title: Changing depot medroxyprogesterone acetate access at a faith-based institution.
abstract: BACKGROUND
  Loyola University Medical Center is a Jesuit faith-based hospital that previously offered immediate postpartum depot medroxyprogesterone acetate (DMPA) for noncontraceptive indications.
  
  
  METHODS
  We performed a historical cohort study comparing patients aged 25 years or less who received immediate postpartum DMPA versus women who did not. We used logistic regression to analyze associations between patient characteristics and repeat pregnancy within 1 year.
  
  
  RESULTS
  There was a total of 258 women in our cohort: 105 (40.70%) exposed to DMPA. Majorities were non-Caucasian, unmarried, Catholic and received public insurance. Multivariable analysis, after adjusting for race and religion, shows a statistically significant decrease in repeat pregnancy for patients given immediate postpartum DMPA (OR 0.27, 95% CI 0.10-0.72).
  
  
  CONCLUSIONS
  Limits on access to DMPA for noncontraceptive indications during the postpartum period resulted in significant increases in pregnancy rates for adolescents and young adult women at this faith-based institution.
authors.affiliation: Division of Family Planning, Department of Obstetrics and Gynecology, Columbia University, New York, NY 10032, USA. mg2852@columbia.edu
authors.forename: Maryam
authors.initials: M
authors.lastname: Guiahi
authors.forename: Moira
authors.initials: M
authors.lastname: McNulty
authors.forename: Gretchen
authors.initials: G
authors.lastname: Garbe
authors.forename: Sarah
authors.initials: S
authors.lastname: Edwards
authors.forename: Kimberly
authors.initials: K
authors.lastname: Kenton
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D016015:Logistic Models; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage*; D015999:Multivariate Analysis; D049590:Postpartum Period; D011247:Pregnancy; D012068:Religion and Medicine; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D017258:Medroxyprogesterone Acetate