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Women’s choices around contraception after childbirth
- Rachel Wooldridge, Pippa Oakeshott (8 November 2005)
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Rachel Wooldridge, 4th Year Medical Student St George's, University of London, Pippa Oakeshott
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Roche et al. conducted a qualitative study examining parents’ attitudes towards child health surveillance and health promotion programmes(1). They found that what parents wanted was often different to what they experienced. Their study highlights once again the importance of asking the views of consumers. We decided to ask women who had just had a baby about their choices of contraception and the reasons for these choices. We conducted a cross-sectional questionnaire survey of women on a postnatal ward in St. George’s Hospital, South London. The response rate was 75% (47/63). The mean age of participants was 31 years (range 15-44). The women described their ethnicity as White (45%), Indian Sub-Continent (15%), Afro-Caribbean (11%), Black African (11%) and other (19%). Eighty one percent had used some form of contraception in their life. The most widely used method was the condom (66%) followed by the combined oral contraceptive (COC) pill (47%) and the withdrawal method (23%). White women were more likely to have used the COC than women of other ethnic origins: 15/22 white women had used the COC compared with 6/19 of the remainder p<0.01. Ninety two percent of participants were planning to use contraception after the birth of their baby, but 27% were undecided on which method. The most popular method of contraception was the condom (36%) followed by the COC (9%), withdrawal method (9%), intra-uterine system (9%), mini pill (6%), sterilisation (6%), injection (4%), implant (4%), diaphragm/cap (4%), rhythm method (4%) and the coil (2%). Reasons for choice of contraception included safety and side effects (23%), ease of use (21%), efficacy (19%), previous use (9%), no delay in return to fertility (6%), cost (4%), “fun” (2%) and “long term solution to contraceptive need” (2%). Surprisingly breast-feeding was only a factor in one woman’s decision. These results are in line with a similar study from Manchester(2). Comments about contraceptive choices included: “Been on the pill about 10 years and want to come off and use another method.” “I don’t want to use any pill because I heard it’s not good for women’s health.” “Delighted though we are to be blessed with another child so soon after our first, we don’t want another yet. The mini pill is effective unlike the rhythm method!” “My husband is having the snip”. Our study shows that women do have ideas and expectations about what they want from their contraception. Health professionals need to consider not only the change in contraceptive need after childbirth but also, like Roche et al, the attitudes and opinions of the women. Yours sincerely Rachel Wooldridge 4th Year Medical Student St George's, University of London London SW17 0RE Email: m0100030@sgul.ac.uk Pippa Oakeshott Reader in General Practice Please send correspondence to Rachel Wooldridge, 100 Graveney Road, Tooting London, SW17 0EH 1.Roche B, Cowley S, Salt N, Scammell A, Malone M, Savile P et al. Reassurance or judgement? Parents’ views on the delivery of child health surveillance programmes. Family Practice, Oct 2005; 22(5):507. 2. Jarvis Rani R. Lewis P. Assessing the quality and acceptability of immediate postpartum family planning advice in a hospital setting. Br J Family Planning 1996;22: 95-96. Conflict of Interest:None declared |
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