Family Planning in a New Country: A Qualitative Inquiry of Immigrant Mothers' Postpartum Perceptions of Contraceptive Use

Background: Few studies examine immigrant mothers’ postpartum perceptions to contraceptive use. Although immigrant women experience positive birth outcomes, immigrant mothers are consistently less likely to use contraceptive methods for maximizing timeframes between pregnancies. This qualitative case study evaluation of the program’s pilot pregnancy support classes examined immigrant mothers’ postpartum perceptions of contraceptive methods, facilitators and barriers toward contraceptive use.

Methods: A multi-ethnic sample included three cohorts of program participants (n=22 mothers including 13 immigrants from 9 countries) from a pilot community-based perinatal support program in North Carolina.  Field observations (n=20) and semi-structured interviews (n=6) with immigrant mothers were completed from December 2010 through December 2012. Content analysis was used to identify and explore themes related to contraceptive use in the field reports and interview transcripts.

Results: Several barriers and facilitators to contraceptive use were identified for potential intervention. General distrust of contraception and cost of services were the main barriers of obtaining contraceptive methods after pregnancy. Preference for “natural methods” (ex. abstinence from intercourse, withdrawal) and concerns about impact on breastfeeding also surfaced as barriers for contraceptive use. In contrast, mothers’ decisions for using contraceptive methods were facilitated by prenatal education about long acting reversible contraception (ex. implants and IUDs) and navigation of pregnancy Medicaid.

Conclusions: These findings illuminate the need to further develop prenatal and postnatal education to address distrust for contraceptive use among immigrant mothers. Navigational support of Medicaid and health insurance policies should also be further explored for developing and improving pregnancy support interventions.