Maternal contact with Child Protective Services around childbirth and postpartum contraception

In the U.S., child protective services (CPS) frequently intervenes with mothers and infants around the time of childbirth, as newborns are particularly vulnerable to adverse exposures and peripartum women and their infants are highly visible to mandated reporters, especially health care providers. In this study, we explored whether involvement with CPS around childbirth is related to whether mothers receive contraception in the postpartum period. Using population-level administrative data, we conducted discrete-time survival analyses to assess the association between maternal CPS involvement around childbirth and contraceptive receipt from a health care provider within 6 months postpartum. Adjusting for demographic, health, and birth characteristics, we find that CPS involvement is associated with lower odds of receiving routine contraception (both short-acting hormonal and long-acting reversable methods) and higher odds of emergency contraception. The largest difference in the probability of receipt of routine contraception occurred around week 6 postpartum-a common time for general postpartum visits. Our findings highlight the importance of considering how maternal CPS involvement intersects with key dimensions of healthcare, such as postpartum contraceptive access. Given the intersection of healthcare and mandated CPS reporting, along with significant concerns that CPS involvement may threaten women's reproductive autonomy and contribute to or interact with stigma and provider bias in health care settings, these issues warrant further in-depth investigation.