Women's experiences of postpartum contraceptive services when elective caesarean section is the method of birth: a qualitative study.

IF 3.4 3区 医学 Q1 FAMILY STUDIES BMJ Sexual & Reproductive Health Pub Date : 2024-04-11 DOI:10.1136/bmjsrh-2023-202046
Karin Lichtenstein Liljeblad, Helena Kopp Kallner, Jan Brynhildsen, Helena Kilander
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Abstract

Background: The unmet need for postpartum contraception is a global challenge. Postpartum placement of an intrauterine device (IUD) within 48 hours of vaginal delivery is available in many settings worldwide, but is not routinely practised in Sweden. To improve contraceptive services and facilitate the informed choice of IUD placement at the time of a caesarean section (CS), we performed this study to identify and describe women's experiences of contraceptive services before, during and after an elective CS.

Methods: A qualitative design and methodology was used. We interviewed 20 women aged 28-42 years who underwent elective CS in Sweden. Interviews were analysed using reflexive thematic analysis.

Results: The three main themes found were (1) receptivity to contraceptive counselling in the context of CS, (2) communication and decision-making about postpartum contraception before CS and (3) lack of support and guidance to receive contraceptive services before and after CS. The participants described readiness and interest regarding postpartum contraception. They prefered counselling from around 25 weeks of gestation. Despite this finding, antenatal communication and contraceptive decision-making seemed rare. Participants reported a lack of support and guidance which necessitated a need by women to navigate the contraceptive services themselves in order to receive information about contraception before CS and to receive postpartum support.

Conclusions: Antenatal contraceptive counselling including information about IUD placement during CS was appreciated and welcomed by women with elective CS as their birth method. Most of the women whom we interviewed would prefer to receive contraception counselling on postpartum use during the second half of their pregnancy.

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选择剖腹产作为分娩方式的妇女对产后避孕服务的体验:一项定性研究。
背景:产后避孕需求得不到满足是一项全球性挑战。产后在阴道分娩后 48 小时内放置宫内节育器(IUD)在全球许多地方都可实现,但在瑞典尚未常规实施。为了改善避孕服务并促进在剖腹产(CS)时在知情的情况下选择放置宫内节育器,我们开展了这项研究,以确定并描述妇女在选择性剖腹产之前、期间和之后对避孕服务的体验:研究采用了定性设计和方法。我们采访了 20 名在瑞典接受选择性 CS 的 28-42 岁女性。采用反思性主题分析法对访谈进行分析:发现的三大主题是:(1)在 CS 的背景下接受避孕咨询;(2)CS 前关于产后避孕的沟通和决策;(3)CS 前后在接受避孕服务方面缺乏支持和指导。参与者描述了对产后避孕的准备情况和兴趣。他们倾向于在妊娠 25 周左右开始接受咨询。尽管如此,产前沟通和避孕决策似乎并不多见。参与者报告称,由于缺乏支持和指导,妇女需要自己掌握避孕服务,以便在分娩前获得避孕信息,并在产后获得支持:结论:产前避孕咨询,包括在 CS 期间放置宫内节育器的相关信息,受到了选择 CS 作为生育方法的妇女的赞赏和欢迎。我们采访的大多数妇女都希望在妊娠后半期接受有关产后使用避孕药具的咨询。
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来源期刊
BMJ Sexual & Reproductive Health
BMJ Sexual & Reproductive Health Medicine-Reproductive Medicine
CiteScore
5.10
自引率
6.10%
发文量
38
期刊介绍: BMJ Sexual & Reproductive Health is a multiprofessional journal that promotes sexual and reproductive health and wellbeing, and best contraceptive practice, worldwide. It publishes research, debate and comment to inform policy and practice, and recognises the importance of professional-patient partnership.
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