Related Experiment Video
Updated: Aug 6, 2026
A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
Use of contraception after birth, experience of contraception counselling and structural barriers to access: a
Eleanor M F Richards1, Annette Thwaites2,3, Jennifer Hall3
1Department of Gynaecological Oncology, The University of Manchester, Manchester, UK eleanor.richards@manchester.ac.uk.
Background:
To avoid unplanned, rapid repeat pregnancies, women are recommended to use effective contraception by day 21 postpartum. This study describes postpartum contraception use, impact of contraception counselling, and structural barriers to access from the perspective of doctor-mothers who have knowledge of health systems and high health-literacy.
Methods:
This is a secondary analysis of a survey which compared postpartum contraception use in women who had conceived spontaneously versus with in vitro fertilisation, using data from doctor-mothers who conceived spontaneously. Contraception use over time is presented as a Sankey plot. Chi-squared or Fisher's exact tests compared contraception effectiveness by sociodemographics and pregnancy planning. Qualitative data on contraception counselling experience were analysed using thematic analysis.
Results:
Of 634 records, 177 participants were eligible for analysis, with 72 providing qualitative data. Most (146/177, 82.5%) reported vaginal sex post-birth, and 19.8% had had sex within 6 weeks. Only 11.6% (17/146) of sexually active participants used very effective methods as first contraception. Greater contraception effectiveness was associated with earlier initiation (p<0.001). Of sexually active participants who initiated contraception within 3 weeks postpartum, 92.3% (12/13) used effective or very effective methods. Counselling only at place of birth was associated with initiation of effective contraception (p=0.041). Qualitative analysis of counselling experience generated three themes: (1) counselling style, (2) multidisciplinary working and (3) need for self-advocacy.
Conclusions:
Use of effective postpartum contraception was low overall, despite a highly health-literate population. Counselling at place of birth has a potentially significant impact on the individual. Of those who initiated contraception before 3 weeks, almost all chose effective methods indicating acceptability where available.
Related Concept Videos
01:22Birth Control Methods
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
01:30Primary Healthcare Services
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
01:21Barriers to Effective Communication II
Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...
01:21Intrauterine Drug Delivery Systems
01:25Strategies for Assessing and Addressing Confounding
Confounding can be addressed at both the design phase of a study and through analytical methods after data...