Postpartum contraception usage in immigrants compared with non-immigrants in Buffalo, NY

Objectives

The purpose of this study was to compare rates of postpartum contraception use in immigrant populations in Buffalo, NY compared with non-immigrant populations. The study also explores rates of specific birth control selection amongst those who did choose to employ postpartum contraception.

Study design

A retrospective chart review was conducted comparing the rate of postpartum contraceptive use in 132 immigrant individuals with that of 134 non-immigrant individuals, as measured by the documented intent or refusal to initiate any contraceptive method within the first three months postpartum. Patients were from clinics affiliated with the Women and Children’s Hospital of Buffalo (WCHOB) who delivered during the years 2015–2016. The immigrant patients were chosen from the top ten immigrant countries of origin who delivered at WCHOB at the time.

Results

After controlling for factors of maternal age, gestational age at time of delivery, and gravidity and parity, the immigrant group was more likely to decline postpartum contraception in the first three months postpartum compared with the non-immigrant group (25.8% vs 6.7%, p < 0.001). Immigrants were more likely to select a barrier method (p = 0.036) and decided to employ contraception more remotely from delivery when compared with non-immigrant individuals (p < 0.001). Amongst the immigrant cohort, there was no statistically significant difference in methods chosen based on broad geographic areas of origin.

Conclusions

Immigrant obstetric populations in Buffalo are less likely to employ postpartum contraception compared with non-immigrant populations. The factors influencing this are multifactorial; however, this information can inform care for both immigrant and non-immigrant patients.