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Contraception post severe maternal morbidity: a retrospective audit.
E Jane MacDonald1, Beverley Lawton1, Stacie E Geller2
1Women's Health Research Centre, Department of Primary Care, University of Otago, PO Box 7343, Wellington 6021, New Zealand.
Contraception
|June 13, 2015
Summary
Women experiencing severe acute maternal morbidity (SAMM) received inadequate postpartum contraception care. All women with severe preexisting comorbidities left the hospital without prescriptions, highlighting a critical need for improved contraceptive services to prevent further maternal morbidity.
Area of Science:
- Obstetrics and Gynecology
- Maternal Health
- Reproductive Health
Background:
- Rapid repeat pregnancies increase maternal and neonatal morbidity risks.
- Effective postpartum contraception is crucial for all women, especially those with severe acute maternal morbidity (SAMM).
- Limited data exists on contraceptive practices among women with SAMM, particularly those with severe preexisting comorbidities.
Purpose of the Study:
- To examine contraceptive advice and prescription patterns in women experiencing SAMM.
- To assess contraceptive care for SAMM cases with and without severe preexisting comorbidities.
Main Methods:
- Retrospective audit of 98 SAMM cases in New Zealand over 17 months.
- Analysis of contraceptive advice and prescription preconception, antenatally, and postnatally.
- Secondary analysis of cases audited for SAMM preventability.
Main Results:
- 85.7% of SAMM cases (84/98) left hospital without a contraception prescription.
- Only 14.3% (14/98) had documented contraception at discharge, including permanent methods or condoms.
- All 7 women with severe preexisting comorbidities left postpartum without contraceptive prescriptions.
Conclusions:
- Substandard contraceptive care is evident for women experiencing SAMM.
- Women with severe preexisting comorbidities are particularly underserved regarding postpartum contraception.
- Immediate improvement in postpartum contraceptive care for SAMM patients is essential to reduce future morbidity and mortality.
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