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MICH-16.6 Data Details

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MICH-16.6 Increase the proportion of women delivering a live birth who used a most effective or moderately effective contraception method postpartum

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

Data Source: 
California's Maternal and Infant Health Assessment (MIHA); California Department of Public Health (CDPH)
Pregnancy Risk Assessment Monitoring System (PRAMS); Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion (CDC/NCCDPHP)
Changed Since the Healthy People 2020 Launch: 
Yes
Measure: 
percent
Baseline (Year): 
53.2 (2012)
Target: 
58.5
Target-Setting Method: 
10 percent improvement
Target-Setting Method Justification: 
Given the current prevalence of this health behavior, a 10% improvement over baseline as a target setting method is both realistic and aspirational. In addition, given that we are half way through the decade for Healthy People 2020, setting a target at a level of 10% improvement over baseline is meaningful.
Numerator: 

Number of women with a recent live birth who reported using a most effective or moderately effective contraception method 2-8 months after delivery

Denominator: 

Number of women with a recent live birth

Comparable Healthy People 2010 Objective: 
Not applicable
Questions Used to Obtain the National Baseline Data: 

    From the 2011 Pregnancy Risk Assessment Monitoring System:

    [NUMERATOR:]

    Are you or your husband or partner doing anything now to keep from getting pregnant? (Some things people do to keep from getting pregnant include using birth control pills, condoms, withdrawal, or natural family planning.)

    • Yes
    • No

    What are your reasons or your husband’s or partner’s reasons for not doing anything to keep from getting pregnant now? Check all that apply

    1. I am not having sex
    2. I want to get pregnant
    3. I don’t want to use birth control
    4. I am worried about side effects from birth control
    5. My husband or partner doesn’t want to use anything
    6. I have problems getting birth control when I need it
    7. I had my tubes tied or blocked
    8. My husband or partner had a vasectomy
    9. I am pregnant now
    10. Other

    What kind of birth control are you or your husband or partner using now to keep from getting pregnant? Check ALL that apply.

    1. Tubes tied or blocked (female sterilization, Essure®, Adiana®)
    2. Vasectomy (male sterilization)
    3. Birth control pills
    4. Condoms
    5. Injections (Depo-Provera®)
    6. Contraceptive implants (Implanon®)
    7. Contraceptive patch (OrthoEvra®) or vaginal ring (NuvaRing®)
    8. IUD (including Mirena® or ParaGard®)
    9. Natural family planning (including rhythm method)
    10. Withdrawal (pulling out)
    11. Not having sex (abstinence)
    12. Other

    From the 2012 Maternal and Infant Health Assessment:

    [NUMERATOR:]

    Are you or your husband or partner doing anything now to keep from getting pregnant?
    (Some things people do to keep from getting pregnant include using birth control pills,
    condoms, withdrawal, or natural family planning.)

    • Yes
    • No

    What are your reasons for not doing anything to keep from getting pregnant now?
    Check ALL that apply

    1. I am not having sex
    2. I want to get pregnant
    3. I don’t want to use birth control
    4. I am worried about side effects from birth control
    5. My husband or partner doesn’t want to use anything
    6. I can’t pay for birth control
    7. I have problems getting birth control when I need it
    8. I had my tubes tied or blocked
    9. My husband or partner had a vasectomy
    10. I am pregnant now
    11. Other

    What kind of birth control are you or your husband or partner using now to keep from getting pregnant? Check ALL that apply.

    1. Tubes tied or blocked (female sterilization)
    2. Vasectomy (male sterilization)
    3. Birth control pills, patch, vaginal ring
    4. Condoms
    5. Shots or injections (Depo-Provera, Lunelle)
    6. Implants (Implanon)
    7. IUD (Mirena or ParaGard)
    8. Natural family planning (rhythm, temperature)
    9. Withdrawal (pulling out)
    10. Not having sex (abstinence)
    11. Other
Data Collection Frequency: 
Annual
Methodology Notes: 

    The following PRAMS states were included in preparing the 2012 estimate: AK, AR, CO, DE, GA, HI, IL, ME, MD, MA, MI, MN, MO, NE, NJ, NM, NYC, OH, OK, OR, PA, RI, TN, UT, VT, WA, WV, WI, and WY. These data were combined with data from the California's Maternal and Infant Health Assessment to produce the displayed estimate.

    Contraception use is reported at the time the survey was completed between 2 and 8 months postpartum. Women who reported they were currently pregnant or had a hysterectomy were excluded.

    The most effective methods of contraception are male or female sterilization, implants, and intrauterine devices or systems (IUD/IUS). Moderately effective methods of contraception are injectables, oral pills, patch, ring, or diaphragm.

    Health Insurance status data reflect postpartum insurance coverage of mother.

Trend Issues: 
The set of states on which this estimate is based will vary over time as only states that meet established response rate thresholds are included. 30 sites were included in preparing the baseline estimate for 2012.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch: 
The wording for this objective was revised twice, and it was promoted from developmental to measureable in 2015. The initial wording “Increase the proportion of women delivering a live birth who used contraception to plan pregnancy” was modified to “Increase the proportion of women delivering a live birth who used postpartum contraception to plan their next pregnancy” in 2015. The wording was again revised in 2017 to “Increase the proportion of women delivering a live birth who used a most effective or moderately effective contraception method postpartum”. The wording change in 2017 resulted in a revised baseline from 88.6% to 53.2% and a revised target value from 97.5% to 58.5%.

References

Additional resources about the objective

  1. Centers for Disease Control and Prevention. Recommendations to improve preconception health and health care – United States: a report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. MMWR 2006; 55 (No. RR-6).
  2. Institute of Medicine. Preventing low birth weight. Washington, DC: National Academy Press; 1985.
  3. Korenbrot C, Steinberg A, Bender C, Newberry S (2002). Preconception care: A systematic Review. MCH Journal, Vol. 7, No 2, pp.75-88.