Advance provision of postpartum emergency contraception and its effects on reproductive autonomy: a mixed methods study

This project will be a prospective observational study, using a mixed-methods design to further explore the impact of EC use on postpartum patients’ feelings of reproductive autonomy. Eligible patients will be 16-40 years of age, English-speaking, have a male partner, delivered of a live infant, desiring to delay pregnancy for at least a year, in general good health, a patient at Northwestern University Feinberg School of Medicine Department of Obstetrics and Gynecology, and choosing the following contraceptive method after delivery: none, condoms, fertility awareness method. Exclusion criteria include allergy to UPA, those who have had tubal sterilization, those who conceived via assisted reproductive technology, or those with inability to follow up. We will aim to recruit 75 participants, with an expected 40-50 participants retained at 6 months, and 15-20 of those participants choosing to participate in an in-depth interview at 6 months. Patients who meet eligibility criteria will be approached on postpartum day 1, after they have decided their method of contraception. If they choose to enroll in the study, they will undergo an informed consent and a baseline survey comprised of standard demographic questions, questions on reproductive and contraceptive history, knowledge on EC, and questions on reproductive autonomy. The section on reproductive autonomy is adapted from the Reproductive Autonomy Scale.28 This survey will be designed to take ~10 minutes to complete. Participants will undergo standardized counseling on EC that details instructions for use. They will receive a package of three doses of UPA prior to being discharged home. Participants will be aware that if they were to need additional doses of EC, they would be able to call the clinic. Participants will then complete surveys at 6 weeks, 3 months, and 6 months. In the 6-week survey, if they have used EC by that time, they will be invited to participate in a brief, 20-30 minute interview that will foc