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Postpartum contraception: a missed opportunity to prevent unintended pregnancy

By: Contributor(s): Publication details: 2016Uniform titles:
  • BJOG
Online resources: Summary: <span style="font-size: 10pt;">Introduction In our unit, we felt there was a 'missed' opportunity to educate and supply contraception to postnatal patients. We therefore carried out a face-to-face survey of 50 women in the week after delivery. Results The hospital serves a culturally and ethnically diverse area of London, with 5300 deliveries annually and where 44% (n = 20) of patients do not have English as their first language. The median age of women completing the survey was 30 years (range 17- 43 years) with 72% (n = 36) having a higher education qualification. The average parity following the index pregnancy was two, with 64% (n = 32) having delivered vaginally, 4% (n = 2) had instrumental delivery and 32% (n = 16) had caesarean births. We asked women what method of contraception they had used previously and found that 36% (n = 18) had not used any contraception method, 18% (n = 9) were using barrier methods and 30% (n = 15) either the progesterone-only pill, or combined pill or patch. Only 16% (n = 8) of women surveyed had previously used a long acting reversible contraception (LARC) method, well below the country average of 37%. With regard to the immediate fitting of an IUS/IUD; 16% (n = 8) were 'very likely' to accept, 6% (n = 3) 'likely' and 78% (n = 39) said they were 'not likely' to accept. When the same question was asked with regard to immediate fitting of the implant; 18% (n = 9) said they were 'very likely' to accept, 10% (n = 5) 'likely' and 72% (n = 36) 'not likely' to accept. Some of the comments patients made as to why they would not accept these methods included; 'too early', 'don't feel need for it', 'not heard of either', and 'no information (provided)'. Conclusion This small survey has highlighted a significant need for patient education regarding contraception and as a result, we are keen to work collaboratively on training and education opportunities with the Community SRH teams.&nbsp;</span>
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&lt;span style="font-size: 10pt;"&gt;Introduction In our unit, we felt there was a 'missed' opportunity to educate and supply contraception to postnatal patients. We therefore carried out a face-to-face survey of 50 women in the week after delivery. Results The hospital serves a culturally and ethnically diverse area of London, with 5300 deliveries annually and where 44% (n = 20) of patients do not have English as their first language. The median age of women completing the survey was 30 years (range 17- 43 years) with 72% (n = 36) having a higher education qualification. The average parity following the index pregnancy was two, with 64% (n = 32) having delivered vaginally, 4% (n = 2) had instrumental delivery and 32% (n = 16) had caesarean births. We asked women what method of contraception they had used previously and found that 36% (n = 18) had not used any contraception method, 18% (n = 9) were using barrier methods and 30% (n = 15) either the progesterone-only pill, or combined pill or patch. Only 16% (n = 8) of women surveyed had previously used a long acting reversible contraception (LARC) method, well below the country average of 37%. With regard to the immediate fitting of an IUS/IUD; 16% (n = 8) were 'very likely' to accept, 6% (n = 3) 'likely' and 78% (n = 39) said they were 'not likely' to accept. When the same question was asked with regard to immediate fitting of the implant; 18% (n = 9) said they were 'very likely' to accept, 10% (n = 5) 'likely' and 72% (n = 36) 'not likely' to accept. Some of the comments patients made as to why they would not accept these methods included; 'too early', 'don't feel need for it', 'not heard of either', and 'no information (provided)'. Conclusion This small survey has highlighted a significant need for patient education regarding contraception and as a result, we are keen to work collaboratively on training and education opportunities with the Community SRH teams.&amp;nbsp;&lt;/span&gt;

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