Postnatal contraception provision in an inpatient perinatal mental health unit

• Published in: BMJ sexual & reproductive health Vol. 49; no. 1; pp. 62 - 65
• Main Authors: Bathgate, Gabriella, Sharp, Chelsea, Yates, Emma, Curnock, Pauline, Protti, Olivia, Mann, Sue
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 01.01.2023; BMJ Publishing Group LTD
• Subjects: Better way of working; Birth control; Collaboration; COVID-19; family planning services; Feedback; Health promotion; Health services; health services accessibility; Initiatives; long-acting reversible contraception; Maternal child nursing; Medical screening; Mental disorders; Mental health; Obstetrics; Outreach services; Pregnancy; Primary care; Sexual health; Sexually transmitted diseases; STD; Womens health; United Kingdom > UK; England; health services accessibility; long-acting reversible contraception; family planning services
• ISSN: 2515-1991; 2515-2009
• DOI: 10.1136/bmjsrh-2022-201578

Correspondence to Dr Gabriella Bathgate, Sexual Health, Homerton University Hospital NHS Foundation Trust, London, UK; g.j.bathgate@doctors.org.uk Key messages A sexual health outreach programme focused on postnatal contraception education and provision was introduced on the East London Mother & Baby Unit. Background Increasing postnatal contraception (PNC) uptake supports effective interpregnancy spacing, prevents unplanned repeat pregnancy following childbirth, improves subsequent obstetric outcomes and is a topical service development focus in sexual and reproductive healthcare.1 Provision offers high return on investment in postnatal women as well as the general population.2 3 Recent years have seen substantial progress in increasing PNC provision through coordinated programmes in the UK, particularly via maternity services.4–7 However, across the UK there is a long way to go to realising universal direct, convenient access to the full range of contraceptive methods for PNC, including long-acting reversible contraception (LARC) for eligible women desiring these methods.8 Improving access for women poorly served through mainstream sexual health, maternity and primary care services remains a particular priority. Co-located with the service’s main clinic is the City & Hackney Centre for Mental Health, housing the 12-bedded East London Mother & Baby Unit, one of three highly specialised units in London and 19 in England providing inpatient care for women with serious, high-risk perinatal mental illness. Respondent numbers were small (n=7), but valuable qualitative feedback was gained regarding factors including timing of review (a proportion felt they were referred too early during their psychiatric recovery), site seen (MBU was preferred by all), preference for prior discussion around PNC with the perinatal team (generally desired) and perceptions regarding alternative sources of contraceptive and sexual health provision had the outreach service not been available to them.