Reproductive outcomes of patients with unfulfilled postpartum permanent contraception requests.

BACKGROUND: Patients who request but do not receive postpartum permanent contraception (PC) are at high risk of subsequent short-interval pregnancy. OBJECTIVE: To describe contemporary subsequent pregnancy rates in patients requesting but not receiving postpartum PC. DESIGN: Single-site retrospective cohort study using medical record data of 2720 patients, 388 of whom presented for delivery with a signed Medicaid sterilization form. METHODS: Reproductive outcomes of patients with unfulfilled postpartum PC requests (n = 234) were compared to a comparison group (n = 246) who did not request postpartum PC using descriptive statistics and multivariate logistic regression. RESULTS: The overall PC completion rate was 39.7%. Among those with unfulfilled requests, 15.0% had a subsequent pregnancy within 18 months, compared to 27.1% of the comparison group. CONCLUSIONS: The subsequent pregnancy rate following an unfulfilled postpartum PC request is lower than historic estimates; however procedure nonfulfillment remains high.