Exploration of the Intersection between Infant Feeding and Postpartum Contraception in Western North Carolina: Perspectives of Postpartum Individuals and Providers.

Objectives: Short interpregnancy intervals are associated with preterm births. Increasing access to postpartum contraception is a preventive intervention. Best practice recommendations suggest that postpartum individuals exclusively breastfeed for up to 6 months. Conversations about these two topics tend to occur simultaneously throughout the perinatal period. This study explores the intersection between infant feeding and postpartum contraception.

Methods: Semistructured key informant interviews were conducted with postpartum individuals and providers from throughout western North Carolina. Interviews were audio recorded and transcribed. The "Sort and Sift, Think and Shift" method was applied. Emergent themes were identified by systematically generating summaries, memoranda, and quotation diagrams independently by two coders.

Results: Key themes included the need to prioritize individual decision-making autonomy and to provide prenatal patient education about infant feeding and postpartum contraception. Participants also discussed the types of social support needed for successful breastfeeding efforts and the impact of infant feeding on mental health. Contextual factors related to infant feeding and postpartum contraceptive decision-making encompassed cultural influences (eg, the historical context of reproductive rights and breastfeeding in public), the inherent challenges of rurality (eg, lack of transportation and the closure of labor and delivery units), and family leave and workplace policies.

Conclusions: Infant feeding method and postpartum contraception are highly individualized decisions, which are supported through patient education and shared decision making, particularly during the prenatal period. Findings suggest the importance of incorporating infant feeding within the sexual and reproductive health literature.