# Contraception Use in Patients With Unfulfilled Permanent Postpartum Contraception Requests

## TL;DR

The study finds that women whose requests for permanent postpartum contraception are unfulfilled are less likely to use effective contraception later.

## Contribution

This study is novel in comparing contraceptive use outcomes between patients with unfulfilled permanent contraception requests and those without such requests.

## Key findings

- Women without fulfilled PPC requests were less likely to use contraception at discharge and postpartum visits.
- Unfulfilled PPC request patients had lower contraceptive use rates compared to the control group at all time points.
- Repeat pregnancy rates were higher in the unfulfilled PPC group.

## Abstract

Introduction

Permanent contraception with tubal surgery is commonly used and a highly effective form of contraception. The postpartum period is a safe, effective, and convenient time for permanent contraception. Our study looked to investigate postpartum permanent contraception (PPC) use and how unfulfilled requests affect overall contraceptive use.

Objective

The primary aim of this study is to determine whether patients who have unfulfilled PPC requests at our institution are as likely as patients who do not desire PPC to use an effective method of contraception in the postpartum period.

Study design

Data was abstracted from the charts of all patients delivering viable infants at a large, urban, academic hospital throughout one year. The primary outcome was contraceptive use at the postpartum visit for those patients who did not want or did not get PPC. Secondary outcomes included: contraceptive use at hospital discharge, contraceptive use one year after delivery, and repeat pregnancy rates.

Results

A total of 1,894 women delivered viable infants during the study period; 1,671 (88.23%) did not request permanent contraception. Of the remaining 223 women, 132 (6.97%) received PPC during their delivery admission, and 91 (4.8%) did not. Of women who did not receive PPC, 48.35% were using some form of contraception at discharge and 81.43% were using contraception at the end of the study period; this is compared to 73.93% and 90.16% in the control group at each time point, respectively.

Conclusion

Women with unfulfilled requests for PPC are significantly less likely to use any form of contraception at hospital discharge, postpartum visit, and one year from delivery compared to women who did not desire PPC.