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  1. Article ; Online: Pregnancy planning and barriers to accessing postnatal contraception in New Zealand.

    Wimsett, Jordon / Sadler, Lynn / Tutty, Sue / Tutty, Esther / Oyston, Charlotte

    Contraception

    2022  Volume 112, Page(s) 100–104

    Abstract: Objective: To estimate rates of pregnancy and contraceptive planning and to identify barriers and enablers to postnatal contraceptive use.: Study design: Face-to-face survey of patients during their immediate postnatal stay at Middlemore Hospital, ... ...

    Abstract Objective: To estimate rates of pregnancy and contraceptive planning and to identify barriers and enablers to postnatal contraceptive use.
    Study design: Face-to-face survey of patients during their immediate postnatal stay at Middlemore Hospital, Auckland, or associated primary birthing units. Patients were approached by study investigators over designated 2-week study periods in 2019 and 2020. The primary outcome was the rate of pregnancy and contraceptive planning. The descriptive analysis explored differences between ethnicities.
    Results: We were able to approach 332 of 497 eligible women (67%), and 313 of 332 (94%) of those who approached completed the survey. Fifty-three percent of pregnancies were reported to have been planned. Pregnancy was more often planned by European (72%), Indian (68%), and Other Asian patients (72%) compared with Māori (33%) and Pacific patients (39%) (p < 0.001). Thirty-seven percent of patients reported an antenatal contraceptive discussion, and these were more commonly reported by Māori and Pacific patients (p < 0.001). A quarter of patients reported never having a conversation about contraception during or immediately after pregnancy, a third of whom said they would have valued one. Fifty-nine percent of patients reported having made a contraceptive plan immediately after birth. Concern about the side effects of contraception was a barrier reported by 51% of patients. Cost, travel, finding time, and family views were less frequent barriers.
    Conclusion: Rates of pregnancy planning reported postnatally are consistent with previous NZ research at approximately 50%, and we also found ethnic differences. Concerns about side effects were the most significant barrier for patients accessing contraception and this needs to be addressed in a culturally useful format.
    Implications: Postpartum patients report low rates of pregnancy planning. A significant proportion of postpartum patients report having no conversations about contraception with clinicians, and concerns about side effects are their most common barrier to contraception.
    MeSH term(s) Contraception ; Contraception Behavior ; Contraceptive Agents ; Family Planning Services ; Female ; Humans ; New Zealand ; Postpartum Period ; Pregnancy
    Chemical Substances Contraceptive Agents
    Language English
    Publishing date 2022-03-03
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80106-9
    ISSN 1879-0518 ; 0010-7824
    ISSN (online) 1879-0518
    ISSN 0010-7824
    DOI 10.1016/j.contraception.2022.02.007
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: How well do we support whānau with postpartum contraception? Comparison of two Auckland maternity hospitals.

    Wimsett, Jordon / Sadler, Lynn / Oyston, Charlotte / Legget, Emelia / Tutty, Sue / Roberts, Helen

    The New Zealand medical journal

    2023  Volume 136, Issue 1577, Page(s) 57–64

    Abstract: Aim: To compare the rates of recall of contraceptive discussion and provision of chosen contraceptive method before discharge among patients who recently birthed in two tertiary maternity units in Auckland, New Zealand.: Method: A cross-sectional ... ...

