Contraceptive trajectories postpartum: A longitudinal qualitative study of women living with HIV in Cape Town, South Africa

McTigue, Georgiana L.; Swartz, Alison; Brittain, Kirsty; Rini, Zanele; Harrison, Abigail; Myer, Landon; Pellowski, Jennifer

doi:10.1016/j.socscimed.2021.114555

Cited by 3 publications

(14 citation statements)

References 39 publications

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“…Our results confirm findings from previous studies, showing that intention to use contraception is dynamic (McTigue et al 2022;Ross and Winfrey 2001) and is also consistent with the TPB. In the TPB, intentions are hypothesized to capture motivational factors (an…”

Section: Discussionsupporting

confidence: 92%

“…We adjusted for a number of covariates associated with intention to use contraception and contraceptive uptake in the postpartum period for objectives two and three (Abraha, Belay, and Welay 2018;Adegbola and Okunowo 2009;Lori et al 2018;McTigue et al 2022;Tang et al 2016;Udomboso, Amoateng, and Doegah 2015). These include age (<25, 25-34, and 35+), parity (0-1, 2-3, and 4+), education (never vs. at least primary level), residence (urban/rural), wealth quintile, menses resumed by six months postpartum (yes/no), and ever used contraception (yes/no).…”

Section: Covariatesmentioning

confidence: 99%

“…The few studies in SSA examining intention to use contraception in the postpartum period showed that women were less likely to report intention to use contraception in the future if they had infrequent sex or had not resumed sexual intercourse (Abraha, Belay, and Welay 2018;Udomboso, Amoateng, and Doegah 2015) or were postpartum amenorrheic (Abraha, Belay, and Welay 2018), potentially due to low perceived pregnancy risk. Other factors found to be associated with contraceptive intention in the postpartum period were age, parity, educational attainment, and past contraceptive use (McTigue et al 2022;Abraha, Belay, and Welay 2018;Lori et al 2018;Tang et al 2016;Udomboso, Amoateng, and Doegah 2015;Adegbola and Okunowo 2009). In addition, some studies showed that access to health services was positively associated with greater contraceptive intentions (McTigue et al 2022;Lori et al 2018;Udomboso, Amoateng, and Doegah 2015;Adegbola and Okunowo 2009), highlighting the importance of delivering family planning information and services in the postpartum period when women may access health providers more frequently due to facility delivery, postnatal, and vaccination visits.…”

Section: Introductionmentioning

confidence: 99%

“…Other factors found to be associated with contraceptive intention in the postpartum period were age, parity, educational attainment, and past contraceptive use (McTigue et al 2022;Abraha, Belay, and Welay 2018;Lori et al 2018;Tang et al 2016;Udomboso, Amoateng, and Doegah 2015;Adegbola and Okunowo 2009). In addition, some studies showed that access to health services was positively associated with greater contraceptive intentions (McTigue et al 2022;Lori et al 2018;Udomboso, Amoateng, and Doegah 2015;Adegbola and Okunowo 2009), highlighting the importance of delivering family planning information and services in the postpartum period when women may access health providers more frequently due to facility delivery, postnatal, and vaccination visits.…”

Section: Introductionmentioning

confidence: 99%

“…A qualitative study by McTigue and colleagues examined the relationship not only between contraceptive intention and uptake but also change in intentions over time and subsequent method used by measuring women's intention to use contraception during pregnancy and again at six to eight weeks and nine to 12 months postpartum. The sample was small, however,-38 respondents-and was limited to women living with HIV in South Africa (McTigue et al 2022). To date, no study has explored the evolution of postpartum contraceptive intentions and the impact of this process on contraceptive use among a large sample of women over multiple time points in the postpartum period.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Contraceptive Intentions and Use throughout the Extended Postpartum Period: A Panel Study in Ethiopia

