Variation in Postpartum Use of Most and Moderately Effective Contraceptive Methods Among Louisiana Women.

Matern Child Health J

Bureau of Family Health, Office of Public Health, Louisiana Department of Health, 1450 Poydras Street, New Orleans, LA, 70112, USA.

Published: September 2020

AI Article Synopsis

  • Women in Louisiana face high rates of unintended pregnancies, with 58% of births being unplanned, which poses risks for adverse health outcomes, yet little research has focused on effective contraceptive use in this state.
  • The study utilized data from the Louisiana Pregnancy Risk Assessment Monitoring System (2015-2018) to analyze contraceptive use among postpartum women not seeking to become pregnant, revealing that 35.4% were not using effective contraception.
  • Key findings indicated that demographic factors, such as race/ethnicity, education level, and type of insurance, significantly influenced contraceptive choices, with disparities evident in the use of long-acting and injectable methods among different groups.

Article Abstract

Background: Women experiencing unintended and short-interval pregnancies are at increased risk for adverse outcomes. Nationally, researchers report disparities in women's use of effective contraceptive methods based on demographic, cultural, financial and system-level factors. Despite 58% of Louisiana births being unplanned, researchers have not reported on these relationships in Louisiana.

Methods: We used Louisiana Pregnancy Risk Assessment Monitoring System data from 2015 to 2018. Among postpartum women who were not abstinent, pregnant, or trying to become pregnant, we estimated use of five categories of effective contraception versus no effective method. We used multivariable multinomial logistic regression to investigate the association between effective contraceptive use and race/ethnicity, postpartum insurance and education.

Results: Among Louisiana postpartum women who were not abstinent, pregnant, or trying to become pregnant, 35.4% were not using effective contraception. Women with public insurance had greater odds of using long-acting reversible contraception than women with private insurance (adjusted odds ratio [AOR] 1.55; 95% confidence interval [CI] 1.11-2.16). Compared to women with a bachelor's or higher, women with less than high school (AOR 2.09; CI 1.22-3.56), high school (AOR 3.11; CI 2.01-4.82) or some college education (AOR 2.48; CI 1.64-3.75) had greater odds of using permanent contraception. Black (AOR 3.83; CI 2.66-5.54) and Hispanic (AOR 3.85; CI 2.09-7.11) women, women with less than high school (AOR 6.79; CI 2.72-16.94), high school (AOR 7.26; CI 3.06-17.21) and some college (AOR 7.22; CI 3.14-16.60), and women with public insurance (AOR 1.91; CI 1.28-2.87) had greater odds of using injectable contraception.

Discussion: Results showed variation in effective contraceptive method use by race/ethnicity, insurance and education. These findings highlight the need for state-level research into the individual, provider, and policy-level factors that influence women's contraceptive choices.

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Source
http://dx.doi.org/10.1007/s10995-020-02971-xDOI Listing

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