Prevalence and Predictors of Prenatal and Postpartum Contraceptive Counseling in Two Texas Cities |
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| Affiliation: | 1. University of New Mexico School of Medicine Department of Obstetrics and Gynecology, Albuquerque, NM, USA;2. University of New Mexico School of Medicine Department of Family and Community Medicine, Albuquerque, NM, USA;1. College of Nursing, University of Colorado Anschutz Medical Campus, Colorado;2. University of Colorado Population Center (CUPC), University of Colorado Boulder, Boulder, Colorado;3. Department of Sociology, University of Colorado Boulder, Boulder, Colorado;4. School of Social Work, University of Texas at Austin, Austin, Texas;5. Law Office of Susan Hays, P.C., Austin, Texas;1. Center for Biomedical Research Population Council, New York, NY 10021, USA;2. Shanghai Institute of Planned Parenthood Research, 2140 Xie Tu Road, Shanghai 200032, P.R. China;1. Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL 35294, USA;2. Population Research Center, University of Texas at Austin, Austin, TX 78712, USA |
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| Abstract: | ObjectivesWe investigated the prevalence of and sociodemographic associations with receiving prenatal and postpartum contraceptive counseling, including counseling on intrauterine devices (IUDs) and implants.MethodsWe used data from a prospective cohort study of 803 postpartum women in El Paso and Austin, Texas. We examined the prevalence of prenatal and postpartum counseling, provider discouragement of IUDs and implants, and associated sociodemographic characteristics using χ2 tests and logistic regression.ResultsOne-half of participants had received any prenatal contraceptive counseling, and 13% and 37% received counseling on both IUDs and implants prenatally and postpartum, respectively. Women with more children were more likely to receive any contraceptive counseling prenatally (odds ratio [OR], 1.99; p < .01). Privately insured women (OR, 0.53; p < .05) had a lower odds of receiving prenatal counseling on IUDs and implants than publicly insured women. Higher education (OR, 2.16; p < .05) and attending a private practice (OR, 2.16; p < .05) were associated with receiving any postpartum counseling. Older age (OR, 0.61; p < .05) was negatively associated with receiving postpartum counseling about IUDs and implants and a family income of $10,000 to $19,000 (OR, 2.21; p < .01) was positively associated. Approximately 20% of women receiving prenatal counseling and 10% receiving postpartum counseling on IUDs and implants were discouraged from using them. The most common reason providers restricted use of these methods was inaccurate medical advice.ConclusionsPrenatal and postpartum counseling, particularly about IUDs and implants, was infrequent and varied by sociodemographics. Providers should implement evidence-based prenatal and postpartum contraceptive counseling to ensure women can make informed choices and access their preferred method of postpartum contraception. |
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