Abstract
Introduction
The aim of this analysis is to present initial contraceptive choices of women offered postpartum contraception in rural Guatemala.
Methods
We trained community nurses participating in the delivery of a home-based antepartum and postpartum care program in rural Guatemala in contraceptive implant placement and had them offer condoms, pills, an injection, or an implant at women’s home-based 40-day postpartum visit in intervention clusters of a non-blinded, cluster-randomized trial. Women who had already started postpartum contraception or were over the age of 35 were excluded from participation. The primary outcome of the trial was contraceptive use at 3 months postpartum, so this initial analysis describes immediate preferences in the population.
Results
Of 208 women enrolled in the study, 108 were in intervention clusters and 100 lived in control clusters. In the intervention group, 32 women declined contraception, 36 women received the injectable, 30 women had an implant placed, 5 women started pills, 2 women chose condoms, and data on 3 women were missing. In the control clusters, 43 women were planning on the injectable, 11 planned on the implant, 10 did not want to start a method, 5 planned on sterilization, 2 aimed for natural family planning, 2 wanted a copper IUD, 1 woman wanted condoms, 18 did not know, and data on 8 women were missing.
Discussion
The contraceptive implant, which was not previously available in this community, had high uptake at 27.8% in the intervention group.
Trial Registration
Clinicaltrials.gov, NCT04005391; Retrospectively Registered 7/2/2019, https://clinicaltrials.gov/ct2/show/NCT04005391
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Data Availability
Data available on request due to privacy/ethical restrictions.
Abbreviations
- IUD:
-
Intrauterine device
References
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Acknowledgements
We want to thank all the women and men involved in collection of the data analyzed in this work and all the women who participated in the study—their health, well-being, and successful pregnancy outcomes are the motivation for performing this work.
Funding
Funding for this project comes from the Eunice Kennedy Shriver National Institutes of Child Health and Human Development Women’s Reproductive Health Research K12 award (5K12HD001271) and the Doris Duke Charitable Foundation.
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MSH and JS conceived of the project with feedback from SBM, CR, EA, GH, and SB. SBM and CR coordinate the study with oversight from MSH and AB, and data management assistance from AJZ. GH aided with the site initiation visit and interpretation of results. MSH performed the analysis and wrote the manuscript with input from all authors.
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The authors have no relationships to disclose that may be deemed to influence the objectivity of this paper and its review. The authors report no commercial associations, either directly or through immediate family, in areas such as expert testimony, consulting, honoraria, stock holdings, equity interest, ownership, patent-licensing situations or employment that might pose a conflict of interest to this analysis. Additionally, the authors have no conflicts such as personal relationships or academic competition to disclose. The findings presented in this paper represent the views of the named authors only, and not the views of their institutions or organizations.
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Harrison, M.S., Bunge-Montes, S., Rivera, C. et al. Initial Contraceptive Choices of Women Enrolled in a Cluster-Randomized Trial in Southwest Trifinio, Guatemala. Matern Child Health J 26, 168–176 (2022). https://doi.org/10.1007/s10995-021-03275-4
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DOI: https://doi.org/10.1007/s10995-021-03275-4