ArticleContraception and reproductive medicine2025
Too far to follow up: associations between residential distance and social vulnerability on immediate postpartum contraceptive uptake.
Article in Contraception and reproductive medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPostpartum contraception plays a vital role in extending interpregnancy intervals and reducing adverse maternal and neonatal outcomes. However, patients at elevated risk due to geographic and social barriers may experience disruptions in postpartum care. We examine associations between residential distance to the delivery hospital and social determinants of health (SDoH) with contraception uptake at delivery discharge.
methodsWe conducted a retrospective cohort study of live births born at 22.0 gestational age and greater at a single urban academic center from March 2020 to March 2022. Demographic, obstetric, and SDoH data were extracted from electronic medical records. Contraceptive method recorded for all births as part of the delivery discharge note was manually reviewed classified into long-acting reversible contraception (LARC) or non-LARC methods. Univariate analyses were used to compare characteristics across groups living within 10.0 miles and those living 10.1 miles or further from the hospital. Logistic regression was used to identify predictors of LARC uptake.
resultsA total of 3,644 births were included; 54.6% of patients were Black, 30.3% Hispanic, and 73.7% utilized public insurance. A total of 74.2% of patients resided within 10.0 miles of the delivery hospital. Patients living farther away were more likely to face transportation barriers, lower educational attainment, and higher SDoH personal risk scores. Overall, 18.6% living closer and 22.3% living further from the delivery hospital received LARC at discharge [X
conclusionSeveral factors remained associated with LARC uptake at delivery discharge including residential distance, SDoH, and insurance. Our findings support the importance of inpatient contraceptive counseling and provision, particularly for socially vulnerable populations.
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