Thwaites Annette, Logan Louise, Nardone Anthony, Mann Sue
King's College Hospital NHS Trust, London, UK.
Public Health England, Health Improvement Directorate, London, UK.
BMJ Sex Reprod Health. 2018 Nov 21. doi: 10.1136/bmjsrh-2018-200078.
Postpartum women are at risk of rapid repeat, unplanned pregnancy with associated adverse outcomes for mother and child. We aimed to better understand their contraceptive needs to improve delivery of services and prevent unplanned pregnancies.
A cross-sectional survey of women on the postnatal ward of an inner-city hospital was administered over a 6-week period in June and July 2017 to determine their level of knowledge, intentions and preferences regarding postnatal contraception.
272 women were surveyed: 86% of all women on the postnatal ward during the study period. 10% (26/272) had never used any method of contraception previously and 22% (59/272) had ever used a long-acting reversible contraception (LARC) method. 18% (48/272) recalled a health professional speaking to them about contraception at any point during their pregnancy and 32% (87/272) said they needed more information to decide on their postnatal contraceptive method. 54% (147/272) of women did not think any LARC methods were safe immediately postnatally, rising to 71% (194/272) if breastfeeding. However, 47% (129/272) of women said that they would prefer to get their contraception from the ward before discharge and 46% (126/272) were likely to accept LARC, if safe, in this setting.
Almost half the women in our survey would welcome provision of postnatal contraception, including LARC, on the postnatal ward but the women surveyed currently lack the knowledge to make informed choices in this setting. There is therefore a need for effective, tailored contraceptive choices discussions with every woman during pregnancy, as well as integrated planning for postnatal provision of the woman's chosen method.
产后女性面临快速再次意外怀孕的风险，这会给母婴带来相关不良后果。我们旨在更好地了解她们的避孕需求，以改善服务提供并预防意外怀孕。
2017年6月至7月的6周时间内，对一家市中心医院产后病房的女性进行了横断面调查，以确定她们对产后避孕的知识水平、意愿和偏好。
共调查了272名女性，占研究期间产后病房所有女性的86%。10%（26/272）的女性此前从未使用过任何避孕方法，22%（59/272）的女性曾使用过长效可逆避孕（LARC）方法。18%（48/272）的女性回忆说在孕期的任何时候有健康专业人员与她们谈论过避孕，32%（87/272）的女性表示她们需要更多信息来决定产后避孕方法。54%（147/272）的女性认为产后立即使用任何LARC方法都不安全，如果是母乳喂养，这一比例升至71%（194/272）。然而，47%（129/272）的女性表示她们更愿意在出院前从病房获得避孕措施，46%（126/272）的女性在这种情况下如果安全愿意接受LARC。
我们调查中近一半的女性欢迎在产后病房提供包括LARC在内的产后避孕措施，但接受调查的女性目前缺乏在这种情况下做出明智选择的知识。因此，有必要在孕期与每位女性进行有效、量身定制的避孕选择讨论，以及对女性所选方法的产后提供进行综合规划。
