RT Journal Article
SR Electronic
T1 Understanding women’s views of and preferences for accessing postpartum contraception: a qualitative evidence synthesis
JF BMJ Sexual & Reproductive Health
JO BMJ Sex Reprod Health
FD British Medical Journal Publishing Group
SP 129
OP 141
DO 10.1136/bmjsrh-2022-201718
VO 49
IS 2
A1 Grace J Freeman-Spratt
A1 Jessica R Botfield
A1 Grace Soeun Lee
A1 Prithi Rajiv
A1 Kirsten I Black
YR 2023
UL http://jfprhc.bmj.com/content/49/2/129.abstract
AB Background Nearly half of women experience unintended pregnancies. These are associated with increased risk of poor maternal physical and psychosocial health outcomes. Many pregnancies in the first year postpartum are unintended, further increasing risks of poor outcomes and complications. We undertook a qualitative evidence synthesis to evaluate qualitative research on women’s views and preferences for accessing postpartum contraception, and identify evidence gaps and opportunities for postpartum contraception provision.Methods Five databases were searched to identify relevant qualitative studies. Included studies focused on views of, and preferences for, accessing postpartum contraception for women of reproductive age in high-income countries.Results Of 1854 studies identified, 28 full texts were assessed and 19 studies included. These were critically appraised using Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) and analysed using thematic synthesis. Included studies indicated the majority of women desire postpartum contraception, but face a range of financial, health system and personal barriers. Women felt unclear about the ideal interpregnancy interval (IPI) and the rationale for this. Women preferred contraceptive counselling at varying times both antenatally and postnatally, and commonly preferred to receive contraception in the immediate postpartum period before hospital discharge. Women commonly saw their obstetrician or general practitioner for contraceptive counselling, but welcomed midwifery involvement.Conclusions Most women were interested in postpartum contraception and pregnancy spacing, but felt unclear about the optimal IPI, highlighting the need for further education and support around this issue. Contraceptive counselling was viewed as valuable antenatally and postnatally, and by varying maternal health providers, as was the provision of immediate postpartum contraception.Data are available in a public, open access repository.