Initiation of postpartum contraception: A survey among health centre physicians and nurses in Finland

Figures & data

Table I. Background characteristics of respondents.

	Physiciansn = 69n (%)	Nursesn = 80n (%)
Age (years)
<40	20 (29)	11 (14)
40–49	35 (51)	34 (43)
≥50	14 (20)	35 (44)
Sex
Female	59 (85.5)	80 (100)
Male	10 (14.5)	0 (0)
Specialist training
Specialist in general practice	34 (49)
Trainee in general practice	5 (7)
Other specialist degree	8 (12)
Non-specialist	20 (29)
Missing information	2 (3)
Nurse education (multiple choice)
Public health nurse		77 (96)
Midwife		32 (40)
Both		29 (36)
Specific training in sexual health counselling	0 (0)	3 (4)
Work experience at health centre, years
0–10	23 (33)	18 (22.5)
>10	46 (67)	62 (77.5)

Table II. Contraceptive methods most commonly initiated or recommended¹ for breastfeeding women at postpartum visit by physicians and nurses representing 69 and 80 municipalities in primary care, respectively.

	Physiciansn (%)	Nursesn (%)
Condom	28 (41)	36 (45)
Progestin-only pills	23 (33)	22 (28)
Copper-releasing intrauterine device	10 (15)	7 (9)
Levonorgestrel-releasing intrauterine system	3 (4)	4 (5)
Missing information	5 (7)	11 (14)

Notes: ¹Open questions, (1) physicians: “Which contraceptive method do you initiate or recommend most commonly to a breastfeeding mother at postpartum visit?”, (2) nurses: “Which contraceptive method do you recommend most commonly to a breastfeeding mother at postpartum visit?”.

Table III. Usual timings of postpartum initiation of medical contraceptive methods by physicians representing 69 municipalities in primary care.

Alternatives	POPsn (%)	IUDn (%)	LNG-IUSn (%)	Implantsn (%)	COCsn (%)	Ring/patchn (%)
Postpartum visit	19 (28)	8 (12)	5 (7)	1 (1)	0 (0)	0 (0)
Before resumption of menses, irrespective of BF	32 (46)	20 (29)	18 (26)	15 (22)	0 (0)	1 (1)
Menses resumed, irrespective of BF	8 (12)	37 (54)	22 (32)	4 (6)	0 (0)	1 (1)
BF finished, irrespective of resumption of menses	1 (1)	0 (0)	2 (3)	3 (4)	15 (22)	15 (22)
BF finished and menses resumed	5 (7)	3 (4)	21 (30)	16 (23)	53 (77)	50 (73)
Never	3 (4)	1 (1)	1 (1)	24 (35)	1 (1)	1 (1)
Cannot say or missing information	1 (1)	0 (0)	0 (0)	6 (9)	0 (0)	1 (1)

Note: “When do you usually initiate the following contraceptive methods postpartum?” POPs = progestin only pills, IUD = copper releasing intrauterine device, LNG-IUS = levonorgestrel-releasing intrauterine system, COCs = combined oral contraceptives, BF = breastfeeding.

Table IV. Supply of contraceptives free of charge postpartum by nurses representing 80 municipalities in primary care.

Contraceptive methods available free of charge	n (%)	Quantity of supplies (months)	Mean	Median	Range
Oral contraceptives (OCs)	33	(41%)	4	3	3–9
Vaginal ring or patch	23	(29%)	4	3	3–9
Copper-releasing intrauterine device (IUD)	20	(25%)
Levonorgestrel-releasing intrauterine system (LNG-IUS)	0	(0%)
Number of contraceptive methods available free of charge
One method
OCs	5	(10%)
IUD	1	(2%)
Two methods
OCs and ring/patch	9	(14%)
OCs and IUD	4	(6%)
Three methods (OCs, ring/patch, IUD)	14	(18%)
No methods available	45	(56%)
Missing information	2	(3%)

Note: Data extracted from multiple-choice questions “In which situations (and OCs, ring/patch: for how long) can a client receive OCs/vaginal rings or contraceptive patches/IUD/LNG-IUS free of charge”, response option “Postpartum” (“Yes”/“No”).