Factors Associated With Contraceptive Initiation and Use Among Women Who Have Given Birth in the Last Year: Findings From the 2023 Women's Reproductive Health Survey.

Objective: This study investigates contraceptive use among individuals who have recently given birth. It aims to identify factors associated with contraceptive use at two months and one-year of giving birth. Additionally, it assesses whether receiving and being satisfied with contraceptive counselling influences contraceptive use.

Design: Cross-sectional analysis of data from the 2023 Women's Reproductive Health Survey.

Setting: England.

Population: Participants who had given birth in the last year (n = 2044).

Methods: Bivariate and multivariable logistic regressions examined factors associated with contraceptive use.

Main Outcome Measures: Contraceptive initiation within two months of giving birth. Contraceptive use within one year of giving birth.

Results: Overall, 73% (n = 1489/2044) of participants were using contraception, however 58% (n = 1154/1998) had not initiated use within two months of giving birth. Bivariate analyses indicated that younger participants, those who received counselling, and those satisfied with it had higher odds of initiating contraception within two months. Similarly, younger individuals, those not desiring more children, and those who received counselling had higher odds of using contraception within one year. Multivariable analysis showed that receiving counselling and being satisfied with it were significantly associated with early initiation.

Conclusions: This study highlights the need for high-quality contraceptive counselling as part of maternity care. Counselling during or immediately after pregnancy was shown to impact contraceptive initiation and use. Policy improvements and further research on achieving universal high-quality counselling are important to ensure equitable access to contraception.