Measure
Among women aged 15-44 who had a live birth, the percentage that is provided a most effective (sterilization, contraceptive implants, intrauterine devices or systems (IUD/IUS)) or moderately effective (injectables, oral pills, patch, ring, or diaphragm) method of contraception within 3 and 60 days of delivery.
The 60-day period reflects (American Congress of Obstetricians and Gynecologists (ACOG) recommendations that women should receive contraceptive care at the 6-week comprehensive postpartum visit. The 3-day period reflects recent Centers for Disease Control and Prevention (CDC) and ACOG recommendations that the immediate postpartum period (i.e., at delivery, while the woman is in the hospital) is a safe time to provide contraception, which also may offer greater convenience to the client and avoid missed opportunities to provide contraceptive care, especially considering that many women do not attend a postpartum visit.
How the Measure Should be Used
The federal Healthy People 2020 initiative and the World Health Organization recommend an inter-pregnancy interval of at least 18 months. Interpregnancy intervals less than 18 months have been associated with adverse perinatal outcomes, including preterm birth, low birth weight, and small size of gestational age, as well as adverse maternal outcomes1,2. Therefore all postpartum women can be considered at risk for unintended pregnancy for that period of time.
Measure specifications and SAS code have been developed to calculate the measures using administrative claims data:
- Link to 2014 Measure Specifications - PDF (151 KB)
- Link to 2015 Measure Specifications - PDF (200 KB)
- Link to 2016 Measure Specifications - PDF (275 KB)
- Link to 2017 Measure Specifications - PDF (214 KB)
- Link to 2018 Measure Specifications - PDF (72 KB)
- Value Sets, Code Lookup Tables, and SAS Code Instructions for Calculating the Measures for All Years
1 Conde-Agudelo, A., Rosas-Bermúdez, A., and Kafury-Goeta, A.C. (2006). Birth spacing and risk of adverse perinatal outcomes: a meta-analysis. Journal of the American Medical Association; 295(15):1809-1823.
2 Conde-Agudelo, A., Rosas-Bermúdez, A., and Kafury-Goeta, A.C. (2007). Effects of birth spacing on maternal health: a systemic review. American Journal of Obstetrics and Gynecology;196(4):297-308.
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