BEYOND BARRIERS: REIMAGINING ACCESS TO POST-PREGNANCY CONTRACEPTION THE CASE FOR CHANGE
We are encouraged to see examples of local areas providing contraception in maternity settings and encourage local commissioners and providers to consider implementing this service.” 21 We also know that there is a significant cost benefit to PPC, which is largely returned to the healthcare service itself. In a financial climate where NHS budgets are under pressure to find savings, the cost efficiency of PPC cannot be overstated. Providing contraceptive counselling and methods at this crucial stage of women’s reproductive life ensures that women have timely access to the contraception they want, while they are already in contact with the health system. As it stands, too many opportunities are missed, to the detriment of women, their families and the health system as a whole. The CoSRH Hatfield Vision and our Work to Improve PPC Provision: Since 2023 we have led a working group of the CoSRH Hatfield Vision on post-pregnancy access to contraception; emphasising the importance of collaborative commissioning to make this a reality. The Hatfield Vision is the CoSRH’s blueprint outlining what needs to be achieved to improve the health of 51% of the UK’s population and tackle the inequalities that women and girls face across their lifetime. The Vision sets out goals and actions endorsed by 70 leading organisations in areas such as contraception, abortion,
menopause, menstrual health, cervical screening, and maternal health outcomes in Black women and women of colour. It is a legacy to the late Jane Hatfield, the first CEO of the Faculty of Sexual and Reproductive Healthcare (now the CoSRH), who worked tirelessly to improve the quality of reproductive healthcare that every woman and girl receives. Goal 8 of the Hatfield Vision focuses on improving access to PPC: “Integrated Care Systems (ICSs) should ensure that all methods of contraception are discussed with women during pregnancy and, where possible, their method of choice should be initiated prior to discharge from maternity services. Rapid follow-up pathways for LARC should be in place when needed.” 22 A wide range of experts and organisations have come together to work on improving PPC, including researchers, obstetricians, midwives, nurses, and commissioners, all of whom are driven and passionate about improving this pathway, including Dr Ed Mullins, Obstetrician and Clinical Lecturer at Imperial College London; Dr Annette Thwaites, Honorary Research Fellow in Sexual and Reproductive Health at The Institute for Women’s Heath at University College London; Vicki Pirie, Lead Contraception Midwife in Gloucestershire, and Fiona Gibb, Director of Midwifery at the Royal College of Midwives. This report is the culmination of the expertise and experiences shared during the meetings of this group since its inception two years ago. It contains invaluable insights from multidisciplinary professionals working tirelessly to research, commission, lead on, and deliver PPC to women across the UK, as well as from women themselves who have accessed this vital service or have faced barriers in doing so.
Health Care 2016;42:93–8. 17 Government UK, Government response to the independent pregnancy loss review: Care and support when baby loss occurs before 24 weeks’ gestation. 18 Government UK, Government response to the independent pregnancy loss review: Care and support when baby loss occurs before 24 weeks’ gestation. 19 Contribution from provider to the report.
20 Heller R, Cameron S, Briggs R, et al. Postpartum contraception: a missed opportunity to prevent unintended pregnancy and short inter-pregnancy intervals. J Fam Plann Reprod Health Care 2016;42:93–8. 21 Government UK, Women’s health strategy for England: Fertility, pregnancy, pregnancy loss, and postnatal support. 22 CoSRH, Hatfield Vision: Two Years in: Progressing our Sector’s Consensus Ambitions for Reproductive Health Outcomes (2024).
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