This study evaluates the impact of a multilevel postpartum family planning (PPFP) intervention on contraceptive use within 12 months postpartum and the prevention of short inter-pregnancy intervals in China.
This multicentre, cluster-randomised trial involved 36 hospitals in China. Hospitals were randomly assigned to either the intervention or control group. Eligible participants were women who were at least at 36 weeks gestation who gave birth at these hospitals, followed for up to 1 year. Between 1 July and 31 December 2019, the first 180 eligible women at each hospital were invited to participate. Control participants received routine antenatal and postnatal care, while the intervention group received integrated PPFP services, enhanced counselling and free contraceptives. The primary outcome was postpartum contraceptive use. Contraceptive prevalence, including any methods, long-acting reversible contraceptives (LARCs), method switching and unmet need was assessed using life table analysis and multilevel Cox regression.
A total of 6315 participants were recruited, with 3116 in the intervention group and 3199 in the control group. The intervention group had higher contraceptive prevalence (88.7% vs 70.2%) and LARC uptake (21.4% vs 15.1%) at 12 months postpartum. Cox regression analysis showed a 1.88-fold increase in contraceptive use, a 2.64-fold increase in LARC uptake and a 48% reduction in unmet need for modern contraceptives in the intervention group. No significant differences in method switching were observed.
The multilevel PPFP intervention effectively increased contraceptive use and LARC uptake while reducing unmet need for modern contraceptives among postpartum women.
Chictr.org.cn Identifier: ChiCTR1900023790 (URL: https://www.chictr.org.cn/).