{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T23:12:48Z","timestamp":1790118768700,"version":"4.0.1"},"reference-count":24,"publisher":"Georg Thieme Verlag KG","issue":"02","funder":[{"name":"University of Cincinnati Department of Obstetrics and Gynecology and the University of Cincinnati College of Medicine Women\u2019s Health Medical Student Scholars Program"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>\n            Objective\u2003This study aimed to describe postpartum contraception preferences in the context of pregnancy intention (PI).<\/jats:p><jats:p>\n            Study Design\u2003A prospective cohort study analyzing postpartum contraceptive choice (PCC) in 431 postpartum women who delivered at a single academic medical center. PCC in women with an unintended or mistimed pregnancy was compared to contraceptive choice in women with an intended pregnancy using the adapted National Survey of Family Growth categorization. Mistimed and unintended pregnancies were grouped for analysis. Generalized linear modeling estimated the relative influence of PI on PCC adjusting for maternal age, race, and parity.<\/jats:p><jats:p>\n            Results\u2003Nearly three out of four (71.9%) pregnancies were mistimed or unintended. These pregnancies were more likely in women who were non-Hispanic Black (62.3%), unmarried (86.3%), 18 to 24 years (51.3%), and insured by Medicaid or Medicare (82.1%), compared to women with an intended pregnancy, p-value &lt;0.001. Women with mistimed or unintended pregnancy were 83% more likely to choose highly effective, user-independent methods compared to any other or no method, adjusted relative risk (aRR)\u2009=\u20091.83 (95% confidence interval [CI]: 1.36, 2.47), and more likely to desire voluntary sterilization, aRR\u2009=\u20092.70 (95% CI: 1.58, 4.59). Additionally, women with these pregnancies were 56% more likely to use user-independent methods compared to user-dependent methods, aRR\u2009=\u20091.56 (95% CI: 1.18, 2.06).<\/jats:p><jats:p>\n            Conclusion\u2003Women with mistimed or unintended pregnancies are 83% more likely to choose highly effective postpartum contraception or voluntary sterilization, and thus initiatives are necessary to increase access and affordability to these methods before hospital discharge after delivery.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-2335-2951","type":"journal-article","created":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T23:22:07Z","timestamp":1717024927000},"page":"196-203","source":"Crossref","is-referenced-by-count":2,"title":["Influence of Pregnancy Intention on Postpartum Contraceptive Choice at an Urban Academic Medical Center"],"prefix":"10.1055","volume":"42","author":[{"given":"Meghan","family":"St John","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Western Pennsylvania Hospital, Allegheny Health Network Medical Education Consortium, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirby","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, George Washington School of Medicine and Health Sciences, Washington, District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0164-5703","authenticated-orcid":false,"given":"Emily A.","family":"DeFranco","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Kentucky College of Medicine, Lexington, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio"},{"name":"Perinatal Institute Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,7,1]]},"reference":[{"key":"ref2","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1056\/NEJMsa1506575","article-title":"Declines in unintended pregnancy in the United States, 2008\u20132011","volume":"374","author":"L B Finer","year":"2016","journal-title":"N Engl J Med"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1097\/01.AOG.0000255666.78427.c5","article-title":"Pregnancy intention and its relationship to birth and maternal outcomes","volume":"109","author":"A P Mohllajee","year":"2007","journal-title":"Obstet Gynecol"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1363\/3919407","article-title":"Pregnancy intentions and happiness among pregnant black women at high risk for adverse infant health outcomes","volume":"39","author":"S M Blake","year":"2007","journal-title":"Perspect Sex Reprod Health"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/s12884-017-1223-x","article-title":"Unplanned pregnancy and subsequent psychological distress in partnered women: a cross-sectional study of the role of relationship quality and wider social support","volume":"17","author":"K Barton","year":"2017","journal-title":"BMC Pregnancy Childbirth"},{"issue":"06","key":"ref6","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1097\/AOG.0000000000000841","article-title":"Contraception after delivery and short interpregnancy intervals among women in the United States","volume":"125","author":"K White","year":"2015","journal-title":"Obstet Gynecol"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.contraception.2018.02.013","article-title":"Unintended pregnancy and interpregnancy interval by maternal age, National Survey of Family Growth","volume":"98","author":"K A Ahrens","year":"2018","journal-title":"Contraception"},{"issue":"10","key":"ref8","doi-asserted-by":"crossref","first-page":"e0206325","DOI":"10.1371\/journal.pone.0206325","article-title":"Contraceptive use following unintended pregnancy among Ugandan women living with HIV","volume":"13","author":"J Jarolimova","year":"2018","journal-title":"PLoS ONE"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1186\/s12905-018-0668-z","article-title":"Unintended