It is recommended that women who give birth have a postpartum visit 4--6 weeks after delivery. This postpartum visit is necessary to assess the physical and psychosocial well-being of the mother, including managing chronic conditions and screening for postpartum depression. Postpartum contraception counseling, a key strategy in reducing unintended pregnancies, is also provided. The purpose of this analysis is to describe receipt of a postpartum visit and postpartum contraceptive use among new mothers in Florida.
METHODS:
Weighted data from the 2012 and 2013 Florida Pregnancy Risk Assessment Monitoring System (PRAMS) matched to birth certificates was used. Women who were pregnant, seeking pregnancy, or were not sexually active at the time of the survey were excluded. Effectiveness categories of contraception were created based on definitions by the Centers for Disease Control and Prevention: most (intrauterine device, implant, female and male sterilization), moderately (pill, patch, shot), and least (condom, withdrawal, natural rhythm) effective methods. Variables were also created for nonuse and any method of contraceptive use. Chi-square statistics were calculated for the outcomes of interest: postpartum visit receipt and the various levels of contraception use. Unadjusted and adjusted risk ratios (aRR) and 95% confidence intervals (C.I.) were calculated using Poisson Regression models for each outcome of interest. We also assessed the impact of a postpartum visit on postpartum contraceptive use. Characteristics of interest included race/ethnicity, age, education, marital status, and insurance type.
RESULTS:
Overall, 88.6% of new mothers in Florida received a postpartum visit. Chi-square statistics revealed differences in receipt of a postpartum visit by all demographic variables of interest, but these differences were not statistically significant in adjusted analyses. Eighty-seven percent of new mothers in Florida use any method of contraception; 29.4% use most effective, 32.3% use moderately effective, 26.2% use least effective, and 12.2% use no method. No statistically significant differences by demographic variables of interest were observed in adjusted analyses. Women with a postpartum visit were 1.3 times more likely to use a most effective method (aRR=1.26, 95% C.I.: 1.00, 1.61) and 1.4 times more likely to use a moderately effective method than women without a postpartum visit (aRR=1.36, 95% C.I.:1.06, 1.75) in adjusted analyses.
CONCLUSIONS:
Receipt of postpartum visit and any postpartum contraceptive use is high in Florida. Women with a postpartum visit are more likely to use a more effective postpartum contraceptive method. These results reinforce the importance of a postpartum visit on postpartum contraceptive use.