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Contraception after delivery and short interpregnancy intervals among women in the United States.
Obstet Gynecol 2015; 125(6):1471-7OG

Abstract

OBJECTIVE

To investigate women's patterns of contraceptive use after delivery and the association between method use and risk of pregnancy within 18 months.

METHODS

We used the 2006-2010 National Survey of Family Growth to examine women's contraceptive use after delivery and at 3, 6, 12, and 18 months after giving birth. The sample included 3,005 births that occurred within 3 years of the survey date and for which information on contraceptive use was available. We estimated multivariable-adjusted Cox regression models to assess the association between women's method use and risk of pregnancy within 18 months after delivery. We also examined the percentage of pregnancies occurring 18 months or less after the index birth that were unintended.

RESULTS

Between delivery and 3 months postpartum, contraceptive use increased from 21% to 72%. At 3 months, 13% of women used permanent contraception, 6% used long-acting reversible contraceptives, 28% used other hormonal methods, and 25% relied on less-effective methods; the distribution of method use was similar in subsequent months. Among women using hormonal methods, 12.6% became pregnant within 18 months of delivery or less compared with 0.5% using permanent and long-acting contraception (adjusted hazard ratio [HR] 21.2, 95% confidence interval [CI] 6.17-72.8). Additionally, 17.8% of women using less-effective methods (HR 34.8, 95% CI 9.26-131) and 23% using no method (HR 43.2, 95% CI 12.3-152) became pregnant 18 months or less. At least 70% of pregnancies within 1 year after delivery were unintended.

CONCLUSION

Few women use long-acting reversible contraceptives after delivery, and those using less-effective methods have an increased risk of unintended pregnancy.

LEVEL OF EVIDENCE

II.

Authors+Show Affiliations

Department of Health Care Organization & Policy, University of Alabama at Birmingham, Birmingham, Alabama; the Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado; and the Population Research Center, University of Texas at Austin, Austin, Texas.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

26000519

Citation

White, Kari, et al. "Contraception After Delivery and Short Interpregnancy Intervals Among Women in the United States." Obstetrics and Gynecology, vol. 125, no. 6, 2015, pp. 1471-7.
White K, Teal SB, Potter JE. Contraception after delivery and short interpregnancy intervals among women in the United States. Obstet Gynecol. 2015;125(6):1471-7.
White, K., Teal, S. B., & Potter, J. E. (2015). Contraception after delivery and short interpregnancy intervals among women in the United States. Obstetrics and Gynecology, 125(6), pp. 1471-7. doi:10.1097/AOG.0000000000000841.
White K, Teal SB, Potter JE. Contraception After Delivery and Short Interpregnancy Intervals Among Women in the United States. Obstet Gynecol. 2015;125(6):1471-7. PubMed PMID: 26000519.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Contraception after delivery and short interpregnancy intervals among women in the United States. AU - White,Kari, AU - Teal,Stephanie B, AU - Potter,Joseph E, PY - 2015/5/23/entrez PY - 2015/5/23/pubmed PY - 2015/8/1/medline SP - 1471 EP - 7 JF - Obstetrics and gynecology JO - Obstet Gynecol VL - 125 IS - 6 N2 - OBJECTIVE: To investigate women's patterns of contraceptive use after delivery and the association between method use and risk of pregnancy within 18 months. METHODS: We used the 2006-2010 National Survey of Family Growth to examine women's contraceptive use after delivery and at 3, 6, 12, and 18 months after giving birth. The sample included 3,005 births that occurred within 3 years of the survey date and for which information on contraceptive use was available. We estimated multivariable-adjusted Cox regression models to assess the association between women's method use and risk of pregnancy within 18 months after delivery. We also examined the percentage of pregnancies occurring 18 months or less after the index birth that were unintended. RESULTS: Between delivery and 3 months postpartum, contraceptive use increased from 21% to 72%. At 3 months, 13% of women used permanent contraception, 6% used long-acting reversible contraceptives, 28% used other hormonal methods, and 25% relied on less-effective methods; the distribution of method use was similar in subsequent months. Among women using hormonal methods, 12.6% became pregnant within 18 months of delivery or less compared with 0.5% using permanent and long-acting contraception (adjusted hazard ratio [HR] 21.2, 95% confidence interval [CI] 6.17-72.8). Additionally, 17.8% of women using less-effective methods (HR 34.8, 95% CI 9.26-131) and 23% using no method (HR 43.2, 95% CI 12.3-152) became pregnant 18 months or less. At least 70% of pregnancies within 1 year after delivery were unintended. CONCLUSION: Few women use long-acting reversible contraceptives after delivery, and those using less-effective methods have an increased risk of unintended pregnancy. LEVEL OF EVIDENCE: II. SN - 1873-233X UR - https://www.unboundmedicine.com/medline/citation/26000519/Contraception_after_delivery_and_short_interpregnancy_intervals_among_women_in_the_United_States_ L2 - http://Insights.ovid.com/pubmed?pmid=26000519 DB - PRIME DP - Unbound Medicine ER -