Is Postpartum Contraception Predicted by Methods Used Before Pregnancy? A Longitudinal Exploration of Women’s Postpartum Contraceptive Practices in Kenya

Celia Karp, Johns Hopkins Bloomberg School of Public Health
Daisy Ruto , Jhpiego
Anne Schuster, University of Southampton
Sara Kennedy
Megan Christofield, Jhpiego
Lindsay Breithaupt, Jhpiego
Michael Muthamia, Jhpiego
Elaine Charurat, Jhpiego

Research on postpartum contraception in low-resource contexts is limited and relies heavily on cross-sectional data. This analysis examines the relationship between contraceptive methods used pre-pregnancy and immediately postpartum. In-person interviews were conducted in 2017-2018 with 866 women receiving antenatal and delivery care in Kenya. Multilevel mixed-effects logistic regression models will estimate associations among three measures of pre-pregnancy contraception (ever use; last method used; timing) and two outcomes of immediate postpartum contraception (any use; method used), adjusting for covariates. Bivariate analyses demonstrated that more ever users adopted immediate postpartum methods compared to never users (17% vs. 13%, respectively); however, most women did not adopt a method, regardless of their pre-pregnancy method effectiveness. When counseled on methods, a similar proportion of ever users and never users adopted contraception (43% and 41%, respectively). Interventions to reduce unmet need through postpartum contraception must consider women’s pre-pregnancy contraceptive experiences and factor this into client-centered counseling.

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 Presented in Session 10. Fertility, Family Planning, Sexual Behavior & Reproductive Health 2