Effective postpartum contraceptive counseling helps patients meet their reproductive life goals. Patient decision aids (PtDA) can facilitate counseling but the optimal structure and medium for a PtDA is unknown.METHODS:
On postpartum day 1, women who had not received a postplacental LARC were randomized to: 1) a paper-based PtDA that featured contraceptive options for side-by-side comparison, 2) standard contraception brochure, or 3) website with comparison of contraceptive options. All patients received counseling utilizing their assigned tool. The concordance between a patient’s decision and their values (“decision quality”) and the extent to which she is clear about her values and feels informed (“decision-making process quality”), were evaluated using validated surveys.RESULTS:
126 patients were enrolled. The average age of participants was 28.9, half were Latina, 69% had public insurance, 42% were primiparous, and 60% had a vaginal delivery. There were no statistical differences among the groups except for counseling time (6.4 min for PtDA, 6.6 min for the website, and 4.9 min for the standard brochure, p=0.0152). The primary outcomes of “decision quality” and “decision-making process quality” were not statistically different. Regardless of the material, women found them helpful and would recommend to a friend. Although none of the materials highlighted LARC methods, half of all participants chose a LARC method.CONCLUSION:
Women were satisfied with all approaches to postpartum contraception counseling in this study, which on average took only seven minutes. Our PtDA offer a low-tech solution that women find helpful. Further research is needed to determine its impact in the long-term.