Patterns of postpartum depot medroxyprogesterone administration among low-income mothers.
BACKGROUND
Depot medroxyprogesterone acetate (DMPA) is often administered immediately postpartum to reduce the risk of short-interval repeat or unintended pregnancies, but little is known about the actual patterns of postpartum DMPA use. This article examines the patterns of DMPA administered among low-income new mothers in an upstate New York State community.


METHODS
Mothers attending urban pediatric practices (births 2009-2011) completed a mailed survey approximately 5 months after delivery. Among 83 survey items were questions about breastfeeding and timing of DMPA receipt.


RESULTS
Unintended pregnancy was reported by 48.8% of the subjects. Their deliveries occurred across four local hospitals. Among the 31.3% of subjects who received postpartum DMPA, 62.6% received it prior to hospital discharge. Those receiving in-hospital DMPA (n=127) were significantly more likely than other mothers to be black, older, urban dwelling, non-high school graduates, multiparous, and planning to formula feed. Administration patterns differed by hospital.


CONCLUSIONS
This study of postpartum DMPA administration among a convenience sample of low-income mothers demonstrated rates of 26% overall, but there was between-hospital variability. Additional study may identify approaches to ensure timely administration to appropriate candidates.
1 Department of Public Health Sciences, University of Rochester , Rochester, New York.
Ann M
AM
Dozier
Alice
A
Nelson
Elizabeth A
EA
Brownell
Cynthia R
CR
Howard
Ruth A
RA
Lawrence
D000293:Adolescent; D000328:Adult; D003268:Contraception Behavior; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D003276:Contraceptives, Oral / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage*; D009518:New York; D049590:Postpartum Period; D011203:Poverty; D011247:Pregnancy; D049168:Pregnancy, Unplanned; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014505:Urban Population; D055815:Young Adult
D003271:Contraceptive Agents, Female; D003276:Contraceptives, Oral; D017258:Medroxyprogesterone Acetate