Many studies correlate lower health literacy with poorer health outcomes and inferior provider-patient communication. Little is known about how impaired health literacy among women receiving perinatal care at inner city public hospitals may impact health behaviors and outcomes.METHODS:
This study used the Rapid Estimate of Adult Literacy in Medicine-short form (REALM-SF) to characterize health literacy among postpartum women in a public tertiary care center and evaluate the association between health literacy and breastfeeding, prenatal care, and contraception use.RESULTS:
These results reflect our interim analysis from 258 participants. The majority were black and completed high school. 94% had a 7th grade or greater reading level with 46% at high school level. 85% reported the most recent pregnancy was unplanned. There was no difference in the proportion breastfeeding at postpartum discharge by literacy level, however there was a significant increase in proportion exclusively breastfeeding at postpartum discharge among women with a higher health literacy (45% high school, 29% 7–8th grade, 8% 6th grade or less, P=.019). Women with higher health literacy were also significantly more likely to continue breastfeeding at the postpartum visit. 97% of women were using contraception at discharge, with 39% using LARC or tubal ligation. There was no difference in contraception use at discharge by health literacy.CONCLUSION:
We demonstrate a correlation between health literacy and positive reproductive health outcomes including breastfeeding. Strong postpartum contraception promotion can overcome differences in health literacy. The strikingly high proportion of unplanned pregnancies among our sample deserves further evaluation.