Buprenorphine and postpartum contraception utilization among people with opioid use disorder: a multi-state analysis
2025

Buprenorphine and Postpartum Contraception Use in People with Opioid Use Disorder

Sample size: 11118 publication 10 minutes Evidence: moderate

Author Information

Author(s): Kevin Y. Xu, Jennifer K. Bello, Joanna Buss, Hendrée E. Jones, Laura J. Bierut, Dustin Stwalley, Hannah S. Szlyk, Caitlin E. Martin, Jeannie C. Kelly, Ebony B. Carter, Elizabeth E. Krans, Richard A. Grucza

Primary Institution: Washington University School of Medicine

Hypothesis

BUP receipt during pregnancy may be associated with greater contraception uptake postpartum in people with OUD compared to the receipt of psychosocial services.

Conclusion

Only 22% of pregnant people with OUD in our cohort used effective or highly-effective postpartum contraception.

Supporting Evidence

  • 22.4% of the cohort were prescribed contraception by 90 days postpartum.
  • BUP receipt was associated with a greater use of prescribed contraceptive methods.
  • Most participants who received contraception used LARC or female sterilization.

Takeaway

This study found that many new mothers with opioid use disorder don't use effective birth control after giving birth, but those who took buprenorphine were a bit more likely to get prescribed contraception.

Methodology

Retrospective cohort study using multistate administrative claims data to compare contraception utilization rates among postpartum people with OUD initiating buprenorphine versus no medication.

Potential Biases

Potential bias due to the treatment-receiving cohort and inability to account for personal motivations and preferences.

Limitations

Findings cannot be generalized to those not receiving treatment or with limited insurance; underpowered for assessing other medications; did not account for non-prescribed contraception methods.

Participant Demographics

Mean age 28.5 years; 60.4% under 30; 81.4% White; 6.9% Black.

Statistical Information

P-Value

p<0.001

Confidence Interval

[1.07–1.28]

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1186/s13722-024-00530-1

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