In Fem Tech circles, conversations about contraception are typically had before conception. With women around the world wondering what they can do to ensure they fall pregnant. Or avoid it! However, while postpartum contraception can be equally important, it is often overlooked. After all, amidst the flurry of adjusting to life with a newborn filled with joy, challenges, and life-altering responsibilities, it is perhaps unsurprising that the thought of another pregnancy is not a priority. However, according to a new Monash University-led study published in the Medical Journal of Australia, early access to contraceptive information and services in the postpartum period can significantly improve family planning and health outcomes for both mothers and their babies.
The unspoken conversation
The postpartum period is intense. And, it’s no surprise that many new mothers focus primarily on their baby’s wellbeing. But this is also a critical time for discussions about contraception, particularly at the ‘six-week check,’ a routine medical review that takes place about six to eight weeks after giving birth. Unfortunately, many women do not receive adequate information on contraception during this period. The recent study highlights how general practitioners (GPs) are perfectly positioned to provide this care, but time constraints and other barriers often prevent it from happening effectively.
As Senior Researcher Dr. Jessica Botfield explains, “Access to contraception information and services to plan for and space pregnancies is critical, particularly in the postpartum period when women may be at risk of an unintended pregnancy soon after giving birth.”
Short inter-pregnancy intervals (within 12 months of a previous birth) can pose significant health risks to both the mother and the baby. These risks include preterm birth, low birth weight, and even developmental delays for the child. By providing new mothers with timely contraceptive advice, healthcare providers can help them avoid these outcomes, and enable families to plan pregnancies in a way that supports both maternal and infant health.
Key players in postpartum care
The Monash University study, which involved interviews with 23 GPs across Australia, sheds light on their views and experiences with postpartum contraceptive care. Many GPs felt that discussions about contraception should be a core part of postnatal check-ups. However, they noted several obstacles that prevent them from offering comprehensive contraceptive counselling. One GP remarked that new mothers often focus so much on their baby’s health that there’s little room to discuss contraception, with time constraints frequently mentioned.
GPs also pointed to a lack of national guidelines on postpartum contraceptive care, leaving many uncertain about when and how to broach the topic. Additionally, some GPs reported that a lack of training and resources limited their ability to provide long-acting reversible contraceptives (LARCs) such as intrauterine devices (IUDs) and implants.
Despite these challenges, the study found that GPs overwhelmingly support the idea of integrating contraceptive discussions into routine postnatal care. They highlighted the need for better education and training, particularly in administering LARCs, as well as financial incentives for upskilling. National guidelines would also help standardise care and ensure that every new mother has access to the contraceptive support she needs.
Why postpartum contraception matters
Contraceptive care for new mothers goes beyond preventing unintended pregnancies – it empowers women to make informed choices about their reproductive health. Pregnancy spacing is crucial for positive outcomes for both mother and baby, yet many women lack the necessary information to make these decisions.
The Monash study emphasises the importance of discussing contraception both antenatally and postnatally. While midwives and obstetricians typically provide antenatal care, GPs play a vital role in postnatal support. As Dr. Botfield notes, GPs often maintain consistent, long-term relationships with new mothers, making them well-positioned to offer personalised contraceptive advice.
By initiating these discussions early and presenting a range of contraceptive options, healthcare providers can assist mothers in planning their families in ways that align with their health, wellbeing, and future aspirations.
The study’s findings suggest several ways to improve postpartum contraceptive care in Australia. A key recommendation is developing national guidelines for postpartum contraception, giving GPs a clear framework for postnatal check-ups. Additionally, enhancing training for GPs in administering long-acting reversible contraceptives (LARCs) would enable more women to access effective, long-term methods.
Collaboration between GPs, midwives, and other maternity care providers is essential. These professionals can work together to initiate contraceptive discussions antenatally and continue them postnatally, ensuring women receive the necessary information at every stage of their pregnancy journey.