title: Understanding Factors Associated with Postpartum Visit Attendance and Contraception Choices: Listening to Low-Income Postpartum Women and Health Care Providers.
abstract: Background While there is considerable variability with respect to attendance at the postpartum visit, not much is known about women's preferences with respect to postpartum care. Likewise, there is also limited information on providers' practices regarding the postpartum visit and care including the delivery of contraception. To understand and address deficits in the delivery and utilization of postpartum care, we examined the perceptions of low-income postpartum women with respect to barriers to and preferences for the timing and location of the postpartum visit and receipt of contraception. We also examined providers' current prenatal and postnatal care practices for promoting the use of postpartum care and their attitudes toward alternative approaches for delivering contraceptive services in the postpartum period. Methods Qualitative face-to-face interviews were completed with 20 postpartum women and in-depth qualitative phone interviews were completed with 12 health care providers who had regular contact with postpartum women. Interviews were coded using Atlas.ti software and themes were identified. Results Women believed that receiving care during the postpartum period was an important resource for monitoring physical and mental health and also strongly supported the provision of contraception earlier than the 6-week postpartum visit. Providers reported barriers to women's use of postpartum care on the patient, provider, and system levels. However, providers were receptive to exploring new clinical practices that may widen the reach of postpartum care and increase access to postpartum contraception. Conclusion Approaches that increase the flexibility and convenience of postpartum care and the delivery of postpartum contraception may increase the likelihood that women will take advantage of essential postpartum services.
authors.affiliation: Community Health Sciences, UIC School of Public Health, 1603 W Taylor, Chicago, IL, 60612, USA. vhende5@uic.edu.
authors.forename: Vida
authors.identifier: 0000-0001-5799-0664
authors.initials: V
authors.lastname: Henderson
authors.affiliation: UIC College of Medicine, 808 S Wood, Chicago, IL, 60612, USA.
authors.forename: Katrina
authors.initials: K
authors.lastname: Stumbras
authors.affiliation: Department of Pediatrics, UIC College of Medicine, 840 S Wood St, Clinical Science North 440, MC 718, Chicago, IL, 60612, USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Caskey
authors.affiliation: Department of Obstetrics and Gynecology, UIC College of Medicine, 840 South Wood Street, Clinical Science North 440, MC 718, Chicago, IL, 60612, USA.
authors.forename: Sadia
authors.initials: S
authors.lastname: Haider
authors.affiliation: Epidemiology and Biostatistics, UIC School of Public Health, 1603 W Taylor, Chicago, IL, 60612, USA.
authors.forename: Kristin
authors.initials: K
authors.lastname: Rankin
authors.affiliation: Community Health Sciences, UIC School of Public Health, 1603 W Taylor, Chicago, IL, 60612, USA.
authors.forename: Arden
authors.initials: A
authors.lastname: Handler
mesh_terms: D000328:Adult; D002641:Chicago; D002755:Choice Behavior; D003267:Contraception / Q000379:methods*; D003268:Contraception Behavior; D005193:Family Planning Services / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D007407:Interviews as Topic; D011181:Postnatal Care / Q000706:statistics & numerical data*; D049590:Postpartum Period; D011203:Poverty; D036301:Qualitative Research; D055815:Young Adult
keywords: Contraceptive services; Low-income women; Postpartum providers; Postpartum visits