Contraceptive use by obese women 1 year postpartum

Background

Obese women have higher rates of pregnancy complications, making the prevention of unintended pregnancies in this group of particular importance.

Study Design

We performed a secondary analysis of data from Active Mothers Postpartum (AMP), a randomized controlled trial aimed at postpartum weight reduction. We assessed contraceptive use among 361 overweight/obese women 12 months postpartum. Logistic regression was used to model the effect of body mass index (BMI) categories on effective contraceptive use (intrauterine, hormonal or sterilization methods) while adjusting for potential confounders including age, race, parity, breastfeeding, education and chronic illness.

Results

Effective contraceptive use was reported by 45% of women. In the multivariable model, women with a BMI ≥35 kg/m² were less likely to use effective contraception than women with a BMI <30 kg/m² (OR 0.5, 95% CI 0.3-0.8). There was a trend towards less use of effective contraception among women with a BMI 30-34.9 kg/m² as compared to women with a BMI <30 kg/m².

Conclusion

At 12 months postpartum, obese women were less likely to use effective contraceptive methods than overweight women. Although certain contraceptive methods may be preferred over others in this population, providers should reinforce the importance of effective contraception to avoid unintended pregnancies in obese women.