Provision of Postpartum Contraception Before and After the Start of the COVID-19 Pandemic in Maine.

Authors

Catherine Gelsinger BSN, RN, University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research CenterFollow
Kristin Palmsten, HealthPartners Institute, Pregnancy and Child Health Research Center
Heather S. Lipkind, Weill Cornell Medical College
Mariah Pfeiffer RN, MPH, University of Southern Maine, Muskie School of Public Service
Christina Ackerman-Banks, Yale School of Medicine
Jennifer A Hutcheon, University of British Columbia
Katherine A. Ahrens PhD, University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research CenterFollow

Document Type

Article

Publication Date

5-2-2023

Keywords

Maine, COVID-19, contraception

Publication Title

Public Health Reports

Abstract

[Journal Abstract] OBJECTIVE: Preliminary findings from selected health systems revealed interruptions in reproductive health care services due to the COVID-19 pandemic. We estimated changes in postpartum contraceptive provision associated with the start of the COVID-19 pandemic in Maine.

METHODS: We used the Maine Health Data Organization's All Payer Claims Database for deliveries from October 2015 through March 2021 (n = 45 916). Using an interrupted time-series analysis design, we estimated changes in provision rates of long-acting reversible contraception (LARC), permanent contraception, and moderately effective contraception within 3 and 60 days of delivery after the start of the COVID-19 pandemic. We performed 6- and 12-month analyses (April 2020-September 2020, April 2020-March 2021) as compared with the reference period (October 2015-March 2020). We used Poisson regression models to calculate level-change rate ratios (RRs) and 95% CIs.

RESULTS: The 6-month analysis found that provision of LARC (RR = 1.89; 95% CI, 1.76-2.02) and moderately effective contraception (RR = 1.51; 95% CI, 1.33-1.72) within 3 days of delivery increased at the start of the COVID-19 pandemic, while provision of LARC (RR = 0.95; 95% CI, 0.93-0.97) and moderately effective contraception (RR = 1.08; 95% CI, 1.05-1.11) within 60 days of delivery was stable. Rates of provision of permanent contraception within 3 days (RR = 0.70; 95% CI, 0.63-0.78) and 60 days (RR = 0.71; 95% CI, 0.63-0.80) decreased. RRs from the 12-month analysis were generally attenuated.

CONCLUSION: Disruptions in postpartum provision of permanent contraception occurred at the beginning of the COVID-19 pandemic in Maine. Public health policies should include guidance for contraceptive provision during public health emergencies and consider designating permanent contraception as a nonelective procedure.

Recommended Citation

Gelsinger, C., Palmsten, K., Lipkind, H. S., Pfeiffer, M., Ackerman-Banks, C., Hutcheon, J. A., & Ahrens, K. A. (2023, May 2). Provision of Postpartum Contraception before and after the Start of the COVID-19 Pandemic in Maine. Public Health Reports, 333549231170198. https://doi.org/10.1177/00333549231170198