Browsing by Subject "Postpartum contraception"

Now showing 1 - 2 of 2
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    Contraceptive Method Choices in Women With and Without Opioid Use Who Have Infants in the Neonatal Intensive Care Unit and Nursery
    (Mary Ann Liebert, Inc., 2020-09-24) Radwan, Alia; Ray, Bobbie Nicole; Haas, David M.; Obstetrics and Gynecology, School of Medicine
    Objective: The aim of this study was to examine whether a history of opioid use predicts tier 1 contraceptive use or plan to use in women with infants in the neonatal intensive care unit (NICU) and nursery. Materials and Methods: We conducted a self-administered, anonymous survey in women with infants in three local NICUs and two postpartum units from November 2018 to May 2019. Women were recruited while visiting their infants in the NICU or in their postpartum rooms. Our survey included adapted questions from the Centers for Disease Control and Prevention (CDC) Pregnancy Risk Assessment Monitoring System (PRAMS) questionnaire, the National Institute of Drug Abuse (NIDA) Modified ASSIST Screening Tool, and ones written by our team. The questions asked about contraceptive use and opioid use. We compared the responses of women with and without a history of opioid use. We conducted a multivariable regression analysis and applied the backward elimination method to identify whether opioid use was a predictor of tier 1 contraceptive use or plan to use. Results: A total of 122 women completed the survey. Fifty-three women (43.4%) reported opioid use in the month before pregnancy and/or during pregnancy, while 69 (56.6%) women reported no opioid use and comprised the control group. Multivariable regression analysis showed that opioid use was not associated with the use or planned use of tier 1 contraceptives (adjusted odds ratio [aOR] 1.47; confidence interval [95% CI] 0.54-4.01). Older maternal age predicted tier 1 choice (aOR 1.12; 95% CI 1.04-1.21), while African American women were less likely to use or plan to use tier 1 contraceptives compared with white women (aOR 0.21; 95% CI 0.08-0.56). Conclusion: A history of opioid use was not independently associated with women using or planning to use tier 1 methods, while age and race were predictors.
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    Informing Policy Change: A Study of Rapid Repeat Pregnancy in Adolescents to Increase Access to Immediate Postpartum Contraception
    (Mary Ann Liebert, Inc., 2020-06) Qasba, Neena T.; Stutsma, John W.; Weaver, Greta E.; Jones, Kathleen E.; Daggy, Joanne K.; Wilkinson, Tracey A.; Obstetrics and Gynecology, School of Medicine
    Background: Rapid repeat pregnancy (RRP) is common among adolescents and is associated with adverse maternal and infant outcomes. Despite evidence that use of long-acting forms of contraception before hospital discharge can help minimize RRP rates, barriers to placement existed within the state of Indiana. We sought to determine state-specific RRP and induced abortion rates for adolescents based on chosen postpartum contraception to inform policy change. Methods: We examined a retrospective cohort of 227 adolescents (ages 12-18 years) who gave birth in Indiana between 2010 and 2012. Demographics, postpartum contraception, and subsequent pregnancies or abortions after the sentinel delivery were obtained. Rates of RRP based on type of immediate postpartum contraception, etonogestrel (ENG) contraceptive implant, depo-medroxyprogesterone acetate (DMPA) injection, and short-acting methods were compared. Bivariate and logistic regression analyses were conducted. Results: RRP rates were 3.7% for those with ENG contraceptive implant, 22.6% for those with DMPA, and 39.1% for those who choose short-acting methods (p = 0.01). Adolescents who did not choose an ENG contraceptive implant were significantly more likely to have an RRP (adjusted odds ratio [aOR] = 11.8, 95% confidence interval: 2.74-110.3), compared with other contraceptive methods, even after adjusting for covariates such as age, prior pregnancies, and postpartum visit attendance. Conclusions: Immediate postpartum receipt of ENG implant was significantly associated with a lower likelihood of RRP in adolescents in Indiana. These data facilitated state policy change regarding insurance reimbursement to improve statewide access for all women, regardless of age, showing how local data can inform policy change.