Postpartum intentions on contraception use and method choice among breastfeeding women attending a university hospital in Ohio: a cross-sectional study.
BACKGROUND
Few postpartum women use effective contraception and those who use less effective methods have increased rates of unintended pregnancy. Little is known about postpartum contraception intentions among breastfeeding women. Our objectives were to measure the extent of prenatal contraceptive counseling, to assess contraceptive intentions, and to identify correlates of both among postpartum women who were planning to breastfeed.


METHODS
We conducted a cross-sectional study using a convenience sample of 100 breastfeeding women before their discharge following delivery at a large university hospital in 2015. We used logistic regression to assess three outcomes of interest: not intending to use contraception before 6 months postpartum, reporting receiving counseling on postpartum contraception during prenatal care, and considering the effects of contraception methods on the breastfeeding mother-infant dyad when choosing a postpartum contraception method.


RESULTS
Most women (91%) intended to use contraception. Prior history of no contraception use was the sole factor related to not intending to use contraception. The most commonly cited reason for the intended choice of contraceptive method was convenience (35%). Few women (21%) reported considering the effects of contraception methods on the breastfeeding dyad when choosing a postpartum contraception method. Nearly half of women reported never discussing postpartum contraception options with their healthcare provider during prenatal care. In the multivariate analysis, receiving public assistance was the only factor that remained statistically significantly associated with reporting having received contraception counseling during prenatal care.


CONCLUSIONS
Although most women intended to use contraception, they did not appear to have received adequate prenatal counseling on postpartum contraception.
The Ohio State University, College of Public Health, 1841 Neil Ave, Columbus, OH, 43210-1351, USA. Loewenbergweisband.1@osu.edu.
Yiska
Y
Loewenberg Weisband
The Department of Obstetrics and Gynecology, Ohio State University, Columbus, OH, 43210, USA.
Lisa M
LM
Keder
Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.
Sarah A
SA
Keim
The Ohio State University, College of Public Health, 1841 Neil Ave, Columbus, OH, 43210-1351, USA.
Maria F
MF
Gallo
D000293:Adolescent; D000328:Adult; D001942:Breast Feeding; D002755:Choice Behavior; 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; D007722:Health Knowledge, Attitudes, Practice; D006785:Hospitals, University; D006801:Humans; D033182:Intention; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy; D011295:Prenatal Care; D055815:Young Adult
Breastfeeding; Contraception; Lactation; Postpartum; Unintended pregnancy