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29-01-2025 | Contraception

Association Between Preterm Birth and Fulfillment of Desired Permanent Contraception

Authors: Andrea Chalem, Claire E. Jensen, Brooke W. Bullington, Kristen A. Berg, Emily S. Miller, Margaret Boozer, Tania Serna, Jennifer L. Bailit, Kavita Shah Arora

Published in: Maternal and Child Health Journal

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Abstract

Objectives

In cases of preterm delivery, the Medicaid sterilization policy mandates a signed consent form at least 72 h before surgery for permanent contraception, which is less than the 30 day minimum waiting period for term births. This study evaluated the association between preterm birth and fulfillment of planned permanent contraception.

Study Design

This was a secondary analysis of a multi-center retrospective cohort study of 3013 patients with a postpartum contraceptive plan of permanent contraception. Primary outcomes were permanent contraception fulfillment, compared between preterm and term deliveries. Secondary analyses examined moderation by delivery mode and insurance type.

Results

At hospital discharge, patients who had a preterm delivery were less likely to undergo desired permanent contraception than those with a term delivery (adjusted odds ratio (aOR): 0.67, 95% CI: 0.53–0.84), and this finding persisted up to one year postpartum (aOR: 0.65, 95% CI: 0.53–0.8). For patients with cesarean deliveries, the odds of permanent contraception fulfillment were significantly lower among those with preterm compared to term deliveries (aOR: 0.54, 95% CI: 0.39–0.76). Among patients with Medicaid insurance, those who delivered preterm were less likely than those who delivered term to undergo desired permanent contraception (aOR: 0.66, 95% CI: 0.59–0.88).

Conclusions for Practice

Patients delivering preterm face barriers to fulfillment of desired permanent contraception postpartum. Prioritization of contraceptive goals is important for patient autonomy and increasing equitable access to contraception for all.
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Metadata
Title
Association Between Preterm Birth and Fulfillment of Desired Permanent Contraception
Authors
Andrea Chalem
Claire E. Jensen
Brooke W. Bullington
Kristen A. Berg
Emily S. Miller
Margaret Boozer
Tania Serna
Jennifer L. Bailit
Kavita Shah Arora
Publication date
29-01-2025
Publisher
Springer US
Published in
Maternal and Child Health Journal
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI
https://doi.org/10.1007/s10995-025-04063-0

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