Couple-based prenatal contraceptive education program for families

Many individuals face multiple challenges to consistent desired contraceptive use. Inconsistent contraceptive use in the postpartum period is associated with unintended short interpregnancy intervals (SII). In fact, 70% of all SIIs are unintended and put families at higher risk of unintended SIIs. SIIs increase the risk of poor postpartum mental and physical health outcomes such as preterm birth, postpartum depression, and maternal and infant morbidity and mortality. Contraceptive education is one solution to improving consistent desired contraceptive use and decreasing the subsequent unintended outcomes. When provided prenatally, contraceptive education can increase contraceptive uptake and increase consistent utilization in the postpartum period. However, contraceptive education is not consistently provided due to time limitations and availability constraints of traditional prenatal appointments. Yet, when contraceptive education is provided, it frequently misses opportunities to simultaneously intervene on other important factors that might impact consistent contraceptive use like couple involvement, paying utilities, poor job training, and assistance finding information and healthcare resources needed to ensure consistent contraceptive use. Planning Together is a couple-based multi-level contraceptive education program to improve consistent desired contraceptive use postpartum via (a) harnessing existing support by including couples in the contraceptive education and optimize couple communication by teaching couple communication skills to improve joint contraceptive decision-making and planning process and (b) reducing transportation challenges and knowledge gaps. Additionally, Planning Together offers a flexible delivery method (asynchronous and synchronous components) that will increase availability of education. Specifically, we aim to develop the Planning Together protocol using community-engaged dyadic semi-structured interviews with pregnant couples who can get pregnant on their own and individual semi-structured interviews with health professionals to gain a variety of perspectives to ensure we meet the needs of all families. Second, we will test the acceptability, feasibility, and fidelity of the Planning Together protocol in a single-arm pilot test. Execution of these aims will provide the first demonstration of the feasibility and acceptability of the Planning Together protocol. This project will provide the necessary pilot data for future NIH funding (R01). Planning Together has the potential to redesign existing family planning education modes to improve consistently desired couple contraceptive usage, with the longer-term goal of reducing short interpregnancy intervals to improve families’ mental and physical health.