title: The free perinatal/postpartum contraceptive services project for migrant women in Shanghai: effects on the incidence of unintended pregnancy.
abstract: OBJECTIVE
  In 2006, the incidence of unintended pregnancy among rural-to-urban migrant women (RUMW) in Shanghai was reported as 12.8 per 100 women-years during the first year postpartum. Among permanent residents of Shanghai, that same rate was 3.8 per 100 women-years. An intervention study was designed to address the unmet need for family planning services among this underserved population of RUMW and reduce their high postpartum unintended pregnancy incidence.
  
  
  METHODS
  We enrolled 840 migrant women into an intervention study that provided free contraceptive counseling and a choice of methods. Subjects were recruited into the study during hospitalization for childbirth and offered a contraceptive method according to their choice prior to discharge. Counseling and further support were offered at 6 weeks and at 3, 6, 9 and 12 months postpartum via scheduled telephone calls and/or clinic visits.
  
  
  RESULTS
  Among all study participants, the median time to contraceptive initiation and sexual resumption was 2 months postpartum, respectively. The overall contraceptive prevalence at 12 months was 97.1%, and more than half of the women were using long-acting contraception. The incidence rate of unintended pregnancy during the first year postpartum was 2.2 per 100 women-years (95% confidence interval: 1.3-3.6).
  
  
  CONCLUSIONS
  Integrating free family planning services into existing childbirth delivery services in a maternity setting in Shanghai was effective in addressing the unmet need for family planning and reduced the risk of unintended pregnancy during the first year postpartum.
  
  
  CONCLUSIONS
  The maternity setting at the time of early labor and prior to postpartum hospital discharge is a practical venue and an optimal time to provide contraception counseling and for postpartum women to initiate use of contraceptive methods. Supporting services during the first year postpartum are also essential to encourage women to continue contraceptive use and reduce the incidence of postpartum unintended pregnancy.
authors.affiliation: Center for Biomedical Research Population Council, New York, NY 10021, USA. Electronic address: yoh251@mail.harvard.edu.
authors.forename: Yongmei
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Center for Biomedical Research Population Council, New York, NY 10021, USA.
authors.forename: Ruth
authors.initials: R
authors.lastname: Merkatz
authors.affiliation: Shanghai Institute of Planned Parenthood Research, 2140 Xie Tu Road, Shanghai 200032, P.R. China.
authors.forename: Haoping
authors.initials: H
authors.lastname: Zhu
authors.affiliation: Center for Biomedical Research Population Council, New York, NY 10021, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Roberts
authors.affiliation: Center for Biomedical Research Population Council, New York, NY 10021, USA.
authors.forename: Régine
authors.initials: R
authors.lastname: Sitruk-Ware
authors.affiliation: Shanghai Institute of Planned Parenthood Research, 2140 Xie Tu Road, Shanghai 200032, P.R. China.
authors.forename: Linan
authors.initials: L
authors.lastname: Cheng
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China; D015331:Cohort Studies; D003268:Contraception Behavior / Q000208:ethnology; D005193:Family Planning Services / Q000191:economics; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D006801:Humans; D008425:Maternal Behavior / Q000208:ethnology; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D010352:Patient Dropouts; D010353:Patient Education as Topic; D018743:Perinatal Care; D011181:Postnatal Care; D011247:Pregnancy; D018873:Pregnancy Rate; D049168:Pregnancy, Unplanned / Q000208:ethnology; D012725:Sexual Behavior / Q000208:ethnology; D014171:Transients and Migrants / Q000193:education; D019037:Urban Health Services / Q000191:economics; D016387:Women's Health / Q000193:education; D055815:Young Adult
keywords: China; Free contraceptive services; Intervention study; Migrants; Postpartum period; Unintended pregnancy