title: The discordance between planned use and actual receipt of immediate postpartum depot medroxyprogesterone among low-income women.
abstract: BACKGROUND
  This study describes the patterns of planned use and actual receipt of immediate postpartum depot medroxyprogesterone (DMPA) prior to hospital discharge among low-income breastfeeding initiators.
  
  
  METHODS
  Bivariate analyses among DMPA recipients by prenatal planned/unplanned use and the sensitivity of DMPA self-report relative to pharmacologic record were calculated.
  
  
  RESULTS
  Among immediate postpartum DMPA recipients (n=58), 72.4% (n=42) did not plan to use DMPA. The sensitivity of self-reported DMPA use was 89.7% (95% confidence interval, 85.2, 94.2).
  
  
  CONCLUSIONS
  Clinically, it is unclear if the immediate postpartum period is the appropriate time to obtain consent and administer a long-acting contraceptive method. In our sample, women accurately recalled receiving DMPA in the immediate postpartum period. However, the majority did not plan to use this contraceptive method. Further high-quality qualitative and quantitative research regarding women's contraceptive plans and perception of the postpartum DMPA consent process and the healthcare provider's attitudes regarding consent and prescription of immediate postpartum DMPA are warranted.
authors.affiliation: 1 Connecticut Human Milk Research Center, Division of Neonatology, Connecticut Children's Medical Center , Hartford, Connecticut.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Brownell
authors.forename: Mary M
authors.initials: MM
authors.lastname: Lussier
authors.forename: Ann M
authors.initials: AM
authors.lastname: Dozier
authors.forename: Cynthia R
authors.initials: CR
authors.lastname: Howard
authors.forename: Susan G
authors.initials: SG
authors.lastname: Fisher
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Duckett
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Lawrence
authors.forename: I Diana
authors.initials: ID
authors.lastname: Fernandez
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data*; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D005260:Female; D019538:Health Care Surveys; D057220:Health Literacy; D006801:Humans; D033182:Intention; D008525:Medroxyprogesterone / Q000008:administration & dosage*; D010353:Patient Education as Topic; D049590:Postpartum Period; D011247:Pregnancy; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D003271:Contraceptive Agents, Female; D008525:Medroxyprogesterone