Dr. Kari White, assistant professor in the department of health care organization and policy at the University of Alabama at Birmingham, and colleagues recently investigated women’s patterns of contraceptive use after delivery and the association between method use and risk of pregnancy within 18 months.
The team used the 2006–2010 National Survey of Family Growth — which collects information on pregnancy, use of contraception, and men’s and women’s health — to examine women’s contraceptive use after delivery and at 3, 6, 12, and 18 months after giving birth. The investigators also examined the association between women’s method use and risk of pregnancy within 18 months after delivery and the percentage of these pregnancies that were unintended.
Among women in the initial cohort of 3,005 births that occurred within three years of the survey date, 72 percent had initiated a contraceptive method by three months postpartum. At three months, 13 percent of women used permanent contraception, 6 percent used long-acting reversible contraceptives, 28 percent used other hormonal methods, and 25 percent relied on less-effective methods; there was little change in the distribution of women’s method use in subsequent months. Among women using hormonal methods, 12.6 percent became pregnant within 18 months of delivery or less compared with 0.5 percent using permanent and long-acting contraception. Additionally, 17.8 percent of women using less-effective methods and 23 percent using no method became pregnant 18 months or less. At least 70 percent of pregnancies within one year after delivery were unintended.
Dr. White and her fellow researchers concluded that many women are at an increased risk of having a short interpregnancy interval and unintended pregnancy because they rely on less effective contraceptive methods — or use no method — in the 18 months following delivery. The authors note that it is unclear from these data why few postpartum women make use of highly effective methods but suggest that this may be due to insurance-related barriers that prevent women from obtaining long-acting reversible contraception in the hospital and in the initial months after giving birth.
“Contraception After Delivery and Short Interpregnancy Intervals Among Women in the United States” is published in the June issue of the journal Obstetrics & Gynecology.