Zivich Paul N, Kawende Bienvenu, Lapika Bruno, Behets Frieda, Yotebieng Marcel
Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg, CB #7435, Chapel Hill, NC, 27599, USA.
School of Public Health, The University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
Matern Child Health J. 2019 Apr;23(4):530-537. doi: 10.1007/s10995-018-2667-y.
Introduction Unintended pregnancy during the postpartum period is common. The aim of this study was to describe contraceptive use among postpartum women and assess whether family planning counseling offered by health care providers during well-baby clinic visits increased use of modern contraceptive methods at 6 months following delivery. Methods Data comes from a cohort of women enrolled in a breastfeeding promotion trial in Kinshasa, Democratic Republic of Congo who reported being sexually active at 24-weeks post-partum. Modern contraceptive methods included intrauterine devices, injectables, implants, and contraception pills. Logistic regression models were used to estimate odd ratios (OR) and 95% confidence intervals (CI) for the impact of nurse counseling on use of modern birth control methods. Results Of 522 participants who reported being sexually active, 251 (48.0%) reported doing at least one thing to avoid pregnancy and were included in this analysis. Of these 251, 14.3% were using a modern contraceptive method, despite availability at the clinic. Discussion with a nurse about family planning was associated with increased odds of using modern birth control relative to other methods (OR 4.0, 95% CI 1.9, 8.6). Discussion Discussion of family planning with a nurse increased the odds of using a modern contraceptive among postpartum women. Integration of family planning counseling into postpartum services offers a potential avenue to increase modern contraceptive use among women with access.
引言 产后意外怀孕很常见。本研究的目的是描述产后女性的避孕措施使用情况,并评估在健康婴儿诊所就诊期间医疗保健提供者提供的计划生育咨询是否会增加产后6个月现代避孕方法的使用。方法 数据来自刚果民主共和国金沙萨一项母乳喂养促进试验中的一组女性,她们报告在产后24周有性生活。现代避孕方法包括宫内节育器、注射剂、植入剂和避孕药。使用逻辑回归模型估计护士咨询对现代避孕方法使用的影响的比值比(OR)和95%置信区间(CI)。结果 在522名报告有性生活的参与者中,251名(48.0%)报告采取了至少一种避免怀孕的措施,并被纳入本分析。在这251名中,14.3%正在使用现代避孕方法,尽管诊所提供这些方法。与护士讨论计划生育与使用现代避孕措施而非其他方法的几率增加有关(OR 4.0,95%CI 1.9,8.6)。讨论 与护士讨论计划生育增加了产后女性使用现代避孕措施的几率。将计划生育咨询纳入产后服务为增加有机会获得服务的女性对现代避孕措施的使用提供了一条潜在途径。