Postpartum contraception counseling and uptake in an uninsured population

Abstract

Objective: Assess postpartum contraceptive preferences and use before and after implementation of interventions to improve contraceptive counseling at a free clinic for uninsured pregnant patients. Methods: This was a pre- and post-intervention observational study in Iowa City, Iowa, that included patients from February 2019 – December 2021. Multilingual educational charts and an electronic medical record (EMR) template reminder to prompt antenatal contraceptive discussion were implemented in April 2021. Results: There were 117 pre-intervention patients and 33 post-intervention. Prior to the intervention, 30% of patients had no documentation of contraceptive counseling; afterward, 3% had no documentation (p=.001). Thirty-three percent of patients obtained highly or moderately effective contraception prior to the interventions and 52% did after (p=.068). Conclusions: Multi-lingual educational handouts and an EMR template reminder were associated with increased postpartum contraceptive counseling; contraceptive use also generally increased with the interventions. Increasing access to contraceptive education may increase contraceptive autonomy in underserved populations.