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Published on: January 12, 2018
A Pilot Study to Develop and Evaluate an In-Person Group Prenatal Contraceptive Counseling Intervention in the United
Neena Qasba1, Lisbet Lundsberg1, Nancy Stanwood1
1Section of Family Planning, Department of Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, USA.
Context:
We aimed to develop and pilot a patient-centered group prenatal contraceptive counseling intervention to assist pregnant people in selecting a postpartum contraceptive method.
Methods:
In this United States-based mixed-methods study, we conducted focus group discussions (FGDs) with pregnant and postpartum participants to identify priorities and preferences for contraceptive counseling. We then designed a group prenatal contraceptive counseling intervention and administered the intervention among a group of pregnant individuals, with pre- and post-intervention assessments of changes in contraception knowledge, participant satisfaction, and decisional conflict.
Results:
Twenty-four FGD participants identified several counseling priorities: hearing others' experiences; addressing contraception while breastfeeding and experiencing menstrual changes and/or weight gain; and seeing and holding contraceptive method models. We incorporated these priorities into the group prenatal contraceptive counseling intervention and tested it among 39 pregnant participants. Compared to pre-intervention, contraceptive knowledge post-intervention improved regarding intrauterine devices' relative effectiveness versus oral contraceptive pills (p = 0.015) and sterilization compared to external condoms (p = 0.035), as did knowledge of individual contraceptive methods' potential impact on breastfeeding (all p values < 0.0001). Most (87%) reported high satisfaction with the counseling intervention and would recommend it to others. Based on a validated decisional conflict scale, most participants (97-100%) felt they had enough support and knowledge after the intervention to choose a contraceptive method.
Conclusions:
We successfully developed a patient-centered, group prenatal contraceptive counseling intervention based on people's values and preferences, demonstrating high satisfaction, acceptability, and improved contraceptive knowledge. This intervention, designed to address participants' priorities, can be an innovative approach to prenatal contraception counseling.