Poster Presentation Women's Health Forum 2021

To what extent do postpartum contraception policies or guidelines exist in Australia and New Zealand: a document analysis study. (#70)

Edwina Dorney 1 , Kate Cheney 1 , Kirsten Black 1 , Luke Grzeskowiak 2 3 , Kevin McGeechan 1 4
  1. The University of Sydney, Sydney, NSW, Australia
  2. Robinson Research Institute , Adelaide , South Australia, Australia
  3. Adelaide Medical School , University of Adelaide , Adelaide , South Australia , Australia
  4. School of Public Health , The University of Sydney, Sydney, NSW, Australia

Background

Unintended pregnancies in the first 12 months following a birth are associated with increased maternal and fetal morbidity. Appropriate post-partum contraception is critical to address this. Access to postpartum contraception enables women to better plan the timing of pregnancies and optimise their health prior to the next conception. This positively impacts maternal and fetal outcomes and the health of future generations.

Objective

To investigate and analyse existing Australian and New Zealand (ANZ) Clinical Practice Guidelines (CPG) and Policy Statements on the provision of postpartum contraception to determine deficiencies in clinical guidance.

Methodology

We conducted a search of online publicly available grey literature that focused on postpartum contraception as a policy statement or CPG in ANZ. Site searches of Australian and New Zealand government, state health services, related professional organisations and five leading Australian Clinical Guideline Registers were performed. The AGREE II checklist was used independently by two researchers to appraise relevant guidelines.

Results

Only one CPG was identified that included specific information about postpartum contraception. This was a link to the Faculty of Sexual and Reproductive Health in the United Kingdom, available from  The Royal Australian and New Zealand College of Obstetricians and Gynaecologists website. This guideline was rated of high quality on the AGREE II tool. Both reviewers concluded that they would use this guideline in practice, with modifications required for the Australian context.

Conclusions

We identified one high-quality evidence-based guideline on postpartum contraception. This CPG is UK in origin yet can be modified to the Australian and New Zealand context. A structured, systematic and collaborative approach is needed to adapt and implement this CPG to clinical care. This will help in promoting a high standard of consistent contraceptive care to all women after birth in Australia and NZ.

  1. Conde-Agudelo A, Rosas-Bermúdez A, Kafury-Goeta AC. Birth spacing and risk of adverse perinatal outcomes: a meta-analysis. Jama. 2006;295(15):1809-1823.
  2. Makins A, Cameron S. Post pregnancy contraception. Best Practice & Research Clinical Obstetrics & Gynaecology. 2020(66):41-54.
  3. Faculty of Sexual & Reproductive Healthcare (FSRH). FSRH Guideline Contraception After Pregnancy UK: Faculty of Sexual & Reproductive Healthcare.; 2017.