The role of pregnancy intendedness and prenatal contraceptive counseling on postpartum contraceptive use

Background The study was conducted to prospectively examine how pregnancy intendedness and prenatal provider counseling about postpartum contraceptive options are associated with lack of contraception use at 6 months post-birth (e.g., increased risk for a short interpregnancy interval). Methods Logistic regression models were used to examine risk for no postpartum contraception use among a sample of low-income and racially/ethnically diverse women recruited from two metropolitan perinatal clinics in Tulsa, OK. Results Women who reported that they were trying to get pregnant or “okay either way” about getting pregnant had significantly lower odds of using contraception at 6 months post childbirth than those who had unintended pregnancies. Having providers who discussed postpartum contraceptive options during pregnancy significantly increased the odds of contraceptive uptake among those who were planning or ambivalent about their pregnancies. Conclusions Intentions of a current pregnancy and provider contraceptive counseling matter for postpartum contraceptive use and the associated risk for a short interval subsequent pregnancy. Provider contraceptive counseling that accounts for the intendedness of a current pregnancy may offer a more targeted approach to prevent a short interval subsequent pregnancy.

Meaning of Pregnancy Terms Among African-American Women

The concept of pregnancy intendedness is complex and may not bear the same meaning to all women. Moreover, researcher definition and women’s meaning were thought to be different. Some researchers have indicated that it is unclear how well women understand and relate to questions used by the National Survey of Family Growth (NSFG) and how the classifications relate to women’s lives. The purpose of this study was to explore the meaning of terms such as planned and/or intended pregnancy among African-American women of childbearing age using a qualitative exploratory descriptive method. Although African-American women want children, they are three times as likely to experience an unintended pregnancy as white women. Data extracted from transcripts were coded and analyzed for recurrent patterns and themes. For this study, the Theory of Planned Behavior (Ajzen & Fishbein, 1980) was employed to frame interview questions and to interpret data. Findings suggest participants and partners often did not have the same perceptions or meanings of pregnancy planning or intentions. These findings have implications for research and family planning policy.

Determinants of dietary patterns and diet quality during pregnancy: a systematic review with narrative synthesis

ObjectiveTo identify determinants of diet in pregnancy, by detecting factors in our multiple-determinants life course framework that are associated with dietary patterns, quality or guideline adherence.DesignA systematic review of observational studies, published in English or German, was conducted. Sociodemographic, lifestyle, environmental and pregnancy-related determinants were considered. Four electronic databases were searched in January 2015 and updated in April 2016 and a total of 4368 articles identified. Risk of bias was assessed using adapted Newcastle–Ottawa Scales.SettingHigh- and upper-middle-income countries.SubjectsPregnant or postpartum women reporting their dietary intake during pregnancy.ResultsSeventeen publications of twelve studies were included and compared narratively due to heterogeneity. Diet in pregnancy was patterned along a social gradient and aligned with other health behaviours before and during pregnancy. Few studies investigated the influence of the social and built environment and their findings were inconsistent. Except for parity, pregnancy determinants were rarely assessed even though pregnancy is a physiologically and psychologically unique period. Various less well-researched factors such as the role of ethnicity, pregnancy intendedness, pregnancy ailments and macro-level environment were identified that need to be studied in more detail.ConclusionsThe framework was supported by the literature identified, but more research of sound methodology is needed in order to conclusively disentangle the interplay of the different determinants. Practitioners should be aware that pregnant women who are young, have a low education or do not follow general health advice appear to be at higher risk of inadequate dietary intake.