Expectant inner-city women: attitudes about contraception given infant feeding choice

Abstract

Purpose: We sought to examine whether low-income inner-city expectant women who intend to breastfeed make different contraceptive choices than those who intend to formula feed.

Materials and methods: This cross-sectional pilot study surveyed expectant women age 14 years and older receiving prenatal care at MacDonald Women’s Hospital, Cleveland Ohio (01 November 2016–15 January 2017). Questions assessed knowledge and attitudes regarding infant feeding and contraception options, and postpartum feeding and contraceptive intentions.

Results: We enrolled 223 expectant women, mean age 25.6 years at a median of 30 weeks gestation; 192 (86.5%) were African–American and 171 (75%) were multiparous. Women intending to breastfeed had 0.44 times the odds of intending to use birth control after delivery (95% CI [0.19–1.05], p = .06), while women intending to feed formula had 2.26 times the odds of intending to use birth control after delivery (95% CI [0.95–5.40]). Contraceptive attitudes significantly impacted intent to use contraception (p = .007), with every point higher on the contraception attitudes scale equating to a 7% increase in odds of postpartum contraception use.

Conclusions: Postpartum contraceptive intentions do not differ significantly between women intending to breastfeed and those intending formula feeding. Contraception attitudes do not significantly change this association, but were significantly related to contraceptive intent. Findings highlight the importance of providing comprehensive birth control education to all expectant mothers, regardless of feeding intention. Our study is unique in addressing interactions between maternal contraceptive and feeding intentions among expectant women at high risk for both not breastfeeding and unintended short interval pregnancy.

Chinese abstract

目的：我们希望调查计划母乳喂养的市中心低收入妊娠女性对避孕方式的选择与计划人工喂养的女性是否不同。

资料与方法：本横断面研究调查了2016年11月到2017年1月, 在俄亥俄州克利夫兰麦克唐纳德女子医院进行产前保健的14岁或年纪更大的妊娠女性。调查的问题评估了对婴儿喂养和避孕方法的选择, 产后喂养与避孕打算的知识与态度。

结果：我们招募了223名妊娠女性, 平均年龄25.6岁, 妊娠周数中位数30周。192名（86.5%）为非洲美洲女性, 171名（75%）为经产妇。产后打算母乳喂养使用计划生育的几率是人工喂养的0.44倍(95% CI[0.19–1.05], p¼.06), 不打算母乳喂养使用计划生育的几率是母乳喂养的2.26倍(95% CI [0.95–5.40]). 避孕的态度显著影响使用避孕措施的意向（p = 0.007）, 对避孕态度每增加一个百分点, 产后避孕措施的使用几率增加7%。

结论：计划母乳喂养和人工喂养对于产后避孕的意向的影响没有显著性差异。避孕的态度不会明显改变这种联系, 但与避孕意图显著相关。研究结果强调对所有妊娠的女性, 无论打算采取哪种喂养方式, 进行综合的计划生育教育的重要性。我们的研究是唯一对于那些高危的非母乳喂养和非意愿短间隔周期妊娠的女性, 提出母亲的计划生育与喂养意向的相互影响。

Keywords:

• Contraception
• breastfeeding
• maternal attitudes
• inner-city
• prenatal decision-making

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.