Strategies for Improving Postpartum Contraception Compared With Routine Maternal Care: A Systematic Review and Meta-Analysis

Int J Public Health. 2023 Apr 13:68:1605564. doi: 10.3389/ijph.2023.1605564. eCollection 2023.

Abstract

Objectives: This study aimed to systematically review the effectiveness of service interventions for improving postpartum contraception, including contraceptive use, prevention of repeat pregnancies and induced abortions. Methods: A systematic literature search was conducted in three databases until June 2022 (PROSPERO registration CRD42022328349). Estimates of intervention effects from meta-analyses were represented as odds ratios (OR) with 95% confidence intervals (CI). Results: 16 studies with 14,289 participants were included, with four kinds of interventions recognized. Interventions effect in increasing use of contraceptives and decreasing rates of repeated pregnancy for up to 6 months postpartum (OR = 2.24, 0.06, 95% CI = 1.46-3.44, 0.02-0.22, respectively), with no significant associations with contraceptive use at 12 months postpartum, prevention of postpartum repeat pregnancies and induced abortions during 1 year after childbirth. Conclusion: We concluded that interventions impact the initiation of postpartum contraceptive use and prevention of repeat pregnancy with an overall certainty from low to moderate. These findings highlight the need for additional studies to integrate the beneficial effect of several interventions and then design more feasible strategies, which is important for the maternal and child healthcare systems.

Keywords: contraception; family planning; maternal care; meta-analysis; postpartum; systematic review.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Abortion, Induced*
  • Child
  • Contraception
  • Contraceptive Agents
  • Female
  • Humans
  • Maternal Health Services*
  • Postpartum Period
  • Pregnancy

Substances

  • Contraceptive Agents

Grants and funding

Open access funding provided by a project “Improving Sexual and Reproductive Health among Vulnerable Populations in Qinghai and Shanxi Provinces in China” under the United Nations Population Fund-Government of China Ninth Country Programme (2020–2025).