Mothers of preterm birth infants: Pregnancy intentions and contraception use at six months postpartum

Previous preterm delivery is the most salient predictor of a repeat preterm birth (RPTB). Unintended pregnancies with short inter-pregnancy intervals are known risk factors for preterm birth (PTB), yet postpartum pregnancy intentions, sexual practices and birth control (BC) use among women with a previous PTB remain largely unexplored. This study describes these intentions and behaviors among a high risk group of PTB mothers 6 months after the index PTB. Methods: Detailed 6-month postpartum contraception use data were obtained from 589 mothers enrolled in a larger longitudinal study of urban mothers who delivered a live premature (<35 weeks gestation) infant in one of 12 hospitals. Assessments were conducted at regular intervals for up to two years after enrollment. Results: The vast majority of all of the women in the study (90.5%, n= 533) reported they did not want to get pregnant within one year of the index delivery. However, most were sexually active at 6 months postpartum (85%, n=500). Among those sexually active, use of somewhat ineffective methods of contraception was common. Only 28%(n =141) used a ‘moderately effective' method of BC (pills, patch, or Depo) and 2% (n=10) used a ‘highly effective' BC method (IUD, Sterilization or Norplant). Conclusions: More understanding is needed to explain why such a high risk group of mothers for PTB, most of whom express no intention to have a short-interval pregnancy, do not use more effective contraceptive during this postpartum period.