Changing depot medroxyprogesterone acetate access at a faith-based institution

Abstract

Background: Loyola University Medical Center is a Jesuit faith-based hospital that previously offered immediate postpartum depot medroxyprogesterone acetate (DMPA) for noncontraceptive indications.

Study design: We performed a historical cohort study comparing patients aged 25 years or less who received immediate postpartum DMPA versus women who did not. We used logistic regression to analyze associations between patient characteristics and repeat pregnancy within 1 year.

Results: There was a total of 258 women in our cohort: 105 (40.70%) exposed to DMPA. Majorities were non-Caucasian, unmarried, Catholic and received public insurance. Multivariable analysis, after adjusting for race and religion, shows a statistically significant decrease in repeat pregnancy for patients given immediate postpartum DMPA (OR 0.27, 95% CI 0.10-0.72).

Conclusion: Limits on access to DMPA for noncontraceptive indications during the postpartum period resulted in significant increases in pregnancy rates for adolescents and young adult women at this faith-based institution.