Rapid Repeat Pregnancies among Women Reporting a Preference for Long-Acting or Permanent Contraception in Texas

Joseph E. Potter, University of Texas at Austin
Celia Hubert, University of Texas at Austin
Kristine Hopkins, University of Texas at Austin
Abigail R. A. Aiken, Princeton University
Kari White, University of Alabama at Birmingham
Daniel Grossman, Ibis Reproductive Health

We assess what might have been: births that could have been averted through improved access to highly effective contraception in the postpartum period. In a 24-month prospective study of 403 women who wanted to delay childbearing for 2 years or more, participants completed interviews following delivery, and at 3, 6, 9, 12, 18, and 24 months postpartum. At each interview, participants were asked about their pregnancy status and their current contraceptive method. The 6-month interview also asked participants about the method they would like to use if cost were not a barrier. Retention was 80%. 88 women reported a pregnancy in the period of observation. 84% of women who became pregnant had said in an earlier interview that they would be interested in using a highly effective method. This study points to the impact that provision of LARC in the immediate postpartum period could have on unintended pregnancy in Texas.