Contraceptive counseling among individuals with genetic conditions: a retrospective cohort study

Abstract

Individuals with genetic conditions are at increased risk for adverse pregnancy outcomes; therefore, effective postpartum contraception is essential. Limited data exists regarding postpartum LARC counseling and uptake in this population. A retrospective chart review was used to evaluate documentation of LARC counseling in pregnancies of individuals with genetic diagnoses who delivered at two delivery sites from 2011 to 2024. LARC counseling was documented in 83.3% of patients, of which 27.1% initiated LARC. Nulliparity was associated with lower counseling rates, while antepartum disease progression and certain complications were associated with higher counseling. Variation by demographic and clinical factors suggests gaps in equitable counseling, highlighting the need to better understand barriers in this population.