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Demand for postpartum contraception in Texas

Joseph Potter, University of Texas at Austin, 2013

Project abstract

The proposed research will extend an ongoing prospective cohort study of 400 women in Texas in order to assess the risk of an unintended pregnancy during the two years following childbirth, and how that risk varies according to both the type of contraception being used and whether a woman’s method is the method that she would like to be using. This study has two key strengths. First, it assesses pregnancy intentions prospectively and repeatedly. Second, it repetitively assesses the type of contraception a woman would like to be using as well as the method that she is actually using. The proposed extension builds on a successful cohort study with excellent retention. Also, at six months after delivery, a large proportion of women in the cohort had not yet been able to access their preferred method of contraception.

In addition to estimating the risk of unintended pregnancy by contraceptive status, the proposed project will also permit us to delineate 24-month trajectories in contraceptive preferences, contraceptive use, and concordance between preferences and use. In the analysis, we will account for duration since delivery, age, parity, insurance status, breastfeeding status, relationship status, and race/ethnicity. The research site is a setting where the resources for family planning are limited, and where not all groups have access to subsidized contraceptive services, a situation that exists throughout much of the United States. The key hypothesis we will test is whether not getting the method a woman would prefer to use has an influence on the risk of pregnancy above and beyond the average effectiveness of the method used.

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