The prevalence of contraceptive use among postpartum women during the early phase of COVID-19 outbreak: A cross sectional study

We investigated the prevalence of postpartum contraceptives during the COVID-19 outbreak and identify factors associated with contraceptive initiation. We reviewed the electronic medical records of 4506 postpartum women who delivered at King Chulalongkorn Memorial Hospital (KCMH) during the early phase of COVID-19 in Thailand and the historical cohort period. A total of 3765 women (83.6%), of which 1821 delivered during the pandemic and 1944 during the historical cohort period, were included in this study. The proportion of women who initiated modern contraceptives at six-week postpartum was comparable between the COVID-19 (73.4%) and historical cohort (75.3%) (p = 0.27) periods. The proportion of women who initiated highly effective contraception tended to be higher during the historical cohort period (22.5%) than during the COVID-19 period (19.7%) (p = 0.05). Accessing a six-week postpartum check-up was independently associated with highly effective contraceptive initiation, of which the adjusted odds ratio (OR) (95% confidence interval) was 3.01 (2.26 to 4.02). The findings highlight that the pandemic worsened the healthcare system by limiting access to postpartum check-ups, which contributed to fewer opportunities to initiate highly effective contraception.