Pregnancies conceived within 18 months of a prior delivery (termed short inter-pregnancy interval [IPI]) place mothers and infants at high risk for poor health outcomes including pre-eclampsia, anemia, and preterm birth. Despite these negative health consequences, nearly one third of women experience a short IPI, highlighting a significant public health problem in the U.S.
A critical approach to preventing short IPIs is to provide postpartum (PP) women with timely access to contraception. The current standard clinical practice is to have women return six weeks after delivery for a PP visit, at which time contraceptive needs are addressed. However, many women resume sexual activity prior to six weeks PP, and many women, particularly low-income minority women, do not present for this visit. Low rates of postpartum contraception uptake leave women vulnerable to an unplanned pregnancy and significant negative health consequences. Thus, there is an urgent need for alternative approaches to increase timely access to PP contraception to improve outcomes for women and children.
The LINCC Trial aims to:
(1) Develop a comprehensive implementation plan to link PP contraception and newborn care through co-scheduling visits in community health centers (CHC);
(2) Use an effectiveness-implementation hybrid design to evaluate this novel system-level approach to linking maternal and newborn care at CHCs served by our partner organization, AllianceChicago and;
(3) Assess implementation of linked PP contraception and newborn care and report on key barriers and facilitators related to successful implementation of the intervention.
The ultimate goal is to build and study a comprehensive fully integrated model of care for PP women and children. This project will be foundational research to study how best to integrate a new model of care while addressing what is often the most immediate care need for PP women – family planning.
Sadia Haider, MD, MPH; Rachel Caskey, MD, MAPP; Nivedita Mohanty, MD