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Women’s and healthcare professionals’ views on immediate postnatal contraception provision: a literature review
  1. Annette Thwaites1,
  2. Anh B Tran2,
  3. Sue Mann2
  1. 1 EGA Institute for Women’s Health, University College London, London, UK
  2. 2 Public Health England, London, UK
  1. Correspondence to Dr Annette Thwaites, Sexual Health, London SE5 9RS, UK; annettethwaites{at}doctors.org.uk

Abstract

Objectives Provision of immediate postnatal contraception, including long-acting reversible contraceptive (LARC) methods, is increasingly identified and endorsed as a key strategy for reducing unplanned and rapid repeat pregnancies. This literature review aims to evaluatethe views of women and healthcare professionals regarding the receipt, initiation or delivery of these services.

Methods Databases (Embase, Medline, CINAHL, HMIC) were searched for relevant English language studies, from January2003 to December 2017. In addition, Evidence Search, Google Scholar and Scopus (citation search) were used to identify further literature. Other relevant websites were accessed for policies, guidance and supplementary grey literature.

Results There is clear guidance on how to deliver good-quality postnatal contraception to women, but the reality of service delivery in the UK does not currently meet these aspirations, and guidance on implementation is lacking. The available evidence on the provision of immediate postnatal contraception focuses more on clinical rather than patient-centred outcomes. Research on postnatal women’s views is limited to receptivity to LARC and contraception counselling rather than what influences their decision-making process at this time. Research on views of healthcare professionals highlights a range of key systemic barriers to implementation.

Conclusions While views of postnatal women and healthcare professionals are largely in support of immediate postnatal contraception provision, important challenges have been raised and present a need for national sharing of service commissioning and delivery models, resources and evaluation data. Provider attitudes and training needs across multidisciplinary groups also need to be assessed and addressed as collaborative working across a motivated, skilled and up-to-date network of healthcare professionals is viewed as key to successful service implementation.

  • postnatal
  • postpartum
  • contraception
  • long-acting reversible contraception
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Footnotes

  • Contributors AT and ABT designed and performed the literature search and appraisal. SM contributed to the study design. AT wrote the paper and had final responsibility for the decision to submit for publication. All authors provided input and assisted with revision of the manuscript.

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

  • Competing interests None declared.

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

  • Patient consent for publication Not required.

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