We aimed to identify barriers to breastfeeding-compatible post-placental intrauterine devices (IUDs) for expectant predominantly non-Hispanic African-American women.

Materials and methods

This cross-sectional survey study, conducted at 3 Cleveland community partner locations, enrolled 119 expectant predominantly unmarried but partnered non-Hispanic African-American women. The survey assessed contraceptive, IUD-specific and breastfeeding attitudes and intentions. Survey responses were described with percentages and frequencies, and compared by feeding intention using 2-sided Chi-Square tests. Factor analysis with Varimax rotation identified 2 potential measures of reluctance to post-placental IUD acceptance. The relationship of factors scores to maternal characteristics was assessed.


Feeding intention (breastfeeding versus not) was not related to perceived barriers to post-placental IUD receipt among expectant minority women. A “Personal Risks Reluctance” factor included low risk IUD events (migration and expulsion), misconceptions (delayed fertility return), menstrual changes and partner preference: a higher score was significantly associated with younger age group but no other maternal characteristics. A “Not Me Reasons” factor included provider and insurance barriers, and was not related to any maternal characteristics.


Expectant minority women’s perceived barriers to post-placental IUDs are not related to prenatal feeding intentions. We identified two clinically relevant factors that appear to measure barriers to post-placental IUD acceptance.



材料和方法:这项横断面调查研究, 在Cleveland的3个合作社区进行调查, 纳入了119名未婚但有伴侣的非西班牙裔的非裔美国孕妇。该调查评估了避孕、宫内节育器特异性和母乳喂养的内容和意图。用百分比和频次描述问卷回答, 采用双侧卡方检验对答案进行比较。采用正交旋转法分析确定2种不愿意接受胎盘分娩后节育器的潜在措施, 评估各因子得分与母体特征的关系。

结果:在怀孕的少数民族妇女中, 喂养意图(母乳喂养和非母乳喂养)与胎盘分娩后宫内节育器应用障碍无关。“个体不情愿风险”因素包括低风险IUD事件(植入和脱落), 误解(延迟生育功能恢复), 月经变化和伴侣偏好:更高得分显著相关的是年轻组, 但是没有其他母性的特征。“非本人原因”因素包括提供者和保险问题阻碍, 与任何母性特征无关。

结论:少数民族妇女对胎盘分娩后植入宫内节育器的认识障碍和产前喂养意图无关。我们确定了两个临床相关因素, 似乎可以推测胎盘分娩后宫内节育器接受的障碍。


Thank you to the Community Researchers who recruited and enrolled participants: Brikelle Hart PCA (Care Alliance Health Center), Charlesretta Wynn CHW (WIC), Verna Darby (Birthing Beautiful), and to the colleagues at each of our Community Partners: Barbara Riley, Susan Conover and Mistie Winkfield-Hughes (the Cuyahoga County WIC Program), Sarah Sweeney MD (Care Alliance Health Center) and Kristin Farmer (Birthing Beautiful Communities), and to each of the women who participated in the study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information


This work was supported by an American Academy of Pediatrics Community Access to Child Health Planning Grant [AAP CATCH grant] to Dr. Furman.


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