Acceptability of digital health intervention during pregnancy to inform women about postpartum contraception...

Pregnancy within a year of childbirth has negative impacts on women and their children's health. We developed a digital health intervention (DHI) to empower women in contraceptive choices postpartum. Our pilot randomised controlled trial (RCT) aimed to establish the feasibility of a main RCT of the effects of the DHI compared with standard care on long-acting contraception use.

Our pilot RCT recruited 52, 20-24 weeks pregnant women in NHS Lothian, UK between October 2022 and April 2023. Participants were randomised 7:3 to receive either the DHI (n=37) in addition to standard care, or standard care alone (n=15). Telephone survey follow-up was at 24 weeks' gestation and 6 weeks postpartum. Semi-structured qualitative interviews (n=10) were conducted with participants receiving the DHI.

All eligible women joined the study and completed follow-up. All intervention participants found the animation highly acceptable; one participant requested text message discontinuation. We completed followed up on 37/37 (100%) of participants. DHI participants reported they valued access to credible contraceptive information that supported decision making in a non-pressurised way.

Our DHI is highly acceptable and a trial is feasible. A larger trial is needed to establish if the DHI increases uptake of long-acting reversible contraception postpartum and reduces unintended pregnancies within 12 months of childbirth.

(Trial registration ISRCTN48521918).