Women's experiences of postnatal contraception care while breastfeeding: a multi-methods cross-sectional study

Möller-Christensen, Christine, Moffat, Malcolm, Thompson, Caitlin, Jackowich, Robyn ORCID: https://orcid.org/0000-0002-1125-8141, Sullivan, Claire and Rankin, Judith 2024. Women's experiences of postnatal contraception care while breastfeeding: a multi-methods cross-sectional study. The Lancet 404 , S79. 10.1016/S0140-6736(24)02024-5

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Abstract

Background Due to the possible effects of hormonal contraception on milk supply and the often-misunderstood contraceptive effect of breastfeeding itself, breastfeeding and postnatal contraception (PNC) are two connected elements of a comprehensive public health offer to new mothers in the weeks after completing a pregnancy. However, research describing the relationship between these two health behaviours is sparse. The aim of this study was to explore women's experiences of the interface between breastfeeding and PNC, to inform better practice. Methods Women who had completed a pregnancy during the three years prior to December 2022 and had received their postnatal care in the North East and North Cumbria Integrated Care System were invited to share their postnatal experiences in an online survey. Questions explored PNC uptake by methods and access to preferred method, as well as breastfeeding duration. Free text responses were analysed thematically, and quantitative data were analysed using binary logistic regression and chi-square tests of association. Findings From 2509 eligible survey responses received, 30·7% (n=766) of respondents reported no breastfeeding postnatally. Breastfeeding and non-breastfeeding women differed significantly in relation to several socioeconomic and pregnancy-related characteristics, with non-breastfeeding women consistently significantly more likely to belong to low-socioeconomic status groups. Breastfeeding women were significantly more likely to report no PNC use (OR 1·40, 95% CI 1·15–1·68), and significantly less likely to report using any long-acting reversible contraception (LARC) during the postnatal period (OR 0·68, 95% CI 0·54–0·85). Thematic analysis of free text responses identified three themes: 1. Breastfeeding influences women's PNC choices; 2. Healthcare professionals’ PNC advice to breastfeeding women is inconsistent; and 3. Breastfeeding women require a personalised approach to PNC. Interpretation Opportunities exist to tailor PNC provision to the particular needs of women who breastfeed, to better realise the individual- and population-level benefits of both important elements of a postnatal care offer.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Schools > Psychology
Publisher:	Elsevier
ISSN:	0140-6736
Date of First Compliant Deposit:	5 December 2024
Date of Acceptance:	1 November 2024
Last Modified:	06 Dec 2024 11:15
URI:	https://orca.cardiff.ac.uk/id/eprint/174531

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