Magalona,

Karp,

Shiferaw

et al. 2023

Studies in Family Planning

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The postpartum period is an ideal time for women to access contraception, but the prevalence of postpartum contraceptive use remains low in sub‐Saharan Africa. To better understand the gap between women's desires to space or limit births and their contraceptive behaviors, intention to use contraception has been proposed as a person‐centered measure of contraceptive demand. Using data from a panel study of Ethiopian women aged 15–49 who were interviewed at six weeks, six months, and one year postpartum, we examined the dynamics of contraceptive intention in the first year postpartum and its relationship with contraceptive use. Contraceptive intention fluctuated considerably in the year after childbirth. At six weeks, 60.9 percent of women intended to use a contraceptive method in the next year; 23.2% did not. By one year, less than half (43.5 percent) were using a method, and those who had no intention to use doubled (44.5 percent). Women who developed or sustained their intention to use a method in the postpartum period were more likely to adopt a method by one year than those who did not, showing that contraceptive intention is a strong predictor of use and has the potential to inform person‐centered reproductive health programming in the extended postpartum period.

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Section: Discussionsupporting

confidence: 92%

Section: Covariatesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Contraceptive Intentions and Use throughout the Extended Postpartum Period: A Panel Study in Ethiopia

Magalona,

Karp,

Shiferaw

et al. 2023

Studies in Family Planning

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Making Sense of Making Sense of Time: Longitudinal Narrative Research

McKibben

Breheny

2023

International Journal of Qualitative Methods

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Narratives, like the people who tell them, are fluid, changing through time and in response to context. Longitudinal narrative interviewing enables researchers to explore the meaning of stability and change in narratives over time. Despite much attention to and application of longitudinal narrative interviews in recent years, the ways that time is conceptualized and the ways it is applied are markedly different. In this paper the authors present a scoping review to examine the methodological and empirical literature on longitudinal narrative interviewing in health-related research. This research is used to highlight a methodological tension between narrative theorizing of time and analytic practice in research involving longitudinal narrative interviews. Longitudinal narrative research struggles to acknowledge time as both chronological and interpretative, and in doing so misses an opportunity to examine interviews as both multiple data collections and as multiple instances of narrative re-configuration. The authors suggest that future theorizing and empirical work can strive to bridge an onto-epistemological gap by intentionally foregrounding theoretical orientations to time within narrative analytic approaches using repeated interviews.

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Womandla Health: development and rationale of a behavioral intervention to support HIV treatment adherence among postpartum women in South Africa

Pellowski,

Jensen,

Tsawe

et al. 2023

BMC Women's Health

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Background While Option B + has made great strides in eliminating vertical transmission of HIV and improving access to lifelong antiretroviral therapy (ART) for women, the postpartum period remains a risk period for disengagement from HIV care and non-adherence. Methods Longitudinal qualitative data was collected from 30 women living with HIV in Cape Town, South Africa from pregnancy through 1 year postpartum to examine key barriers and facilitators to HIV treatment adherence across this transition. Participants were also asked about their preferences for behavioral intervention content, format, and scope. The intervention development process was guided by Fernandez et al.’s Intervention Mapping process and was informed by the qualitative data, the wider literature on ART adherence, and Transition Theory. Results The Womandla Health Intervention is a multicomponent intervention consisting of four individual sessions with a lay health worker and four peer group sessions, which span late pregnancy and early postpartum. These sessions are guided by Transition Theory and utilize motivational interviewing techniques to empower women to ascertain their own individual barriers to HIV care and identify solutions and strategies to overcome these barriers. Conclusions This intervention will be tested in a small scale RCT. If successful, findings will provide an innovative approach to HIV treatment by capitalizing on the transition into motherhood to bolster self-care behaviors, focusing on ART adherence and also women’s overall postpartum health and psychosocial needs.

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Contraceptive trajectories postpartum: A longitudinal qualitative study of women living with HIV in Cape Town, South Africa

Cited by 3 publications

References 39 publications

Contraceptive Intentions and Use throughout the Extended Postpartum Period: A Panel Study in Ethiopia

Contraceptive Intentions and Use throughout the Extended Postpartum Period: A Panel Study in Ethiopia

Making Sense of Making Sense of Time: Longitudinal Narrative Research

Womandla Health: development and rationale of a behavioral intervention to support HIV treatment adherence among postpartum women in South Africa

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