individual needs benefits families and is cost effective. Lopez et al. (2015) 1. NR. 4. 12 trials, 4145 women – 8. 2nd birth (by 24 mts). 10. Given the 13. Insufficient evidence to USA, Australia, Nepal, Contraception use at 6mts, associated costs and recommend any particular USA 2. Nurses, midwives (and Pakistan, and Syria. effective contraception at logistics, some educational interventions physicians) postpartum 6mths. programs would not be on contraceptive use. Cochrane Systematic educational interventions 5. Unplanned pregnancy feasible in many Review on contraceptive use. and contraceptive use. Adolescents, with homebased settings. 14. Although half of the mentoring had fewer 2nd births interventions were To assess the effectiveness 3. Included individual or 6. Postpartum hospital or within 2 years compared to the 11. NR. effective in reducing repeat of postpartum educational group counselling, written 2-3 wks later (home/clinic/ control group (OR 0.41, 95% CI pregnancies or births and interventions on materials, video or audio phone). 0.17 to 1.00). The other five 12. NR. increasing contraceptive contraceptive use. recordings interventions had no effect. Of use, the overall evidence of 7. Nurses, midwives. trials with lower quality effectiveness was of low to evidence, two showed some moderate quality. Two effectiveness. In Nepal, women trials of counselling with an educational session providing one or two immediately postpartum were sessions were effective but more likely to use were limited by contraception at six months reported outcomes and than those with a later or no short term outcome session (OR 1.62, 95% CI 1.06 assessment. Three trials of to 2.50). In an Australian study, multifaceted programmes teenagers in a structured involving multiple contacts program were more were effective but their likely to have effective applicability in other contraception use at six months locations is uncertain and than those with standard home health care providers visits (OR 3.24; 95% CI 1.35 to would need to consider 7.79). which intervention might be appropriate for their Meta-analysis not done due to setting and level of varying study designs resources. 9. NR Valid and reliable outcome measures are needed to obtain meaningful results.
individual needs benefits families and is cost effective. Lopez et al. (2015) USA Cochrane Systematic Review To assess the effectiveness of postpartum educational interventions on contraceptive use. 1. NR. 2. Nurses, midwives (and physicians) postpartum educational interventions on contraceptive use. 3. Included individual or group counselling, written materials, video or audio recordings 4. 12 trials, 4145 women – USA, Australia, Nepal, Pakistan, and Syria. 5. Unplanned pregnancy and contraceptive use. 6. Postpartum hospital or 2-3 wks later (home/clinic/ phone). 7. Nurses, midwives. 8. 2nd birth (by 24 mts). Contraception use at 6mts, effective contraception at 6mths. Adolescents, with homebased mentoring had fewer 2nd births within 2 years compared to the control group (OR 0.41, 95% CI 0.17 to 1.00). The other five interventions had no effect. Of trials with lower quality evidence, two showed some effectiveness. In Nepal, women with an educational session immediately postpartum were more likely to use contraception at six months than those with a later or no session (OR 1.62, 95% CI 1.06 to 2.50). In an Australian study, teenagers in a structured program were more likely to have effective contraception use at six months than those with standard home visits (OR 3.24; 95% CI 1.35 to 7.79). Meta-analysis not done due to varying study designs 9. NR 10. Given the associated costs and logistics, some programs would not be feasible in many settings. 11. NR. 12. NR. 13. Insufficient evidence to recommend any particular educational interventions on contraceptive use. 14. Although half of the interventions were effective in reducing repeat pregnancies or births and increasing contraceptive use, the overall evidence of effectiveness was of low to moderate quality. Two trials of counselling providing one or two sessions were effective but were limited by reported outcomes and short term outcome assessment. Three trials of multifaceted programmes involving multiple contacts were effective but their applicability in other locations is uncertain and health care providers would need to consider which intervention might be appropriate for their setting and level of resources. Valid and reliable outcome measures are needed to obtain meaningful results.
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