Improving Contraception Use in the Postpartum Period

Abstract

In the United States (U.S.) there are 6.4 million pregnancies per year, over half of which (51%) are unintended. At the time of hospital discharge many women do not have a postpartum contraception plan which puts them at risk for an unintended pregnancy. The consequences of unintended pregnancy for women, children, society and the healthcare system can be devastating. Healthy People 2020 recognized pregnancy and postpartum health behaviors as national objectives but did not include contraception. In 2015, the World Health Organization (WHO) reported an especially high-unmet need for contraception in postpartum women. The purpose of this educational counseling intervention was to address contraception education and planning for the postpartum period using the Plan-Do-Study-Act Cycle as a conceptual framework. The target population was postpartum patients who received their antenatal care at East Carolina University Women’s Physicians and Brody School of Medicine Outpatient Center (ECU OB/GYN). The methodology for this educational counseling intervention was to (a) perform a retrospective chart review to assess if postpartum contraception education was introduced prenatally and at hospital discharge, (b) implement an educational intervention for providers using the Diffusion of Innovations framework, and (c) perform a prospective chart review following implementation of the educational intervention at hospital discharge. The goal of this educational intervention was to formulate a plan to ensure all prenatal patients received standard education regarding postpartum contraception and were discharged after delivery with a well-defined plan for contraception.