Chalmers Sexual Health Centre, NHS Lothian & Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK.
Department of Obstetrics, Gynaecology & Neonatology, University of Sydney, Sydney, Australia.
Curr Opin Obstet Gynecol. 2024 Oct 1;36(5):331-337. doi: 10.1097/GCO.0000000000000982. Epub 2024 Aug 2.
PURPOSE OF REVIEW: Women are particularly vulnerable to unintended pregnancy in the 12 months following a birth. Improving access to postpartum contraception within maternity settings can prevent unintended and closely spaced births, improving the health of mother and child. This review will summarize the recent research in postpartum contraception (PPC), building on existing knowledge and developments in this field. RECENT FINDINGS: Current models of postpartum contraceptive provision may not adequately meet women's needs. The COVID-19 pandemic led to changes in postpartum contraceptive provision, with an increasing emphasis placed on maternity services. Antenatal contraceptive discussion is associated with increased postpartum contraceptive planning and uptake of methods after birth. Digital health interventions may be a useful tool to support information about contraception. The most effective long-acting reversible contraceptive (LARC) methods, such as the intrauterine device (IUD) and implant, can be challenging to provide in the maternity setting because of availability of trained providers. Postpartum IUD insertion remains relatively under-utilized, despite evidence supporting its safety, efficacy and cost-effectiveness. SUMMARY: Antenatal information needs to be partnered with access to the full range of methods immediately after birth to reduce barriers to PPC uptake. Training and education of maternity providers is central to successful implementation of PPC services.
目的综述:女性在分娩后 12 个月内特别容易意外怀孕。改善产妇环境中产后避孕的可及性可以防止意外怀孕和间隔时间过近的分娩,从而改善母婴健康。本综述将在该领域现有知识和发展的基础上,总结产后避孕(PPC)的最新研究进展。
最新发现:目前的产后避孕措施模式可能无法充分满足女性的需求。COVID-19 大流行导致产后避孕措施发生变化,越来越重视产妇服务。产前避孕讨论与增加产后避孕计划和产后方法的使用有关。数字健康干预措施可能是支持避孕信息的有用工具。最有效的长效可逆避孕(LARC)方法,如宫内节育器(IUD)和植入物,由于缺乏经过培训的提供者,在产妇环境中提供这些方法具有挑战性。尽管有证据支持其安全性、有效性和成本效益,但产后 IUD 放置的使用仍然相对不足。
总结:需要将产前信息与分娩后立即获得全套方法相结合,以减少 PPC 采用的障碍。对产妇提供者进行培训和教育是成功实施 PPC 服务的核心。
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