(179) Postpartum Contraceptive Use Among South Asians: ​A Retrospective Cohort Study from Kaiser Northern California

Health outcomes data among South Asian subgroups are scarce due to outdated federal reporting standards that merge various racial and ethnic groups into a single ‘Asian or Pacific Islander’ category, potentially obscuring disparities. As a result, obstetric and gynecologic outcomes, including contraception use and abortion trends, are poorly understood in this population. This study aimed to characterize postpartum contraceptive use among South Asian patients, factors associated with usage, and to determine the proportion of short interval pregnancies based on postpartum contraceptive use.

Study Design:

This retrospective cohort study included all South Asian patients who delivered at Kaiser Northern California hospitals between 1/1/2018-1/1/2021 and had documentation of contraceptive use or declination within 12 weeks postpartum. Adjusted odds ratios for each outcome were calculated using multivariate logistic regression adjusting for variables found to be significant in bivariate comparisons.

Results:

11,264 patients met study inclusion criteria (91% Indian, 3% Pakistani, 2% Nepali, and 4% other South Asian or mixed race). 64.6% reported no postpartum birth control use. Only 7.37% of the total cohort selected a LARC (Nexplanon, Mirena or Copper IUD). Multiparity was associated with increased likelihood of birth control use (p< 0.05); while increasing age, higher socioeconomic status, marriage, and Indian descent (p< 0.05) were associated with lower likelihood of birth control and LARC use. Postpartum LARC users had the lowest incidence of short interval pregnancies (p< 0.05) and the use of any postpartum birth control was associated with a 14% lower incidence of short interval pregnancies (p< 0.05).

Conclusion:

Use of postpartum birth control reduces the likelihood of short interval pregnancies. The majority of South Asians in our cohort reported no postpartum birth control use, and the rate of postpartum LARC use was lower than the US average of 9-15%. These findings suggest that targeted counseling and interventions are needed to improve postpartum contraception uptake among South Asian patients.