Postpartum contraceptive trajectories and preference alignment in a birthing cohort in rural India

Rachel Murro
Rutuja Patil, Kem Hospital Research Centre, Pune
Dhiraj Agarwal, KEM Hospital Research Centre Pune
Alison El Ayadi, University of California San Francisco
Nadia Diamond-Smith, University of California, San Francisco

Reproductive healthcare needs during the extended postpartum period (12 months) are unique due to fluctuations in fertility. Access to high-quality, person-centered sexual and reproductive healthcare during this time is essential for achieving contraceptive and childbearing goals, including birth spacing. Traditional demographic indicators for family planning progress are inadequate for measuring this type of person-centered care access, as contraceptive needs depend on individual preferences. Recently developed preference-sensitive measures like “preference-aligned fertility management” are thus critical to evaluating whether people’s use of contraceptive method(s) align with their self-defined preferences. There is a growing need to apply these measures across diverse geographies and populations with distinct fertility characteristics, such as postpartum individuals. The primary goals of this research are to examine how preferences for postpartum contraception fluctuate throughout the pregnancy and postpartum periods, and to describe the prevalence and correlates of preference-aligned fertility management among postpartum individuals. We will propose and employ a longitudinal measure of preference-aligned fertility management to establish temporality between expressed preferences and contraceptive use in the postpartum period. We will compare this measure to the traditional DHS measure of “unmet need” in a sample of n=1000 birthing people in rural Maharashtra, India.

Keywords: Longitudinal studies , Family Planning and Contraception, Data and Methods, Sexual and Reproductive Health and Rights

See extended abstract.