Recorded presentation

Abike James, MD¹, Ian Bennett, MD, PhD², Vivian Gadsden, PhD³, Julia F. Switzer, BA⁴, and Abigail Calkins Aguirre, MPA². (1) Department of Obstetrics and Gynecology, University of Pennsylvania, 7th Floor Penn Tower Building, 3400 Spruce Street, Philadelphia, PA 19104, (2) Family Practice and Community Medicine, University of Pennsylvania, 2nd Floor Gates Building, 3400 Spruce Street, Philadelphia, PA 19104, 215-615-0209, ian.bennett@uphs.upenn.edu, (3) Graduate School of Education, University of Pennsylvania, 3700 Walnut Street, Philadelphia, PA 19104, (4) Department of Family Practice and Community Medicine, University of Pennsylvania, 3400 Spruce Street, 2-Gates, Philadelphia, PA 19104-4283

Introduction: Lower socioeconomic status is associated with higher rates of contraceptive noncompliance, unintended pregnancy, as well as low literacy. We conducted a prospective, cohort study designed to evaluate any association of low literacy with contraceptive knowledge and utilization in the postpartum period. Methods: A prospective observational cohort study was carried out with 237 low-income (93% Medicaid), primarily African American (96%) women. Enrollment immediately postpartum was followed up by telephone interviews two months after delivery. Literacy level was assessed at recruitment. Women were dichotomized into a low literacy (less than 7th grade) and higher literacy group (greater than 8th grade). Results: 17.5% of the sample had low literacy and 75% reported that their just completed pregnancy was unplanned. Low literacy was found to be associated with not using birth control before that pregnancy (OR 2.7; 95%CI 1.1-6.8), and with lack of knowledge of emergency contraception (OR 2.4; 95% CI 1.2-5.1). No association between low literacy and contraceptive use at 2 months postpartum was observed (P=1.00). There was a 74.1% follow up rate at two months and there was no selective loss of women with low literacy. Conclusion: In this sample of low income, primarily African American women, low literacy was associated with being less likely to have used birth control before the pregnancy that was just completed and with less contraceptive knowledge. While it was not associated with contraceptive compliance at 2 months post partum, this may have been too short a follow up period to observe a significant association.

Learning Objectives:

• 1.Recognize the potential impact of low literacy on postpartum contraceptive knowledge and compliance.
• 2.Define the importance of postpartum fertility control for the reproductive health trajectory of vulnerable families.
• 3.Recognize the limitations of literacy screening instruments for this population.

Keywords: Contraception, Literacy

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation