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Keywords:

  • contraception counseling;
  • postpartum contraception;
  • unintended pregnancy

Introduction: Focused antenatal contraceptive counseling about postpartum contraception may reduce the risk of contraceptive nonuse and misuse, although the optimal timing, content, and communication style of such counseling remain controversial. This study used an in-depth, qualitative approach in a population of young, postpartum, urban, minority group women in order to examine women's perspectives toward the optimal provision of comprehensive contraceptive counseling.

Methods: Brief surveys and semistructured interviews were conducted with 30 consenting postpartum women. In-person, one-on-one interviews were then reviewed for themes, by using an iterative process. Qualitative analysis techniques identifying emergent themes were applied to interview data.

Results: In this cohort of African American (63%) and Hispanic (37%) women (median age 26 y), 73% had unplanned pregnancies. Women preferred frequent, short sessions of provider-initiated comprehensive contraceptive counseling throughout the antepartum period with reinforcement of decisions during the postpartum period. Participants valued patient-centered counseling that was inclusive of all appropriate methods and personalized to individual needs.

Discussion: We recommend that frequent, provider-initiated, multiple-modality discussions of appropriate postpartum contraceptive options should take place throughout pregnancy in an open, individualized manner. Further work should address the long-term effects of improved patient-centered antenatal contraceptive counseling on rates of unintended pregnancy.