Published in PLOS One on 2026-05-28, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original study title: Contraceptive uptake and characteristics in the immediate postpartum period among women attending Tygerberg Academic Hospital
Original authors: Denise Sproul, Michael McCaul, Gerhard Hanekom
Source: PLOS One • DOI 10.1371/journal.pone.0349790
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
The immediate postpartum period is a unique opportunity to motivate and educate women on family planning options. This study aimed to determine the prevalence of family planning use in our setting. Secondary objectives include determining the frequency of the various methods used, the safety of the method(s), common risk factors, the interval spacing between births and associations with family planning method choices. A cross-sectional study was conducted at Tygerberg Academic Hospital, South Africa, which serves a predominantly low socioeconomic status and high-risk obstetric population. Medical records were assessed prospectively from January 2023 till July 2023. Data was collected and captured from maternity medical records on the day of discharge. The statistical analysis was done using frequencies and percentages, with 95% confidence intervals (95%CI). A secondary bivariant analysis was done to evaluate the associations between these variables. Of the 1066 participants included, 97.5% (95%CI 96.5–98.5) received family planning. The majority of the patients (48.8%) requested the injectable depo medroxyprogesterone acetate. These patients who chose this method were on average younger (OR 0.962, p < 0.001), had a lower BMI (OR 0.983, p = 0.012), and were a higher parity (OR 0.721, p < 0.001). HIV positive women were also 35% less likely (OR 0.651, p = 0.008) to choose this method compared to other methods. Of the 1039 patients who had received family planning, 47.8% were classified into a World Health Organization medical eligibility category three. This was almost exclusively attributed due to patients who were breastfeeding and requested the depo medroxyprogesterone acetate as their family planning method postpartum. The majority (66%) of the patients had spaced their pregnancies more than two years apart. The exceptionally high prevalence of uptake of family planning indicates it can be successfully implemented in the postpartum period. Patients should be counselled individually on the safest and the most appropriate method.
Introduction
Globally, family planning is recognized as a life-saving intervention [1]. Family planning is an effective method to reduce unintended pregnancies and live birth rates, thus reducing maternal mortality rates. It can also have an influence on education, promotion of gender equality and women’s rights, and can assist in reduction of human immunodeficiency virus (HIV) by use of barrier contraception in the form of male and female condoms [2]. This unique intervention could prevent a third of maternal deaths by delaying motherhood, allowing for appropriate interval spacing between births, limiting unplanned and unwanted pregnancies and subsequent abortions. For these reasons, the World Health Organization (WHO) issued a report in 2019 recommending family planning as one of the critical strategies in reducing maternal mortality [2,3]. Another recommendation is to space birth intervals by at least 24 months after childbirth to reduce the risk of adverse maternal and neonatal outcomes [4]. Evidence has shown that spacing live births by contraception can save more than two million newborns annually [2].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider hospital systems desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Denise Sproul, Michael McCaul, Gerhard Hanekom. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
Explore connected evidence
- Evidence brief: The impact of expanded access to antiretroviral treatment on engagement in HIV care and viral suppression among pregnant women living with HIV in South Africa
- Evidence brief: Anemia among HIV‑positive women in LMICs: Multilevel analysis of recent DHS survey
- Evidence brief: Geographic inequalities in HIV testing uptake among young women in sub-Saharan Africa: A hierarchical bayesian spatial analysis
