Do women with unintended births use highly effective postpartum contraception? An analysis of data from the National Survey of Family Growth, 2006-2010

Thesis (M.S.C.E.) PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.OBJECTIVES: Half of all U. S. pregnancies are unintended, and of these, about 6 out of 10 are carried to term. These are known as “unintended births,” and they are at elevated risk for adverse social, economic and health outcomes. The goal of this study was to examine, using the latest data from the National Survey of Family Growth (2006-2010), whether women with unintended births were more likely than their counterparts to use effective postpartum contraception. METHODS: In this retrospective cohort study of U.S. women ages 15-44, all births within three years of the study interview were classified as intended or unintended, and the method and timing of postpartum contraception were ascertained. Our primary outcome was time to initiation of a highly effective postpartum contraceptive method during the first postpartum year. Highly effective contraception was defined as a method with less than one pregnancy per 100 woman-years of typical use. Secondary outcomes included time to initiation of any contraceptive use over the first postpartum year, and postpartum contraceptive non-use. RESULTS: Complete data was available for 2,691 births. Young, black, undereducated, unmarried, and poor women, as well as those who paid for their delivery with Medicaid were more likely than their counterparts to have unintended births (p