Work

Provider Counseling and Women's Family Planning Decisions in the Postpartum Period

Year: 2020
Type: article
Study design: Observational Study
Abstract: Introduction: Provider counseling may influence women's postpartum family planning decisions. Materials and Methods: We conducted an anonymous Internet-based cross-sectional survey of postpartum women regarding multiple topics, including prenatal/postpartum care and family planning. We used multivariable logistic regression to determine associations between quantity of provider counseling (indexed as number of family planning topics discussed with a health care provider) and women's decisions regarding contraception and pregnancy spacing. Results: From January to May 2016, 2,850 women completed the survey and met inclusion criteria. Among this group, the majority were white (93%), ≥30 years (63%), and had obtained a college degree or higher (74%). Approximately half (49%) desired an interpregnancy interval (IPI) >2 years, and the minority (21%) used a highly effective contraceptive method (defined as long-acting reversible contraception or sterilization). The majority of women (56%) had received counseling on three to six family planning topics (defined as “more counseling” in regression models). Women who received more counseling were more likely to use a highly effective contraceptive method (adjusted odds ratio [AOR] 1.33, confidence interval [95% CI] 1.09–1.62) but were not more likely to desire an IPI >2 years (AOR 0.96, 95% CI 0.81–1.14). Desired IPI modified the association between provider counseling and contraception ( p = 0.06 for interaction): Among those desiring an IPI >2 years, more counseling was associated with use of a highly effective contraceptive method (AOR 1.58, 95% CI 1.23–2.03), but this was not observed among those desiring a shorter IPI (AOR 1.05, 95% CI 0.73–1.49). Conclusions: Contraceptive decisions depend on both provider counseling and patient goals.
Language: English
Field: Medicine
Open Access status: green
OpenAlex ID: W3010659337
FWCI: 0.935
Cites: 30
Cited by: 9
Related to: 10