Breastfeeding and contraception counseling: a qualitative study

A Scoping Review of Patient-Centered Perinatal Contraceptive Counseling

INTRODUCTION

Contraceptive counseling during the perinatal period is an important component of comprehensive perinatal care. We synthesized research about contraceptive counseling during the perinatal period, which has not previously been systematically compiled.

METHODS

We developed search criteria to identify articles listed in PubMed, Embase, and Popline databases published between 1992 and July 2022 that address patients' preferences for, and experiences of, perinatal contraceptive counseling, as well as health outcomes associated with this counseling. Search results were independently reviewed by multiple reviewers to assess relevance for the present review. Methods were conducted in accordance with PRISMA guidelines.

RESULTS

Thirty-four articles were included in the final full text review. Of the included articles, 10 included implementation and evaluation of a contraceptive counseling method or protocol, and 24 evaluated preferences for or experiences of existing contraceptive counseling in the perinatal period. Common themes included the acceptability of contraceptive counseling in the peripartum and postpartum periods, and a preference for contraceptive counseling at some point during the antenatal period and before the inpatient hospital experience, and direct provider-patient discussion instead of video or written material. Multiple studies suggest that timing, content, and modality should be individualized. In general, avoiding actual or perceived directiveness and providing multi-modal counseling that includes both written educational materials and patient-provider conversations was desired.

DISCUSSION

The perinatal period constitutes a critical opportunity to provide contraceptive counseling that can support pregnant and postpartum people's management of their reproductive futures. The reviewed studies highlight the importance of patient-centered approach to providing this care, including flexibility of timing, content, and modality to accommodate individual preferences.

Breastfeeding Self-Efficacy, Personal Well-Being and Related Factors in Pregnant Women Living in a District of Istanbul

In this study, we examined breastfeeding self-efficacy levels, well-being and sociodemographic factors in pregnant women. The population of this descriptive study consisted of women with a pregnancy of 27 weeks or more in the Sultanbeyli district of Istanbul, Türkiye. A questionnaire was administered via telephone calls to pregnant women aged 18 years and older. The first part of the questionnaire included questions regarding breastfeeding history and sociodemographic information. The second part included the Prenatal Breastfeeding Self-Efficacy Scale, and the last part included the Personal Well-Being Scale. Higher scale scores indicate higher levels of self-efficacy and well-being. In total, 385 women participated in the study. The median age of the pregnant women was 28.0 years (18.0-43.0). The median gestational week was 33.0 (27.0-42.0). Among women who had received breastfeeding counseling, those with a higher level of knowledge about breastfeeding had higher breastfeeding self-efficacy (p < 0.05). Women with better economic status also had higher well-being scores (p < 0.05). There was a positive correlation between well-being and breastfeeding self-efficacy approaching the statistical significance level (p = 0.052). It is important to consider factors that may be associated with women's well-being and self-efficacy.

Evaluation of prenatal breastfeeding workshop to inform and support mother with antenatal diagnosis of cleft lip/palate

INTRODUCTION

To support mother with antenatal diagnosis of cleft lip/palate (CL/P), we implement an antenatal breastfeeding workshop to promote breastfeeding and its continuation. The aim of this study was to evaluate patient satisfaction after this workshop and efficiency of this workshop on breastfeeding rates and duration.

MATERIALS AND METHODS

We conducted a prospective study from February 2018 to April 2022. Patients received two surveys after the workshop and after birth, to evaluate their satisfaction. A prospective breastfeeding follow-up were pursued by email, at 1-3-6 and 12 months to determine if the breastfeeding had been continued or stopped.

RESULTS

We included 124 pregnant women who participated to the workshop. After the workshop, most participants (114/124) answered to the first survey. Amongst the 114 participants who answered to the first survey, 45 participated to a face-to-face workshop; and 69 to a teleworkshop. Participants were globally satisfied or very satisfied from the workshop; and felt more capable to breastfeed their child. 95/124 participants answered to the second survey. Most of the participants considered that the workshop had help them carry on a maternal milk feeding to their child Breastfeeding was pursued 1 month at 90%, 3 months at 62.5%, 6 months at 41.9%, after 6 months at 18.4%. Duration of breastfeeding were not statistically different, depending on the cleft type(p = 0.022).

CONCLUSION

The prenatal information helped the future mothers and met their requests and needs. The satisfaction rate reflected the importance of informing and supporting mothers in their feeding choices for their infants. The rate of breastfeeding at birth of a cleft-infant, whatever its type, for mothers who participated in the breastfeeding workshop, was over 90%.