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Centering contraception: postpartum contraceptive choices of women enrolled in Centering group prenatal care versus traditional prenatal care
  1. Erin Smith
  1. Department of Obstetrics and Gynecology, Christiana Care Health System, Newark, Delaware, USA
  1. Correspondence to Dr Erin Smith, Department of Obstetrics and Gynecology, Christiana Care Health System, Newark, DE 19713, USA; erinrenaesmith{at}gmail.com

Abstract

Objective To assess postpartum contraceptive choices of women participating in group versus traditional prenatal care.

Methods This is a retrospective cohort study assessing postpartum contraceptive choices of women participating in group versus traditional prenatal care. Patients were derived from a database of all deliveries from 1 January 2009 to 31 December 2014 at Christiana Hospital in Newark, Delaware, USA. Within this database, group prenatal care patients were identified and a two-to-one matched set of similar traditional prenatal care patients was created. Contraceptive methods utilised by these women were ascertained via chart review. The proportion of women using each method in each care model was calculated. Multinomial logistic regression was carried out for statistical analysis.

Results Included in the final analysis were 867 patients: 289 group and 587 traditional prenatal care participants. Groups were similar in selection of sterilisation, condoms, injection, and other short-acting hormonal contraceptive methods (a composite of patch, vaginal ring, and pills). Group prenatal care patients were more likely to utilise contraception postpartum (as measured by use of no method with AOR 0.50, 95% CI 0.32 to 0.78, P=0.002), particularly long-acting reversible contraceptives (LARCs) (OR 1.67, 95% CI 1.16 to 2.40, P=0.005). This difference was most pronounced for women aged 20–24 years (AOR 1.98, 95% CI 1.10 to 3.56).

Conclusion Participation in group prenatal care as opposed to traditional prenatal care increases use of postpartum contraception and increases uptake of LARCs. The association of group prenatal care participation with LARC use is particularly apparent for women aged 20–24 years.

  • counselling
  • health education
  • long-acting reversible contraception
  • hormonal contraception
  • service delivery

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Footnotes

  • Competing interests None declared.

  • Ethics approval Christiana Care Health System Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All data are on a secure database accessible by the author and Dana Thompson (data analyst).

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