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Background
Many pregnancies in the first year after a birth are not intended. Access to postpartum
contraception is critical for the health of the mother and subsequent pregnancies.
In many maternity settings in Australia, the roles and responsibilities of maternity
care providers (including midwives, obstetricians and general practitioners) in providing
postpartum contraception information and services is not always clear, and there is
no consistent system or process to ensure timely access.
Objective
We undertook an analysis of interview data conducted with hospital-based maternity
clinicians as part of a larger study on midwifery provision of contraceptive implants
in New South Wales, Australia, to document their views regarding access to postpartum
contraception and clinician responsibilities.
Methods
Interviews were conducted with maternity hospital clinicians (midwives, doctors, midwifery
managers and clinical midwifery specialists) in two hospitals. Reflexive thematic
analysis was used for the analysis of interview data. Themes relating to postpartum
contraception access, timing of contraceptive discussions and the role of clinicians
were identified.
Results
Interviews were conducted with 21 hospital-based maternity clinicians. Participants
suggested contraception discussions and provision are a shared responsibility by maternity
care providers but identified inconsistencies and issues with current approaches.
Ensuring postpartum contraception was accessible in hospital, primary care and community
settings was raised.
Conclusion
Postpartum contraception discussions and provision are regarded as a shared responsibility
by maternity care providers. This would ideally be led by the primary provider. These
services are not routinely available or always easily accessible in Australian maternity
care settings, however, and there is a lack of consistency in how postpartum contraception
is managed. Access to postpartum contraception could be improved through routine inclusion
of contraception discussions during antenatal and postpartum care, and greater collaboration
between maternity care providers in hospital, community and primary care settings
to support continuity of care through the postpartum period.
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Copyright
© 2022 Published by Elsevier Inc.
