IMPROVE – Promoting equitable reproductive health: IMplementing best practice postpartum contraceptive services through a quality imPROVEment initiative for and with immigrant women in Sweden

Postpartum care represents a key opportunity to improve women’s sexual, reproductive health and rights (SRHR), as it facilitates women’s choice of effective contraceptive methods. This, in turn, supports birth spacing and indirectly prevents unintended pregnancies and abortions.

In European studies, immigrant women report lower use of effective contraception, higher fertility rates, unintended pregnancies and abortions compared to native-born women.In Sweden, the rate of repeat abortions is increasing among women of childbearing age.

Among women who did not intend to have more children, 32% chose to use less effective or no contraception, reflecting the need for improved counseling.

Almost 1/3 of women giving birth in Sweden are immigrants.The IMPROVE project aims to promote SRHR equity and improve immigrant women’s choice of effective postpartum contraceptive methods. The project will involve cooperation between immigrant women and men and health care professionals.

Immigrant women and men from the largest immigrant groups in Sweden will be included in focus group discussions on reproductive decision making, contraception, how to involve partners and how to improve postpartum contraceptive services (Study 1).Using a cluster randomized trial with a process-evaluation, informed by the results from study 1, we aim to enhance contraceptive services for immigrant women by evaluating a Quality Improvement Collaborative through registration of contraception in the Swedish Pregnancy Register (Study 2).By combining qualitative studies, and a cluster randomized controlled trail with process evaluation, we will gain an in-depth understanding of how to improve contraceptive services with and for immigrant women, and how best to involve partners when seeking to support immigrant women’s choice of effective postpartum contraceptive methods.