POSTPARTUM contraception uptake in the first year after birth appears closely linked to delivery-related factors, according to a large Finnish cohort study.1
The findings highlight how clinical events around labour and birth may influence contraceptive initiation, an important consideration for preventing unplanned pregnancy and supporting optimal birth spacing.
Adequate time between births is associated with improved maternal and neonatal outcomes.2 Despite its importance, knowledge about what drives uptake and adherence remains inconsistent.1
Delivery Experiences Shape Postpartum Contraception Uptake
The study analysed 26,650 women who gave birth in 2019, using national registry data with one year of follow-up. Researchers tracked hormonal contraception purchases through prescription records and intrauterine device (IUD) provision in primary care.
Overall, 33% women purchased a hormonal contraceptive method within the first postpartum year, while 4% received an IUD. Combined, this brought total contraceptive uptake to 37%.
Progestogen-only methods dominated prescribing patterns. The desogestrel-only pill accounted for more than half of all hormonal methods initiated, with other progestogen-only options bringing the total share to nearly 90%.
Associations Between Complications and Contraceptive Use
Several delivery-related factors were associated with a higher likelihood of initiating hormonal contraception. Instrumental delivery, both planned and emergency caesarean section, epidural analgesia, and induction of labour using an intracervical balloon were all linked to increased uptake.
These associations suggest that more complex or medically managed births may influence postpartum contraceptive decisions due to potentially more complex recovery trajectories, although the underlying reasons were not examined.
Interpreting Patterns in Postpartum Contraception
Overall uptake of postpartum contraception remained limited. Only 33% of women purchased hormonal contraception, and 37% initiated either hormonal methods or an intrauterine device within one year of birth, meaning fewer than half of the cohort received recorded contraceptive coverage.
The findings do not establish causation, but they point to potential differences in how postpartum contraception is discussed or prioritised in women experiencing delivery complications. Possible contributing factors may include differences in clinical counselling, patient preference, or recovery following more complex births, although these were not examined.
Additionally, the study relied on prescription purchases and recorded procedures, which may not reflect actual use, adherence, or uptake of non-hormonal methods.
Implications for Clinical Practice
The results underscore the need for consistent, equitable contraceptive counselling across all delivery pathways. Clinicians should make it clear to patients that fertility can return quickly after childbirth, sometimes as early as three weeks, so timely discussion of contraceptive options is essential.3 Understanding how delivery experiences shape postpartum contraception uptake may help healthcare professionals tailor conversations and ensure informed choice.
Further research is needed to clarify underlying mechanisms and to determine whether targeted interventions could improve uptake among groups less likely to initiate contraception after birth.
References
- Jäntti C et al. Purchase of hormonal contraceptive methods after delivery: a population-based study from Finland. BMJ Sex Reprod Health. 2026;DOI:10.1136/bmjsrh-2025-203105.
- National Health Service (NHS) North Bristol Trust. Birth/pregnancy spacing 2024. Available at: https://www.nbt.nhs.uk/maternity-services/after-birth/post-birth-contraception/birthpregnancy-spacing. Last accessed 9 April 2026.
- National Health Service (NHS) North Bristol Trust. Post-birth contraception. 2024. Available at: https://www.nbt.nhs.uk/maternity-services/after-birth/post-birth-contraception. Last accessed 9 April 2026.
Featured image: (JLco) Julia Amaral on Adobe stock
