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Objectives To evaluate whether the prevalence of postpartum contraceptive use was lower among people who delivered at a Catholic hospital compared to a non‐Catholic hospital. Methods We linked 2015–2018 Pregnancy Risk Assessment Monitoring System (PRAMS) survey data from five states to hospital information from the corresponding birth certificate file. People with a live birth self‐reported their use of contraception methods on the PRAMS survey at 2–6 months postpartum, which we coded into two dichotomous (yes vs. no) outcomes for use of female sterilization and highly‐effective contraception (female/male sterilization, intrauterine device, implant, injectable, oral contraception, patch, or ring). We conducted multilevel log‐binomial regression to examine the relationship between birth hospital type and postpartum contraception use adjusting for confounders. Results Prevalence of female sterilization for people who delivered at a Catholic hospital was 51% lower than that of their counterparts delivering at a non‐Catholic hospital (adjusted prevalence ratio: 0.49; 95% confidence interval: 0.37–0.65). Conclusion We found lower use of postpartum female sterilization, but no difference in highly effective contraception overall, for people who delivered at a Catholic hospital compared to a non‐Catholic hospital.

Learning how to best meet a patient's contraceptive needs improves her chances of using her birth control consistently and is crucial to providing patient-centered care. The best contraceptive method for an individual patient is the one that is safe and that she is most comfortable using. Women's health care providers must be equipped to talk to each patient about her needs and options. The shared decision-making model in contraceptive counseling allows the patient and provider to work together in order to meet a patient's needs while remaining medically safe.

INTRODUCTION: Providers promote long-acting reversible contraception (LARC) because LARCs are highly effective at preventing pregnancy. The FDA recommends a maximum length of time for LARC use, but not a minimum. When women requesting early LARC removal perceive resistance from their providers, frustration and damaged patient-provider relationships can result. Understanding provider attitudes and practices about LARC removal is vital to patient-centered care. METHODS: Ten interviews were conducted with LARC providers and analyzed using qualitative techniques. LARC providers included physicians and mid-level providers in Ob/Gyn, pediatrics, and family medicine, in academic and community settings. Transcribed interviews were coded for themes and analyzed using a modified grounded theory approach. NVivo software was used for analysis. RESULTS: Providers defined early LARC removal as two weeks after insertion to anything prior to device expiration. Providers highlighted the importance of respecting patient autonomy when early LARC removal was requested, but many felt that patients should try LARC for a minimum amount of time to acclimate to the device or because of cost. Providers want to know why LARC removal is desired so that patient can be reassured and side effects can be treated to possibly delay or prevent removal. Many providers expressed internal conflict about early removal. They felt strongly about the benefits of LARC and disappointment or irritation with patients when LARC is removed early. CONCLUSION: Providers feel conflicted between their desire to promote effective birth control and patient requests for early LARC removal. Training around LARC provision and removal should include emphasis on the importance of patient-centered care.

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