    Abstract Aim: To compare the rates of recall of contraceptive discussion and provision of chosen contraceptive method before discharge among patients who recently birthed in two tertiary maternity units in Auckland, New Zealand.
    Method: A cross-sectional survey of recently postpartum patients at tertiary and associated primary birthing units aligned with Auckland and Counties Manukau maternity services was undertaken in 2019 and 2020.
    Results: Five hundred and seventy-one patients took part in the survey. Overall recall around contraceptive discussions was low, as was the number of patients leaving hospital with their preferred method of contraception. Compared to Counties Manukau, almost twice as many patients at Auckland were unable to recall either an antenatal or postpartum discussion with a health professional about contraception (77% vs 39%, p<0.001). Those birthing at Counties Manukau were also more likely to recall seeing a hospital contraceptive brochure than those at Auckland (42% vs 20%, p<0.001). Twice as many patients at Counties Manukau left hospital with their chosen method compared to those at Auckland (31% vs 14%, p<0.001). In addition, long-acting reversible contraceptives (LARCs) were more often chosen for contraception at Counties Manukau (31% vs 22%, p=0.01) and more patients left hospital with their LARC compared to Auckland (13% vs 7%, p=0.03).
    Conclusion: These differences between two large tertiary maternity services suggests an opportunity for quality improvement around contraception provision.
    MeSH term(s) Humans ; Female ; Pregnancy ; Cross-Sectional Studies ; Hospitals, Maternity ; New Zealand ; Contraception ; Postpartum Period ; Contraceptive Agents
    Chemical Substances Contraceptive Agents
    Language English
    Publishing date 2023-06-16
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 390590-1
    ISSN 1175-8716 ; 0028-8446 ; 0110-7704
    ISSN (online) 1175-8716
    ISSN 0028-8446 ; 0110-7704
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Inequities in pre-pregnancy folic acid use in Central and South Auckland: secondary analysis from a postpartum contraception survey.

    Tutty, Esther / Wimsett, Jordon / Oyston, Charlotte / Tutty, Sue / Harwood, Matire / Legget, Emelia / Sadler, Lynn

    Journal of primary health care

    2023  Volume 15, Issue 4, Page(s) 308–315

    Abstract: Introduction In Aotearoa New Zealand (NZ), there is inequity in rates of neural tube defects (NTDs). Among Maaori, NTD occur in 4.58/10 000 live births, and for Pacific peoples, it is 4.09/10 000 live births; this is compared to 2.81/10 000 live births ... ...

    Abstract Introduction In Aotearoa New Zealand (NZ), there is inequity in rates of neural tube defects (NTDs). Among Maaori, NTD occur in 4.58/10 000 live births, and for Pacific peoples, it is 4.09/10 000 live births; this is compared to 2.81/10 000 live births for non-Maaori, non-Pacific peoples. Aim To describe self-reported pre-pregnancy folic acid supplementation and to determine the association between pregnancy intendedness, ethnicity, parity, maternal age, care provider and pre-pregnancy folic acid supplementation. Methods Secondary analysis of postpartum survey data collected at Te Whatu Ora Te Toka Tumai and Counties Manukau birthing facilities in 2020 was conducted. Descriptive analyses explored pregnancy intendedness and self-reported folic acid use by demographic variables. Multivariable logistic regression explored independent associations between demographic variables and folic acid use among intended pregnancies. Results In total, 398 participants completed the survey. The response rate was (140/149) 94% at Counties Manukau and (258/315) 82% at Te Toka Tumai. Pre-pregnancy supplementation was reported by 182 of 398 participants (46%). Use was higher among those who intended their pregnancy (151/262, 58%) compared to those who were 'pregnancy ambivalent' (9/33, 27%) or did not intend to become pregnant (22/103, 21%). Factors independently associated with supplementation among intended pregnancies included: 'Other ethnicity' (European, Middle Eastern, Latin American, African) compared to Maaori (aOR 5.3 (95% CI 1.3, 21.8)), age ≥30 years compared to Discussion Low rates of pre-pregnancy folic acid supplementation exist in Auckland with significant ethnic disparity. Mandatory fortification of non-organic wheat is important, but supplementation is still recommended to maximally reduce risk.
    MeSH term(s) Pregnancy ; Female ; Humans ; Adult ; Folic Acid ; Dietary Supplements ; Neural Tube Defects/epidemiology ; Neural Tube Defects/prevention & control ; Postpartum Period ; Contraception
    Chemical Substances Folic Acid (935E97BOY8)
    Language English
    Publishing date 2023-12-19
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2572943-3
    ISSN 1172-6156 ; 1172-6156
    ISSN (online) 1172-6156
    ISSN 1172-6156
    DOI 10.1071/HC23103
    Database MEDical Literature Analysis and Retrieval System OnLINE

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