Effect of Prenatal Contraceptive Counseling on Postpartum Contraceptive Use at a Rural Health Department

Abstract

Pregnant women in a prenatal clinic at a rural health department (HD) were not effectively using contraception following delivery. This placed them at risk for unplanned pregnancies, increased their health risks, and placed a financial burden on individuals, the HD, and the community. The purpose of this project was to determine if contraceptive counseling, provided during prenatal visits, increased effective use of contraception in the postpartum period. The subjects were pregnant women, aged 18 and older, of all races, ethnicities, and cultures, which were enrolled in prenatal clinic at a rural HD. A chart review was conducted to evaluate the documented contraceptive education provided to patients prior to implementation. The intervention included contraceptive counseling at the initial prenatal visit, the 28-week prenatal visit, and the 36-week prenatal visit. Counseling included discussion of contraceptive options, a brochure with information on all contraceptive methods in English and Spanish, educational materials related to the contraceptive method of interest in English and Spanish, and directions for making an appointment for family planning after delivery. Registered nurses in prenatal clinic implemented the counseling. Counseling was documented in the patient’s chart. Evaluation included a chart review of prenatal patients seen following the implementation of contraceptive counseling, to determine who received counseling and had documentation in their chart, and which patients chose a form of contraception by the third trimester. Results were compared to the contraceptive education provided and documented prior to the implementation of this project and the number of patients who chose a contraceptive method at that time. Results indicated an increase in the number of patients who choose a contraceptive method by the third trimester. Therefore, it can be presumed that prenatal contraceptive counseling was beneficial and recommendations to continue contraceptive counseling would be appropriate.