Kopp Dawn M, Rosenberg Nora E, Stuart Gretchen S, Miller William C, Hosseinipour Mina C, Bonongwe Phylos, Mwale Mwawi, Tang Jennifer H
UNC Project-Malawi, Lilongwe, Malawi.
UNC Department of Obstetrics & Gynecology, Chapel Hill, North Carolina, United States of America.
PLoS One. 2017 Jan 20;12(1):e0170284. doi: 10.1371/journal.pone.0170284. eCollection 2017.
Women who report use of postpartum family planning may not continue their initial method or use it consistently. Understanding the patterns of method uptake, discontinuation, and switching among women after delivery is important to promote uptake and continuation of effective methods of contraception. This is a secondary analysis of 634 Malawian women enrolled into a prospective cohort study after delivery. They completed baseline surveys upon enrollment and follow-up telephone surveys 3, 6, and 12 months post-delivery. Women were included in this analysis if they had completed at least the 3- and 6-month post-delivery surveys. Descriptive statistics were used to assess contraceptive method mix and patterns of switching, whereas Pearson's χ2 tests were used for bivariable analyses to compare characteristics of women who continued and discontinued their initial post-delivery contraceptive method. Among the 479 women included in this analysis, the use of abstinence/traditional methods decreased and the use of long-acting and permanent methods (LAPM) increased over time. Almost half (47%) discontinued the contraceptive method reported at 3-months post-delivery; women using injectables or LAPM at 3-months post-delivery were significantly more likely to continue their method than those using non-modern methods (p<0.001). Of the 216 women who switched methods, 82% switched to a more or equally effective method. The change in contraceptive method mix and high rate of contraceptive switching in the first 12 months postpartum highlights a need to assist women in accessing effective contraceptives soon after delivery.
报告采用产后计划生育措施的女性可能不会继续使用其最初选择的方法或持续使用该方法。了解产后女性采用、停用及更换避孕方法的模式，对于推广有效避孕方法的采用和持续使用至关重要。这是对634名马拉维女性进行的二次分析，这些女性在分娩后纳入了一项前瞻性队列研究。她们在入组时完成了基线调查，并在分娩后3个月、6个月和12个月接受了随访电话调查。如果女性至少完成了分娩后3个月和6个月的调查，就纳入本分析。描述性统计用于评估避孕方法组合及更换模式，而Pearson卡方检验用于双变量分析，以比较继续和停用其最初产后避孕方法的女性特征。在纳入本分析的479名女性中，随着时间推移，禁欲/传统方法的使用减少，长效和永久方法（LAPM）的使用增加。几乎一半（47%）的女性停用了分娩后3个月报告的避孕方法；分娩后3个月使用注射剂或长效和永久方法的女性比使用非现代方法的女性更有可能继续使用该方法（p<0.001）。在216名更换方法的女性中，82%更换为更有效或同等有效的方法。产后头12个月避孕方法组合的变化及高比例的避孕方法更换突出表明，需要在分娩后尽快协助女性获得有效的避孕措施。
