title: Impact of having a high-risk pregnancy on future postpartum contraceptive method choice.
abstract: BACKGROUND
  To compare the knowledge and preference of preconceptional contraception to future postpartum contraceptive method choice in high-risk pregnancies.
  
  
  OBJECTIVE
  Does a high-risk pregnancy condition affect future postpartum contraceptive method choice?
  
  
  METHODS
  Women hospitalised at the High Risk Pregnancy unit of a tertiary research and training hospital were asked to complete a self-reported questionnaire that included demographic characteristics, presence of unintended pregnancy, contraceptive method of choice before the current pregnancy, plans for contraceptive use following delivery and requests for any contraceptive counselling in the postpartum period.
  
  
  RESULTS
  A total of 655 pregnant women were recruited. The mean age, gravidity and parity of the women were 27.48 ± 6.25 years, 2.81 ± 2.15 and 1.40 ± 1.77, respectively. High-risk pregnancy indications included 207 (31.6%) maternal, 396 (60.5%) foetal and 52 (7.9%) uterine factors. All postpartum contraceptive choices except for combined oral contraceptives (COCs) usage were significantly different from preconceptional contraceptive preferences (p<0.001). High-risk pregnancy indications, future child bearing, ideal number of children, income and education levels were the most important factors influencing postpartum contraceptive choices. While the leading contraceptive method in the postpartum period was long-acting reversible contraceptive methods (non-hormonal copper intrauterine device Cu-IUD, the levonorgestrel-releasing intrauterine system (LNG-IUS) (40%), the least preferred method was COCs use (5.2%) and preference of COCs use showed no difference between the preconceptional and postpartum periods (p=0.202). Overall 73.7% of the women wanted to receive contraceptive counselling before their discharge.
  
  
  CONCLUSIONS
  A high-risk pregnancy condition may change the opinion and preference of contraceptive use, and also seems to affect the awareness of family planning methods.
authors.affiliation: Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey. Electronic address: sadimanaltin@gmail.com.
authors.forename: Sadiman
authors.initials: S
authors.lastname: Kiykac Altinbas
authors.affiliation: Recep Tayyip Erdogan University School of Medicine, Department of Obstetrics and Gynecology, Rize, Turkey.
authors.forename: Yesim
authors.initials: Y
authors.lastname: Bayoglu Tekin
authors.affiliation: Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey.
authors.forename: Berna
authors.initials: B
authors.lastname: Dilbaz
authors.affiliation: Gulhane Military Medical Academy, Department of Epidemiology, Ankara, Turkey.
authors.forename: Selim
authors.initials: S
authors.lastname: Kilic
authors.affiliation: St. Luke's Roosevelt Hospitals, Department of Obstetrics and Gynecology, New York, NY, United States.
authors.forename: Susan S
authors.initials: SS
authors.lastname: Khalil
authors.affiliation: Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Kandemir
mesh_terms: D000328:Adult; D002755:Choice Behavior; D003267:Contraception / Q000379:methods*; D003268:Contraception Behavior; D003271:Contraceptive Agents, Female; D003274:Contraceptive Devices, Female; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D049590:Postpartum Period; D016742:Preconception Care; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D011795:Surveys and Questionnaires
chemical_list: D003271:Contraceptive Agents, Female
keywords: Family planning; High-risk; Postpartum contraceptive methods; Preconceptional contraceptive methods; Pregnancy