Leveraging Antenatal Care with Structured Contraceptive Counseling to Cultivate Knowledge and Acceptability of Postpartum Intrauterine Methods

Abstract

A key strategy to reducing unintended and short interval pregnancies is to improve utilization of long-acting reversible contraceptives (LARCs). Yet limited knowledge resulting from an unmet need for early and evidence-based counseling may influence women’s decisions to use these methods. The purpose of this quantitative, quasi-experimental project was to assess if implementation of a structured contraceptive counseling intervention administered during routine antenatal care would impact patient knowledge and acceptability of postpartum intrauterine LARC methods among women in a low-risk primary care maternity clinic in urban British Columbia, Canada over 30 days. An electronic counseling tool adopting the GATHER approach was developed applying constructs from the health belief model and theory of planned behavior to evaluate patient beliefs and attitudes that predict contraceptive behavior. A LARC Knowledge and Acceptability Questionnaire was adopted to measure intervention outcomes in expecting women (n = 16). Using the McNemar-Bowker test of symmetry, results yielded a statistically significant improvement in knowledge scores (M = 9.813; SD = 0.544; p = 0.0011). The McNemar’s Chi-Square test results for antenatal acceptability did not reach statistical significance (p = 0.375) though yielded a large intervention effect size (Cohen’s g = 0.3). Findings suggest blending contraceptive counseling into antenatal care may increase intention to use LARC methods postnatally. Project replication is needed over a longer period of time and with a larger sample size.