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Use of postpartum contraception during coronavirus disease 2019 (COVID‐19): A retrospective cohort study
Author(s) -
Das Kirsten J. H.,
Fuerst Megan,
Brown Ciara,
Lesko Jennifer
Publication year - 2021
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.13805
Subject(s) - medicine , cohort , odds ratio , retrospective cohort study , cohort study , confidence interval , obstetrics , logistic regression , postpartum period , pregnancy , genetics , biology
Abstract Objective To assess how use of postpartum contraception (PPC) changed during the COVID‐19 public health emergency. Methods Billing and coding data from a single urban institution ( n = 1797) were used to compare use of PPC in patients who delivered from March to June 2020 (COVID Cohort, n = 927) and from March to June 2019 (Comparison Cohort, n = 895). χ 2 and multivariable logistic regression models assessed relationships between cohorts, use of contraception, and interactions with postpartum visits and race/ethnicity. Results In the COVID Cohort, 585 women (64%) attended postpartum visits ( n = 488, 83.4%, via telemedicine) compared to 660 (74.7%, in‐person) in the Comparison Cohort ( P < 0.01). Total use of PPC remained similar: 30.4% ( n = 261) in the COVID Cohort and 29.6% ( n = 278) in the Comparison Cohort ( P = 0.69). Compared to in‐person visits in the Comparison Cohort, telemedicine visits in the COVID Cohort had similar odds of insertion of long‐acting reversible contraception (LARC) (adjusted odds ratio [aOR] 1.13, 95% confidence interval [CI] 0.78–1.6), but higher odds of inpatient insertion (aOR 6.4, 95% CI 1.7–24.9). Black patients compared to white patients were more likely to initiate inpatient LARC (aOR 7.29, 95% CI 1.81–29.4) compared to the Comparison Cohort (aOR 3.63, 95% CI 0.29–46.19). Conclusion Use of PPC remained similar during COVID‐19 with a decrease of in‐person postpartum visits, new adoption of postpartum telemedicine visits, and an increase in inpatient insertion of LARC with higher odds of inpatient placement among black patients.