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Immediate postnatal contraception: what women know and think
  1. Annette Thwaites1,
  2. Louise Logan2,
  3. Anthony Nardone2,
  4. Sue Mann2
  1. 1 EGA Institute for Women’s Health, Faculty of Population Health Sciences, University College, London, UK
  2. 2 Public Health England, Health Improvement Directorate, London, UK
  1. Correspondence to Dr Annette Thwaites, EGA Institute for Women’s Health, Faculty of Population Health Sciences, University College London Room 243, Medical School Building, 74 Huntley Street, London, WC1E 6AU ; annettethwaites{at}


Introduction Postpartum women are at risk of rapid repeat, unplanned pregnancy with associated adverse outcomes for mother and child. We aimed to better understand their contraceptive needs to improve delivery of services and prevent unplanned pregnancies.

Methods A cross-sectional survey of women on the postnatal ward of an inner-city hospital was administered over a 6-week period in June and July 2017 to determine their level of knowledge, intentions and preferences regarding postnatal contraception.

Results 272 women were surveyed: 86% of all women on the postnatal ward during the study period. 10% (26/272) had never used any method of contraception previously and 22% (59/272) had ever used a long-acting reversible contraception (LARC) method. 18% (48/272) recalled a health professional speaking to them about contraception at any point during their pregnancy and 32% (87/272) said they needed more information to decide on their postnatal contraceptive method. 54% (147/272) of women did not think any LARC methods were safe immediately postnatally, rising to 71% (194/272) if breastfeeding. However, 47% (129/272) of women said that they would prefer to get their contraception from the ward before discharge and 46% (126/272) were likely to accept LARC, if safe, in this setting.

Conclusions Almost half the women in our survey would welcome provision of postnatal contraception, including LARC, on the postnatal ward but the women surveyed currently lack the knowledge to make informed choices in this setting. There is therefore a need for effective, tailored contraceptive choices discussions with every woman during pregnancy, as well as integrated planning for postnatal provision of the woman’s chosen method.

  • postnatal
  • postpartum
  • contraception
  • long-acting reversible contraception
  • breastfeeding
  • cross-sectional survey

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  • Contributors AT designed the study, performed the analysis together with LL, and wrote the paper. AN and SM contributed to study design. All authors provided input and revision of the manuscript.

  • Funding This study was sponsored by Public Health England (PHE).

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval London City & East NHS Research Ethics Committee.

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

  • Correction notice Since this paper was first published online the corresponding authors address has been updated.

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