Volume 50, Issue 4
Pages 189 - 198

Low‐Income Texas Women's Experiences Accessing Their Desired Contraceptive Method at the First Postpartum Visit

CONTEXT

Early access to contraception may increase postpartum contraceptive use. However, little is known about women's experiences receiving their desired method at the first postpartum visit or how access is associated with use.

METHODS

In a 2014–2016 prospective cohort study of low‐income Texas women, data were collected from 685 individuals who desired a reversible contraceptive and discussed contraception with a provider at their first postpartum visit, usually within six weeks of birth. Women's experiences were captured using open‐ and closed‐ended survey questions. Thematic and multivariate logistic regression analyses were employed to examine contraceptive access and barriers, and method use at three months postpartum.

RESULTS

Twenty‐three percent of women received their desired method at the first postpartum visit; 11% a prescription for their desired pill, patch or ring; 8% a method (or prescription) other than that desired; and 58% no method. Among women who did not receive their desired method, 44% reported clinic‐level barriers (e.g., method unavailability or no same‐day provision), 26% provider‐level barriers (e.g., inaccurate contraceptive counseling) and 23% cost barriers. Women who used private practices were more likely than those who used public clinics to report availability and cost barriers (odds ratios, 6.4 and 2.7, respectively). Forty‐one percent of women who did not receive their desired method, compared with 86% of those who did, were using that method at three months postpartum.

CONCLUSION

Eliminating the various barriers that postpartum women face may improve their access to contraceptives. Further research is needed to improve the understanding of clinic‐ and provider‐level barriers.

Authors' Affiliations

Kate Coleman-Minahan is assistant professor, College of Nursing, University of Colorado Anschutz Medical Campus, Aurora. Chloe H. Dillaway is a graduate student at Johns Hopkins Bloomberg School of Public Health, Baltimore. Caitlin Canfield is evaluation manager, Evaluation and Research, Louisiana Public Health Institute, New Orleans. Daniela M. Kuhn and Katherine S. Strandberg are research associates, and Joseph E. Potter is professor, all at the Population Research Center, University of Texas at Austin.

Disclaimer
The views expressed in this publication do not necessarily reflect those of the Guttmacher Institute.

Perspectives on Sexual and Reproductive Health

Support Our Work

Your support enables the Guttmacher Institute to advance sexual and reproductive health and rights in the United States and globally through our interrelated program of high-quality research, evidence-based advocacy and strategic communications.