The Association Between Postpartum Healthcare Encounters and Contraceptive Use among Rhode Island Mothers, 2012–2015

摘要

Unintended pregnancies account for nearly 50% of all preg- nancies 1 . Compared to those conceived intentionally, chil- dren born of unintended pregnancies have worse outcomes in nutrition, abuse, and overall mortality 2 . Mothers with unintended pregnancies report lower levels of happiness- 3 health, and mother-child relationships. We hypothesize that unwanted childbearing affects mother-child relationships in part because of the physical and mental health conse- quences of unwanted childbearing. Impaired mental health hampers women's interaction with their infants, and these poor neonatal relationships translate into poor mother-adult child relationships. Using the Intergenerational Panel Study of Mothers and Children – a 31-year longitudinal survey of a probability sample of 1,113 mother-child pairs begun in 1961 – we demonstrate that mothers with unwanted births have lower quality relationships with their children from late adolescence (age 18 and higher rates of anxiety 4 . Thus, postpartum contraception is important in preventing these harms. Contraceptive-specific counseling by healthcare workers increases both general contraception use and use of highly effective contraception 5 , raising the question as to which encounters offer opportune times to discuss postpar- tum contraception. To date, the literature has indicated that home visits during pregnancy 6 and postpartum check-ups 7,8 are associated with increased postpartum contraception use. The purpose of this study was to examine the association between encounters with health care workers after preg- nancy and the use of any postpartum contraception method and, specifically, highly effective methods in Rhode Island.