Choice of contraception at 6–8 weeks postpartum in south-eastern Hungary

Abstract

Objectives: The aims of the study were to describe the sociodemographic determinants, breastfeeding- and sexual life-related predictive factors of contraceptive use at 6–8 weeks postpartum.

Methods: A prospective, web-based questionnaire survey was carried out by distributing an access code to women immediately after delivery at the Department of Obstetrics and Gynaecology, the University of Szeged, Szeged, Hungary, between 1 September 2013 and 1 May 2015.

Results: In total, 1875 women were invited to participate in the study, 632 of whom refused or were excluded and 644 were not sexually active. The remaining sexually active women (n = 599) completed the questionnaire. At 6–8 weeks postpartum, 22.5% were using an effective contraceptive method and 40.2% were relying on lactational amenorrhoea (LAM). We found a significant direct association between the educational level of a woman’s partner and her use of an effective contraceptive method (p < .001) (adjusted odds ratio [AOR]: 1.9) or LAM (AOR: 1.49). Use of an effective contraceptive method before pregnancy increased the likelihood of using the same method after delivery (AOR: 3.16) and decreased the likelihood of LAM use at weeks 6–8 (AOR: 0.31). The AOR for effective contraceptive use was 2.23 times higher in women who had sexual intercourse once or more a week compared with those who had sexual intercourse less frequently.

Conclusions: Concerted efforts to promote the use of long-acting reversible contraception (LARC) are required, particularly among women who would like future childbearing. Further research is needed on the factors contributing to the low uptake of LARC in this population.

摘要

目的：本研究的目的是为描述在产后6-8周的时期中避孕药具使用的社会人口决定因素、母乳喂养和性生活相关的预测因素。方法：在2013年9月1日至2015年5月1日期间, 通过立即向分娩后的产妇发放网络访问代码, 在匈牙利塞格德的塞格德大学妇产科进行了一项前瞻性的网络问卷调查。结果：总共有1875名妇女被邀请参加这项研究, 其中632人拒绝访问或被排除, 644人没有性生活。其余性活跃的妇女( n = 599)完成了调查问卷。在产后6-8周时, 22.5%的人使用有效的避孕方法, 40.2%的人依靠哺乳期闭经（LAM）。我们发现女性伴侣的受教育程度与她使用有效避孕方法( p < .001 ) (调整后的比值比（AOR）：1.9)或LAM (AOR：1.49 )之间有显著的直接联系。怀孕前使用有效的避孕方法增加了分娩后使用相同方法的可能性(AOR：3.16), 并降低了在第6-8周使用LAM的可能性(AOR：0.31)。每周有一次或多次性生活的女性有效避孕的AOR比那些性生活频率较低的女性高2.23倍。结论：需要共同努力促进长效可逆避孕方法(LARC)的使用, 特别是在未来有生育要求的妇女中。还需要进一步研究导致该人群使用LARC较低的原因。

Keywords:

• Breastfeeding practise
• contraceptive practise
• postpartum period
• sexual activity

Acknowledgements

The authors thank E. Feketéné and M. Jakó for their assistance in distributing the questionnaires and C. Keresztes for her English language help.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

The project was supported by the European Society of Contraception and Reproductive Health, 2011.