Pediatrician Utilization of a Reproductive Life Plan Tool at the Well-Baby Visit: A Pilot Project

Background: Postpartum women are at high risk of unintended pregnancy as many do not receive timely postpartum contraception. Utilization of routine postpartum care varies widely, especially among low-income women. Conversely, the Well-Baby Visit (WBV) for newborns is highly utilized and provides an opportunity to discuss contraception with mothers.

Objective: To test the feasibility and acceptability of using a simplified Reproductive Life Plan Tool (RLPT) with postpartum women during routine infant care by pediatricians.

Methods: Pediatric resident physicians used the RLPT with mothers of infants under 17 weeks during WBVs. The RLPT prompted physicians to ask general questions about women’s contraceptive needs and offer referral services for mothers who desire contraception services. Residents participated in a focus group and on-line survey to assess their acceptance and perceived feasibility of using the RLPT during routine well-baby care.

Results: Residents completed 50 RLPTs. On the post-intervention survey (n = 14), 92.9% of physicians reported comfort in using the RLPT, 71.4% reported that the tool was easily understood; however, findings were split regarding ease of implementing RLPT in regular practice. During the focus groups (n = 18) residents reported comfort implementing the intervention and acceptance of the RLPT for discussing contraception. Concerns included limited time during WBV and use of the tool potentially detracting focus away from infant.

Conclusions: Findings indicate that use of the RLPT is generally feasible during routine infant care and acceptable to physicians with recognition of challenges in implementation. Discussion of contraception by pediatricians may improve uptake of postpartum contraception.