Use of a Reproductive Life Planning Tool at the Pediatric Well‐Baby Visit with Postpartum Women

在美国，意外怀孕是一个持续的公共卫生挑战。 与其他育龄妇女相比， 在产后第一年使用避孕药具的比例高达44%。此外，适当的生育间隔 在产后期间，对母亲和婴儿的健康都很重要。妊娠期短 解释间隔与先兆子痫、早产和低出生率风险增加有关 重量.低收入的有色人种妇女意外怀孕和生育不足的风险增加 这反过来又增加了她们不良妊娠结果的风险。改善及时获得保健的机会 需要在产后（PP）期间进行护理和避孕，以减少意外怀孕， 妇女实现理想的生育间隔。虽然人民党的访问历来被认为是 由于妇女不愿意讨论和接受避孕药具，许多妇女，特别是低收入妇女， PP访视。增加PP护理和避孕接受的一种新方法是采用生殖保健， 人生规划探索使用自我管理的生殖生活计划工具（RLPT）， 儿科医生在产后母亲的健康婴儿访问（WBV）的背景下，有很大的希望。 本研究的目的是确定是否使用简单的自我管理的生殖 2个月WBV的生活计划工具增加了产后妇女接受妇女保健的比例 与未接受此类干预的女性相比，6个月PP时的护理和避孕。两 该项目的具体目标是：目标一。为了确定是否引入自我管理的生殖生命 计划工具（RLPT）与产后母亲在2个月WBV将增加妇女的比例 在产后6个月内接受健康妇女初级保健健康检查。Aim Ia.为了确定是否引入 产后母亲在2个月WBV期间自我管理生殖生活规划工具（RLPT） 将提高产后6个月避孕的使用率。目的二：评估患者、提供者、 系统一级的障碍和促进因素， 旨在促进产后妇女在儿科背景下接受初级健康妇女护理的转诊， 诊所如果成功的话，这项研究的结果有很大的潜力为临床和公共卫生实践提供信息， 增加妇女在产后期间使用保健和避孕措施。

Unintended pregnancy is a persistent public health challenge in the U.S. Women who have had a recent pregnancy are at increased risk of unintended pregnancy compared to other women of reproductive age not using contraception, with rates up to 44% in the first postpartum (PP) year. In addition, adequate birth spacing in the postpartum period is important for both the health of the mother and the infant. Pregnancies with a short interpregnancy interval have been associated with increased risk of preeclampsia, preterm birth, and low birth weight. Low-income women of color are at increased risk of unintended pregnancy and inadequate birth spacing which in turn increases their risk of adverse pregnancy outcomes. Improved access to timely health care and contraception in the postpartum (PP) period is needed to reduce unintended pregnancies and help women achieve desired birth spacing. While the PP visit has historically been considered to be the place for women to discuss and receive contraception, many women, particularly low-income women, do not attend the PP visit. A novel approach to increasing receipt of PP care and contraception is the adoption of a reproductive life planning. Explorations of the use of a self-administered Reproductive Life Plan Tool (RLPT) by pediatricians in the context of the Well-Baby Visit (WBV) with postpartum mothers, holds great promise. The objective of the proposed study is to determine whether use of a simple self-administered Reproductive Life Plan Tool at the 2-month WBV increases the proportion of postpartum women receiving woman's health care and contraception at 6-months PP, compared to women not exposed to such an intervention. The two specific aims of the project are: Aim I. To determine if introducing a self-administered Reproductive Life Planning Tool (RLPT) with postpartum mothers during the 2-month WBV will increase the proportion of women receiving a well-woman primary care health visit by 6 months postpartum. Aim Ia. To determine if introducing a self-administered Reproductive Life Planning Tool (RLPT) with postpartum mothers during the 2-month WBV will increase utilization rates of contraception by 6 months postpartum. Aim II: To assess patient-, provider-, and systems-level barriers and facilitators to integrating a self-administered Reproductive Life Planning Tool designed to facilitate referral of postpartum women for primary well-woman care in the context of a pediatric clinic. If successful, the results of this study have great potential to inform clinical and public health practice to increase women's use of health care and contraception in the postpartum period.