More than half of people who have given birth are not using contraception two months later despite the risk that back-to-back pregnancies can pose, a new UCL study shows.
The research, published in the British Journal of Obstetrics and Gynaecology, also found that those who were satisfied with professional contraception advice were more likely to use contraception sooner after giving birth.
The researchers are backing calls by the national professional membership organisation the Faculty of Sexual & Reproductive Healthcare for women to get high-quality contraception counselling around the time of birth. The earliest some women and those assigned female at birth discuss contraception with a professional after giving birth is with their GP at their postnatal check at around six to eight weeks, even though there is strong evidence that many people start having sex sooner than this and pregnancy can occur as soon as three weeks after childbirth.
The researchers analysed data from the 2023 Women's Reproductive Health Survey for England (RHSE) conducted by the London School of Hygiene & Tropical Medicine (LSHTM).
The UCL researchers looked at the responses to the 2023 survey of 2,073 people who said they had given birth within the last year.
Of people who had given birth in the last year, 73 per cent were using contraception – but 58 per cent of the 2,073 participants had not started using it within two months of giving birth.
Similarly, while most of the 2,073 participants received contraceptive advice during pregnancy, only around half (54%) were satisfied with it. The researchers found that satisfaction with contraceptive advice was strongly associated with the timely initiation of contraception within the postnatal period.
Senior author Dr Neha Pathak (UCL Institute for Women's Health) said: "Most people are getting contraception advice during pregnancy which is a huge plus compared with 10 years ago, but only one in two are actually satisfied with it.
"It's important that contraceptive counselling is not just about ticking a box. The advice needs to be high quality and patients need to be satisfied they are getting their questions answered so that they have reproductive agency and can choose to prevent pregnancy if they wish to.
"We need to ensure that everyone who wants or needs contraception has started taking it within two months of giving birth because there is a risk of pregnancy three weeks after childbirth and we know that many people do start having sex again during that time."
Lead author Catherine Stewart (UCL Institute for Women's Health) said: "Our study suggests that comprehensive contraception counselling should be a standard part of maternity care, as recommended by the Faculty of Sexual & Reproductive Healthcare.
"Having babies too close together (less than 18 months apart) can put both mother and baby at risk. A short time between pregnancies doesn't give the mother's body enough time to fully recover, which can lead to complications for the baby such as premature birth, low birth weight or stillbirth.
"Spacing pregnancies allows time for physical and emotional recovery which can help improve outcomes. Research shows that giving the body at least 18 months between pregnancies can lead to healthier mothers and babies."
Factors the researchers investigated, as well as whether the participants had got contraception advice after giving birth and how they felt about that advice, included employment, education, financial status and marital status.
The findings also were broken down by the effectiveness of the method of contraception.
Nearly 60,000 women and people assigned female at birth responded to the 2023 survey, which was commissioned by the Department for Health and Social Care.