pregnancy and subsequent postpartum long-acting reversible contraceptive use in Zimbabwe","volume":"18","author":"N Nance","year":"2018","journal-title":"BMC Womens Health"},{"issue":"03","key":"ref10","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1363\/psrh.12074","article-title":"Does postpartum contraceptive use vary by birth intendedness?","volume":"50","author":"K B Guzzo","year":"2018","journal-title":"Perspect Sex Reprod Health"},{"issue":"02","key":"ref11","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.contraception.2019.10.007","article-title":"Pregnancy preferences and contraceptive use among US women","volume":"101","author":"G Samari","year":"2020","journal-title":"Contraception"},{"issue":"06","key":"ref12","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/j.fertnstert.2016.07.1067","article-title":"Pregnancy intentions-a complex construct and call for new measures","volume":"106","author":"S L Mumford","year":"2016","journal-title":"Fertil Steril"},{"issue":"04","key":"ref15","doi-asserted-by":"crossref","first-page":"e44","DOI":"10.1097\/AOG.0000000000001106","article-title":"ACOG Committee Opinion No. 642: Increasing access to contraceptive implants and intrauterine devices to reduce unwanted pregnancy","volume":"126","author":"The American College of Obstetricians and Gynecologists","year":"2015","journal-title":"Obstet Gynecol"},{"key":"ref18","volume-title":"Chapter 7: Covariate selection. In: Developing a Protocol for Observational Comparative Effectiveness Research: A User's Guide","author":"B Sauer","year":"2013"},{"issue":"02","key":"ref19","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2013a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"P A Harris","year":"2009","journal-title":"J Biomed Inform"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1363\/46e8420","article-title":"Contraceptive use behavior change after an unintended birth in Colombia and Peru","volume":"46","author":"E Batyra","year":"2020","journal-title":"Int Perspect Sex Reprod Health"},{"issue":"02","key":"ref22","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1007\/s11606-009-1197-0","article-title":"Unintended pregnancy influences racial disparity in tubal sterilization rates","volume":"25","author":"S Borrero","year":"2010","journal-title":"J Gen Intern Med"},{"issue":"06","key":"ref23","doi-asserted-by":"crossref","first-page":"526.e1","DOI":"10.1016\/j.ajog.2014.01.037","article-title":"Racial\/ethnic disparities in contraceptive use: variation by age and women's reproductive experiences","volume":"210","author":"C Dehlendorf","year":"2014","journal-title":"Am J Obstet Gynecol"},{"issue":"05","key":"ref24","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.contraception.2018.01.006","article-title":"Racial and ethnic differences in patterns of long-acting reversible contraceptive use in the United States, 2011-2015","volume":"97","author":"R D Kramer","year":"2018","journal-title":"Contraception"},{"issue":"02","key":"ref25","doi-asserted-by":"crossref","first-page":"121","DOI":"10.4314\/ejhs.v27i2.4","article-title":"Barriers to contraceptive uptake among women of reproductive age in a semi-urban community of Ekiti State, Southwest Nigeria","volume":"27","author":"K A Durowade","year":"2017","journal-title":"Ethiop J Health Sci"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1186\/s12889-015-1483-1","article-title":"Barriers to modern contraceptive methods uptake among young women in Kenya: a qualitative study","volume":"15","author":"R Ochako","year":"2015","journal-title":"BMC Public Health"},{"issue":"04","key":"ref27","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/j.sxmr.2019.06.005","article-title":"A biopsychosocial model for the counseling of hormonal contraceptives: a review of the psychological, relational, sexual, and cultural elements involved in the choice of contraceptive method","volume":"7","author":"F M Nimbi","year":"2019","journal-title":"Sex Med Rev"},{"issue":"06","key":"ref28","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1016\/j.contraception.2015.02.005","article-title":"Differences in contraceptive use between family planning providers and the U.S. population: results of a nationwide survey","volume":"91","author":"L F Stern","year":"2015","journal-title":"Contraception"},{"issue":"04","key":"ref29","doi-asserted-by":"crossref","first-page":"319.e1","DOI":"10.1016\/j.ajog.2010.05.009","article-title":"Recommendations for intrauterine contraception: a randomized trial of the effects of patients' race\/ethnicity and socioeconomic status","volume":"203","author":"C Dehlendorf","year":"2010","journal-title":"Am J Obstet Gynecol"},{"issue":"11","key":"ref30","doi-asserted-by":"crossref","first-page":"1932","DOI":"10.2105\/AJPH.2016.303393","article-title":"Provider bias in long-acting reversible contraception (LARC) promotion and removal: perceptions of young adult women","volume":"106","author":"J A Higgins","year":"2016","journal-title":"Am J Public Health"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2335-2951.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T23:58:55Z","timestamp":1735689535000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2335-2951"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,29]]},"references-count":24,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2024,12,31]]},"published-print":{"date-parts":[[2025,1]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2335-2951","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,5,29]]},"published":{"date-parts":[[2024,5,29]]}}}