Interpregnancy intervals and women’s knowledge of the ideal timing between birth and conception

Yang, Jenny; Cheney, Kate; Taylor, Rebecca A; Black, Kirsten

doi:10.1136/bmjsrh-2018-200277

Cited by 16 publications

(16 citation statements)

References 27 publications

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“…14 Similar local guidelines are needed to improve postpartum contraceptive care, with Australian research finding that about one in five women in an urban hospital had an IPI of fewer than 12 months, lacked knowledge about postpartum contraception and did not use LARC. 17 A UK review examining the barriers to postpartum contraception identified the need for guidelines to inform/support practice. 3 We cannot determine why local guidelines of this nature have not yet been created in the Australian or New Zealand setting.…”

Section: Discussionmentioning

confidence: 99%

To what extent do postpartum contraception policies or guidelines exist in Australia and New Zealand: A document analysis study

Cheney

Dorney

Black

et al. 2021

Aust NZ J Obst Gynaeco

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Postpartum contraception is the provision of contraception to women within the first six weeks after birth. 1 Such provision is important as women are susceptible to unintended, rapid repeat pregnancies in the first 12 months postpartum. The timing of the next pregnancy is significant as there are a range of adverse maternal and neonatal outcomes associated with shorter intervals, particularly with interpregnancy intervals (IPI) fewer than 12 months. 2 Internationally, there is growing recognition that provision of contraception and particularly long-acting reversible contraception (LARC), including intrauterine devices and implants, around the time of birth and before discharge can increase uptake and reduce unplanned pregnancies. 3 In Australia and New Zealand typical hospital postpartum care includes discussions about breastfeeding, return to sexual activity and contraceptive options by a midwife or doctor. The quality of this postpartum contraceptive counselling is unknown, with evidence suggesting that the discussion in the postnatal period may be unstructured and perfunctory. 4 Midwives in one Australian study identified contraception to lie within their scope of practice, but most had no formal training. 5 It may be that these clinicians have limited educational focus on the various postpartum contraception methods. Organisational limitations also exist; for example, women who birth in a faith-based facility may not have ready access to contraception.Approximately six weeks postpartum is usual for women to visit their general practitioner. It is expected that contraception

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Section: Discussionmentioning

confidence: 99%

To what extent do postpartum contraception policies or guidelines exist in Australia and New Zealand: A document analysis study

Cheney

Dorney

Black

et al. 2021

Aust NZ J Obst Gynaeco

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“…35 Shorter IPIs also occur where there is lack of access to information and a lack of uptake of more reliable contraceptive methods, particularly long-acting reversible contraceptive (LARC). 36…”

Section: Interpregnancy Intervalmentioning

confidence: 99%

Interconception Health: Improving Equitable Access to Pregnancy Planning

Black

Middleton²,

LibSt

et al. 2022

Semin Reprod Med

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Challenges remain with the implementation of preconception care, as many women do not plan their pregnancies and clinicians do not initiate preconception consultations. However, the interconception period may present a more opportune time to address health issues that impact on pregnancy outcomes and may influence future conceptions. It is also an important time to focus on pregnancy complications that may influence a person's health trajectory. This review discusses the evidence pointing to a need for greater attention on interconception health and focuses on five areas of care that may be particularly important in affecting equitable access to good care before a subsequent pregnancy: interpregnancy intervals, contraception, weight, nutrition, and gestational diabetes follow-up. Several programs internationally have developed models of care for interconception health and this review presents one such model developed in the United States that explicitly seeks to reach vulnerable populations of women who may otherwise not receive preconception care.

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“…The quantitative data are published elsewhere. 13 A qualitative approach was chosen to enable detailed exploration of participants' understanding of these topics. 16 Interviews were conducted at Royal Prince Alfred Hospital and Canterbury Hospital, in Sydney, Australia.…”

Section: Study Design and Locationmentioning

confidence: 99%

Short interpregnancy interval: circumstance or choice?

Taylor

Yang

Cheney

et al. 2021

BMJ Sex Reprod Health

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IntroductionDespite the knowledge of pregnancy risks attributable to inadequate birth spacing, over one-third of pregnancies occur within 18 months of a preceding birth. In this qualitative study we sought to interview women with a short interpregnancy interval (sIPI) to explore their knowledge of contraception and birth spacing and their experience of counselling on these themes.MethodsWe conducted in-depth interviews with women with a sIPI (live-birth less than 18 months prior to conception of current pregnancy) at Royal Prince Alfred Hospital and Canterbury Hospital in Sydney, Australia. Women were recruited at the second antenatal visit or day 3 postpartum. Interviews were recorded and transcribed. The six-phase thematic analysis framework described by Braun and Clarke was used to perform qualitative data analysis.ResultsTwenty women were interviewed (IPI range: 3–18 months). The three central themes that arose were that perceptions of IPIs are shaped by individual circumstances, a lack of information from healthcare providers (HCPs) on IPI and contraception limited women’s ability to make informed decisions, and that reproductive life planning is an important element of pregnancy care.ConclusionsIn this study, women with a sIPI did not feel informed about birth spacing, had poor knowledge of reliable contraceptives, and remained at risk of further closely spaced pregnancies. There was a desire among women with a sIPI to receive clear and consistent education on these topics. HCPs need to do more to educate women in the antenatal and postnatal period to help them space their pregnancies appropriately.

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Interpregnancy intervals and women’s knowledge of the ideal timing between birth and conception

Cited by 16 publications

References 27 publications

To what extent do postpartum contraception policies or guidelines exist in Australia and New Zealand: A document analysis study

To what extent do postpartum contraception policies or guidelines exist in Australia and New Zealand: A document analysis study

Interconception Health: Improving Equitable Access to Pregnancy Planning

Short interpregnancy interval: circumstance or choice?

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