Short birth intervals increase risk of low birth weight, preterm birth, neonatal and infant mortality, as well as maternal complications, including third trimester bleeding, postpartum infection, and anemia. To date, research has not reached a consensus on the optimal timing and method to discuss postpartum contraception with patients. Most studies have focused on the postpartum period. The aim of our project is to increase awareness about postpartum contraception, including long acting reversible contraception (LARC) methods and improve access to immediate postpartum LARC in patients who chose it. We will develop a web-based postpartum contraception decision aid (DA) that will be used to inform pregnant women about the importance and options for postpartum contraception.
We will perform a replicated interrupted time-series study to test the hypothesis that a higher proportion of women will choose LARC methods as their postpartum contraception when they receive our antepartum contraception DA compared to a contemporaneous control group who received standard physician education and counseling. We will recruit English-speaking patients, 18 years of age and above, who are obtaining their prenatal care at the UCLA associated clinics and are in their third trimester. We will first enroll our control group, which will be a group of women who will receive the standard physician education and counseling about postpartum contraception. We will then enroll the intervention group, who will receive the web-based postpartum contraception DA in addition to the standard counseling. We will compare which postpartum contraception method women choose as well as demographic and antenatal information about the two groups. We will prospectively follow our participants to delivery to investigate whether they obtain their desired contraception method and possible obstacles.
We will enroll 100 participants into each study group. There will be one study visit at which time the DA will be shown to the participants in the intervention group and demographic and contraception data collected. The study visit will be an extension of one of the routine prenatal visits pregnant patients receive between 24 and 36 weeks gestational age. The duration of active participation will be one study visit. Participants will be followed by way of chart review to investigate whether they receive their intended method of contraception by discharge from the hospital or postpartum visit.