Counseling about family planning is now standard care for most women who have just given birth. Many women feel that this service is just provided as part of a checklist. Few providers and researchers have looked at how well the counseling works. Some people have questioned the basis for such programs. That is, we do not know if postpartum women want to use family planning or whether they will return to a health center for family planning advice. Surveys suggest that women may wish to discuss family planning before they have the baby and after they leave the hospital. Women may also prefer to talk about family planning along with other issues in mother and child health. In this review, we looked at the effects of educational programs about family planning for postpartum women.
We did computer searches to find randomized trials of postpartum education about family planning. We also wrote to researchers to find other trials. Trials were included if they looked at how much the program affected family planning use. The program must have started postpartum and have occurred within one month of giving birth. We looked at titles and abstracts found during the searches with no language limits. We also looked at the studies for the quality of their research methods. We entered the data into RevMan and used the odds ratio to examine effect.
We found eight trials. Of four trials with short programs, one did not have enough data and the other was a very small study. The other two trials had programs given while the women were still in the hospital. They showed more birth control use for those with the counseling. However, not all measures showed an effect in one study and the other looked at short-term use. Three of four trials with longer and complex programs made a difference. Two showed fewer pregnancies or births among teenagers in the special group that had extra services. Also, a special home-visit program showed more birth control use. The long-term programs were promising and may not always cost more than standard care. The programs that worked well were provided in Australia, Nepal, Pakistan, and the USA. Health care providers can test in their own environment the programs that appear to be appropriate for their population, location, and resources.