Midwife Judith Cutter – Contraception after childbirth

A recent study identified 96.7% of women did not plan to conceive in the first year postpartum. 

Midwife Judith Cutter was awarded £19,789 to study postnatal contraception

A recent study identified 96.7% of women did not plan to conceive in the first year postpartum and the RCOG and the Faculty of Sexual and Reproductive Healthcare recommend that contraception should be part of maternity care.

However, following childbirth, women may have difficulty accessing their GP or family planning clinic for contraception.

The unmet need for effective contraception was also highlighted in a recent trial evaluating the Family Nurse Partnership (FNP) programme in England which found 66% of teenage mothers had a subsequent pregnancy within two years of their first birth.

This short interval between birth and the next pregnancy can lead women to terminate unwanted pregnancies.

In response to this need for easily accessible postnatal contraception, women who give birth at WoW research Judith Cutter’s maternity unit are now offered contraception before returning home.

Midwife Judith said: “It is usual for women following childbirth to arrange their contraception through their GP or family planning clinic. Some women may have difficulty accessing this, which in turn may result in another pregnancy sooner after childbirth than they wanted.

“We identified that some women in our area were returning to us in the months after childbirth requesting terminations of unwanted pregnancies. In response to this, in January 2017 we started to offer women the chance to be provided with contraception before they go home with their new baby.  Women on the postnatal ward can now be prescribed contraceptive pills, or have longer lasting contraception including a contraceptive injection or implant.”

Due to the popularity of this service, Judith and her team would like to determine how many, and which, women are taking up this offer of early postnatal contraception.

This is in the hopes that the service will allow women to make informed decisions relating to their fertility, including the avoidance of unintended pregnancies.

The 12-month period of her project will be separated into 3 stages:

  • 1st: More training will be provided to midwives so more can prescribe contraceptive pills and administer injectable contraception and implants.
  • 2nd: Training will continue to be provided and data will be collected on whether women are offered and provided with contraception before leaving the hospital.
  • 3rd: The collected data will be analysed.
  • Aim: It is intended that this project will be used to inform the design of a larger effectiveness study, with the ultimate goal of determining the effectiveness of providing early postnatal contraception in reducing the number of unwanted pregnancies.

This project was co-funded by The Royal College of Midwives and The Burdett Trust for Nursing