Contraception

ObjectivesTo characterize uptake and correlates of effective contraceptive use postpartum.Study DesignWe analyzed data from a national, cross-sectional evaluation of prevention of mother-to-child HIV transmission programs that enrolled women attending 6-week or 9-month infant immunization visits at 120 Kenyan maternal and child health clinics. We classified women who resumed sexual activity postpartum and did not desire a child within 2 years as having a need for family planning (FP).ResultsWe included 955 (94%) of 1012 women 8\u201310 months postpartum in the analysis. Mean age was 25.8 years and 36% were primigravidas. By 9-months postpartum 62% of all women used contraception and 59% used effective contraception (injectables, implants, intrauterine devices [IUDs], oral contraceptives [OCs], and tubal ligations). Most contraceptive users (61%) used injectables, followed by implants (10%), OCs (6%), IUDs (4%), and condoms alone (2%). The majority (n=733, 77%) had a need for FP and 67% of 733 women with FP need used effective contraception. Among women with a need for FP, effective contraception use was higher among those who discussed FP in postnatal care (PNC) than who did not discuss FP in PNC (Prevalence Ratio (PR) for PNC alone: 1.35 (95% Confidence Interval [CI]:1.16-1.58; PR for PNC and antenatal care [ANC]:1.42, 95% CI: 1.21-1.67; p=0.001 for both).ConclusionsTwo-thirds of postpartum women with a need for FP used effective contraception at 9-months postpartum, and use was associated with discussing FP during PNC.ImplicationsIntegrating FP counseling in ANC/PNC could be an effective strategy to increase effective contraception use.20172018-03-21T00:00:00ZU2G PS002047/PS/NCHHSTP CDC HHS/United StatesT32 AI007140/AI/NIAID NIH HHS/United StatesK01 AI116298/AI/NIAID NIH HHS/United StatesK24 HD054314/HD/NICHD NIH HHS/United StatesCC999999/Intramural CDC HHS/United States29031815PMC586129