Virtual Group Contraceptive Counseling: A Feasible Path to Empowering Postpartum Women

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Women reported high satisfaction and increased postpartum contraceptive uptake after participating in virtual group contraceptive counseling.

Virtual group contraceptive counseling (GCC) offers a promising approach to increasing postpartum contraceptive knowledge and uptake, according to research published in the Open Access Journal of Contraception. GCC helps focus on patient preferences and shared decision-making to enhance reproductive health outcomes.

“Traditionally, contraception counseling has been a part of routine prenatal and postpartum care and performed on an individualized basis. Both antepartum and postpartum contraceptive counseling significantly increase postpartum contraceptive uptake compared to no counseling,” wrote Keemi Ereme, MD, MPH, and colleagues.

GCC is an approach where small groups discuss contraception options together. In settings where antenatal care is provided in groups, GCC has been linked to increased contraceptive uptake, patient satisfaction, and family planning service utilization, as well as a decreased risk of unintended pregnancy. However, limited research exists on GCC outside of these structured group settings.

The researchers studied the feasibility and potential benefits of GCC during the antepartum period by assessing participants’ perceptions of its quality and the change in their contraceptive knowledge after receiving group counseling.

The study took place at a large urban academic hospital. Dr. Ereme and colleagues recruited women who received prenatal care at the hospital between August 2021 and September 2022. The participants were fluent in English and had access to a video device.

The participants completed a baseline online survey assessing demographics and contraceptive knowledge and then were grouped into sessions of 2 to 4 people for GCC, which was held virtually using a HIPAA-compliant platform.

In counseling sessions, an obstetrics and gynecology resident provided information on various postpartum contraceptive methods. After the session, participants retook the knowledge survey and completed the Person-Centered Contraceptive Counseling (PCCC) survey to evaluate the quality of counseling.

A total of 22 participants completed the study, with most identifying as Black or Latino, and the majority having a household income of less than $50,000. Participants generally rated the quality of GCC highly, with 77% giving a perfect score of 20 out of 20.

Postpartum contraceptive uptake was also high, with 82% of participants receiving some form of contraception and 88% obtaining their preferred method.

The study demonstrated that participants’ knowledge scores significantly improved after counseling, with a mean increase of 78% to 85%. However, Black participants, part-time employed, and unemployed participants were more likely to experience a decrease in their knowledge scores post-counseling.

“While our study demonstrated an overall increase in knowledge, certain groups were less likely to see this benefit, namely participants who identified as African American or those who were not employed full time,” Dr. Ereme and colleagues said. “We hypothesize that the knowledge survey used in this study may not be the ideal test to ascertain contraceptive knowledge, particularly for certain groups.”

The findings of this study align with prior research, including a randomized control trial in Ghana, which showed that GCC was non-inferior to individual counseling in terms of increasing contraceptive knowledge. Other, smaller studies have found that group counseling can improve knowledge acquisition, though they noted limited effects on actual contraception uptake.

While the overall increase in knowledge in this study was modest, the study authors concluded that virtual GCC still provides a promising option for contraception counseling, especially for those who may prefer the convenience of remote sessions.

“Virtual GCC may be one potential avenue to improve the way we counsel patients on contraception to ensure understanding of the subject and usage of desired contraceptive options,” Dr. Ereme and colleagues concluded.