Abstract

Unmet needs for long acting reversible contraceptives in Virginia mothers who experienced unintended pregnancy -- results from 2016 - 2018 PRAMS data

Lauren Truwit¹, Katharine Hawkes, M.S.¹, Amy C. Paulson, MPH, AE-C¹, Kenesha Smith, MSPH, PhD² and Hongyun Fu, Ph.D.¹
(1)Eastern Virginia Medical School, Norfolk, VA, (2)Virginia Department of Health, Richmond, VA

APHA's 2020 VIRTUAL Annual Meeting and Expo (Oct. 24 - 28)

background: Nearly half of pregnancies in the United States are unintended, leading to a range of adverse maternal and child health (MCH) outcomes. Although Long Acting Reversible Contraceptives (LARC) are the most effective method of birth control, they are not widely used in the U.S. This study examined patterns of contraception before conception and postpartum among mothers with unintended pregnancy, using 2016-2018 Virginia Pregnancy Risk Assessment Monitoring System (VA-PRAMS) data.

methods: The VA-PRAMS collected information about mothers’ experiences before, during and after recent pregnancies. This analysis included a subsample of 1,124 mothers who recently experienced unintended pregnancies. Multivariable logistic regression was used to examine factors related to types of method used before conception and postpartum, using STATA15 to adjust for sampling weights.

results: Before conception, 44% of mothers reported using a contraceptive method, including 29% condoms, 23% rhythm/withdrawal, 17% pills/shots, and 4% LARC. Being unmarried (AOR:1.69; 95% CI:1.24-2.31) and receiving Medicaid (AOR:1.41; 95% CI:1.03-1.94) were associated with increased odds of using withdraw/rhythm. Mothers who were nonwhite (AOR:1.89; 95% CI: 1.32-2.72) and teens (AOR: 3.34, 95% CI:1.55-7.20) had high odds of using condoms.

At postpartum, 21% of mothers reported using rhythm/withdrawal, 24% condoms, 27% pills/shots, 20% LARC, and 11% sterilization. Being under 31-year-old (AOR: 1.30; 95% CI: 1.03-1.90) and having insurance coverage (AOR: 1.69; 95% CI: 1.12-2.50) was related to higher odds of postpartum LARC use.

conclusion: Findings highlight the need to promote postpartum LARC in Virginia, particularly among older, uninsured and minority mothers to reduce unintended pregnancy and improve MCH outcomes.

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