead of print February 28, 2017]. Am J Obstet Gynecol. doi:10.1016/j.ajog.2017.02.036.