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Perinatal contraceptive counselling: Effectiveness of a reinforcement intervention on top of standard clinical practice
To assess the effectiveness of supplemental perinatal contraceptive counselling in addition to standard Spanish postpartum contraceptive counselling with regard to contraceptive use and use of effective contraception up to 1 year postpartum. Women's satisfaction with counselling and the method...
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| Published in: | Midwifery 2020-04, Vol.83, p.102631-102631, Article 102631 |
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| Main Authors: | , , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
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| Online Access: | Get full text |
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| Summary: | To assess the effectiveness of supplemental perinatal contraceptive counselling in addition to standard Spanish postpartum contraceptive counselling with regard to contraceptive use and use of effective contraception up to 1 year postpartum. Women's satisfaction with counselling and the method chosen was also assessed.
Community-randomized trial.
“Reproductive and Sexual Health Care” units of the National Health Care System at twenty public Primary Care facilities in Catalonia (Spain).
1,004 consecutive pregnant women (~week 30) receiving prenatal care between 1st October 2015 and 31st March 2016. Women were considered eligible for analysis if appropriate information was available.
At half of the centres, midwives provided the standard Spanish postpartum contraceptive counselling (control group, CG). At the other half, supplemental perinatal contraceptive counselling was provided in addition to standard counselling (intervention group, IG) at different time points during pregnancy and postpartum. This consisted of a leaflet and a blog with practical information about all contraceptive options plus a short reminder message in the mobile phone during the third quarter of pregnancy and a face-to-face or a virtual meeting lasting 20 min in the first 15 days postpartum. Midwives used ad hoc questionnaires to collect information at week 30 of pregnancy (recruitment), and week 6, month 6 and month 12 postpartum.
975 women were eligible for analysis (482 in the CG and 493 in the IG). ~33% women had resumed sexual intercourse by week 6, and nearly all by months 6 and 12. Use and effectiveness of contraceptives was similar in both groups at week 6 and month 6. At month 12, more women in the IG used more effective contraception and less women used contraceptives considered somewhat effective vs. those of the CG (P = 0.006). When considering the place of origin, this was only true for Spanish women. Women of other origins had a much higher use of very effective contraceptives at month 12 also in the CG, with contraceptive counselling having scarce effect. On multivariate analysis, conducted only in Spanish women, the additional counselling resulted in a higher use of highly effective methods while having a university degree increased 3.6 times the OR for this behaviour. A bias towards fostering use of very effective contraceptives among women with low education was seen in standard clinical practice. Satisfaction with counselling and the type of contraception chosen w |
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| ISSN: | 0266-6138 1532-3099 |
| DOI: | 10.1016/j.midw.2020.102631 |