In publicly insured women wishing to delay childbearing for at least 2 years, limited use of long-acting and permanent contraceptive methods after delivery is associated with indicators of health care provider and system-level barriers, a recent study found. The prospective cohort study interviewed 1,700 women aged 18 to 44 years in Texas immediately postpartum and at 3 and 6 months after delivery. At 3 months, participants were asked what contraceptive method they would prefer at 6 months. Researchers found:

• ~80% of participants completed both the 3- and 6-month interviews.
• Overall, preferences exceeded use for both long-acting reversible contraception (LARC): 40.8% (n=547) compared with 21.9% (n=293) and sterilization: 36.1% (n=484) compared with 17.5% (n=235).
• For women who wanted more children and had a LARC preference, use of LARC was higher in the hospital that offered immediate postpartum provision.
• For women who wanted no more children, there was no significant variability in preferences for long-acting or permanent methods across hospitals.
• Use given preference, however, was lower for black women and higher for US-born women, those aged ≥30 years, and those with public prenatal care providers.