Contraception for mothers of newborn babies can often be overlooked amidst the focus on the health of the newborn baby and the significant adjustments required following the birth of the child.
A Monash University-led study has found that early access to contraception information and services postnatally can support family planning and encourage adequate spacing between pregnancies to ensure better health outcomes for both mothers and babies.
This can help avoid unintended pregnancies and improve the health and wellbeing of women and their families.
The new study gathered general practitioners' (GPs) views on providing contraceptive care during the '6-week check' – a routine medical review of mother and baby 6-8 weeks after birth. Conducted by researchers from SPHERE Centre of Research Excellence at Monash University, it has been published in the Medical Journal of Australia.
Senior author, Dr Jessica Botfield, said GPs were well placed to deliver contraceptive care, including provision of information and education, which new mothers needed to support their decision-making.
Dr Botfield suggested that discussions about contraception should be an essential part of the 6-week check and other postnatal check ups with GPs.
"Access to contraception information and services to plan for and space pregnancies is critical, particularly in the postpartum period when women may be at risk of an unintended pregnancy soon after giving birth," Dr Botfield said.
"Contraception enables women to attain the number and spacing of births they desire. However, many women lack access to information or services to achieve this postnatally, and contraception is often not currently discussed or provided at the 6-week postnatal check."
Dr Botfield said contraception should ideally be discussed both antenatally and postnatally to facilitate decision-making and support access to appropriate contraception, which can reduce the risk of unintended pregnancy and short inter-pregnancy intervals.
"Short interpregnancy intervals – ie. a pregnancy within 12 months of a preceding birth – are associated with higher risks of adverse outcomes for mothers and babies," Dr Botfield said.[1]
"Our study with GPs provides important insights into their views and experiences of providing contraception information and services to mothers of newborn babies and the barriers and issues that need to be addressed."
This work builds on earlier SPHERE studies about Women's views and preferences regarding postpartum contraception and Who is responsible for postpartum contraception advice and provision in Australia.
The GPs interviewed in the study made a number of suggestions for how to overcome the challenges of providing postpartum contraceptive care including:
- Development of national guidelines for postpartum contraceptive care (note: the recently-updated RACGP 'Red Book' now refers to contraception in their 'interconception' chapter, which provides some guidance for GPs)
- Prioritising collaboration with other maternity providers, including midwives and child and family health nurses
- Improving access to contraceptive education and training for GPs, including for long-acting reversible contraceptive (LARC) methods such as IUDs and implants
- Provision of financial incentives for GPs to upskill/undertake contraception and LARC training.
The study involved interviews with 23 GPs across Australia. Most were female and practiced in metropolitan areas.
This study was part of an Honours program at Monash University. The study was led by Jenna Perkins as part of her Honours research under the supervision of Dr Botfield.
Read the full paper in the Medical Journal of Australia: General practitioners' views and experiences of postpartum contraception counselling and provision: a qualitative study DOI: 10.5694/mja2.52438
