Comparison of immediate postpartum contraception among women with a high versus low risk pregnancy in Mexico: a retrospective cohort study

BMJ Open. 2021 Aug 2;11(8):e048048. doi: 10.1136/bmjopen-2020-048048.

Abstract

Objective: We tested whether women who reported high-risk pregnancies or deliveries were more likely to receive immediate postpartum contraception prior to discharge compared with normal-risk women in Mexico.

Methods: This is a retrospective study using the National Health and Nutrition Survey. We classified women as high-risk based on reported complications in pregnancy and delivery. We used multivariable logistic regression to test the association of high-risk status and receipt of postpartum contraception (any modern method and Tier one methods) prior to discharge.

Results: Our sample included 5030 deliveries (population N=3 923 657). Overall, 19.1% of the sample were high risk. Over 60% of women in the high-risk and normal-risk group received immediate postpartum contraception, but a greater proportion of high-risk women received a method (67% vs 61% normal risk; p<0.001). However, in multivariable models, there were no significant differences in receipt of any modern method or tier 1 method by risk group.

Conclusion: Women with high-risk pregnancies were not more likely to receive postpartum contraception than the normal-risk group, once accounting for sociodemographic and clinical factors. Prenatal and postpartum contraception counselling should address the health effects of high-risk pregnancies and interpregnancy intervals to improve maternal health outcomes.

Keywords: epidemiology; gynaecology; maternal medicine; obstetrics; preventive medicine; public health.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Contraception Behavior
  • Contraception*
  • Female
  • Humans
  • Mexico
  • Postpartum Period*
  • Pregnancy
  • Retrospective Studies