Int J Gynaecol Obstet. 2021 Jul 1. doi: 10.1002/ijgo.13805. Online ahead of print.
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). χ2 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.