title: Contraceptive service needs of women with young children presenting for pediatric care.
abstract: OBJECTIVE
  The primary objective of this study is to characterize the need for contraceptive services and contraceptive method use among women with young children presenting to child health clinics. A secondary objective is to characterize the factors, including access to care and health needs, that exist in this population and to evaluate their association with contraceptive method use.
  
  
  METHODS
  This is a cross-sectional study of women with children under age 36 months presenting to four child health practices in the Baltimore, Maryland, area. Participating women completed a survey to assess desire for pregnancy, contraceptive method use and related characteristics.
  
  
  RESULTS
  A total of 238 participants (82%) were in need of contraceptive services (fertile and not desiring pregnancy). Overall, 59 (25%) of women in need were not using a contraceptive method (unmet need) and 79 (33%) were using a highly effective method (implant or intrauterine device). Factors associated with lower odds of unmet need for contraceptive services included attendance at a routine postpartum visit and visiting a healthcare provider to discuss contraception after pregnancy. Approximately half of index pregnancies were unintended and this was the only health factor associated with greater odds of using of a highly effective contraceptive method.
  
  
  CONCLUSIONS
  Most women presenting with young children for pediatric care indicated that they were not currently trying to become pregnant and reported current methods of pregnancy prevention that ranged from none to highly effective. Women who had not sought postpregnancy contraceptive care were more likely to have unmet need for contraceptive services.
  
  
  CONCLUSIONS
  Child health clinics may be a novel site for providing contraceptive care to women with children as part of a strategy to reduce unplanned pregnancies.
authors.affiliation: Department of Pediatrics, Johns Hopkins University School of Medicine, 200 N. Wolfe Street, Baltimore, MD 21287, USA; Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21287, USA. Electronic address: kupadhy2@jhmi.edu.
authors.forename: Krishna K
authors.initials: KK
authors.lastname: Upadhya
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21287, USA; Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, 4940 Eastern Avenue, Baltimore, MD 21224, USA. Electronic address: aburke@jhmi.edu.
authors.forename: Anne E
authors.initials: AE
authors.lastname: Burke
authors.affiliation: Department of Pediatrics, Johns Hopkins University School of Medicine, 200 N. Wolfe Street, Baltimore, MD 21287, USA; Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21287, USA. Electronic address: amarcel2@jhmi.edu.
authors.forename: Arik V
authors.initials: AV
authors.lastname: Marcell
authors.affiliation: Department of Pediatrics, Johns Hopkins University School of Medicine, 200 N. Wolfe Street, Baltimore, MD 21287, USA; Office of Extramural Research, Education and Priority Populations, Agency for Healthcare Research and Quality, 540 Gaither Road, Room 2034, Rockville, MD 20850, USA. Electronic address: kmistry2@jhmi.edu.
authors.forename: Kamila
authors.initials: K
authors.lastname: Mistry
authors.affiliation: Department of Pediatrics, Johns Hopkins University School of Medicine, 200 N. Wolfe Street, Baltimore, MD 21287, USA; Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21287, USA. Electronic address: tcheng2@jhmi.edu.
authors.forename: Tina L
authors.initials: TL
authors.lastname: Cheng
mesh_terms: D000328:Adult; D015142:Baltimore; D002675:Child, Preschool; D003267:Contraception / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data*; D003268:Contraception Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005193:Family Planning Services / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D000068101:Maternal-Child Health Services / Q000706:statistics & numerical data; D009035:Mothers / Q000523:psychology*; D049590:Postpartum Period / Q000523:psychology; D011247:Pregnancy; D055815:Young Adult
keywords: Contraception; Family planning; Health services; Pediatrics; Preconception health