Perceptions and Behaviors Related to Contraceptive Use in the Postpartum Period Among Women With Pregestational Diabetes Mellitus.
Laura E Britton, Diane C Berry, Jamie L Crandell and 2 others
PMID 31951814WHAT IT FOUND
Most postpartum women with diabetes used effective contraception, yet few had improved diabetes control before pregnancy.
Nurses can ask about birth control, sex, and pregnancy plans.
Key findings
0156% of participants used procedure/prescription contraception, and 24% used no contraception since giving birth.
02Women who reported higher perceived benefits of contraception and preconception care were more likely to use procedure/prescription methods, while perceived barriers and self-efficacy were not associated with use.
03Pregnancies were typically planned, but 44% of participants reported doing nothing to improve their health before pregnancy, and few tried to improve diabetes control before conception.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study planned 90 women but 55 completed the survey. It was a single time point survey, so it cannot show that changing women's beliefs causes them to use contraception. Participants were English-speaking women receiving care at three high-risk obstetric clinics associated with an academic medical center, and the study excluded women with fetal demise, newborn major malformation, or provider instructions not to contact. It is unclear why 29 women did not respond and why some who consented did not complete the survey. The RHAB and LMUP scales were not previously used with adult women with diabetes in the postpartum period, and the RHAB Benefits scale had lower internal consistency in this sample. The analysis controlled for several demographic variables but not for breastfeeding goals, mental health, contraceptive preferences, cost of diabetes supplies, or all factors that may affect choices. Findings may not generalize to women with severe complications, non-English speakers, women without academic-center perinatal care, or transgender or gender non-conforming people with diabetes.
Declared interests
The authors reported no conflicts of interest or relevant financial relationships. The publication type indicates NIH extramural research support, but the article text does not state the funder's role.
The easy way to misread this
Do not conclude that counseling about benefits will increase contraceptive use. The study measured perceptions and use at a single time point, so it shows an association, not that changing beliefs caused women to use contraception.