Maureen Norton | October 2015
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Presentation at the Global Maternal Newborn Health Conference, October 19, 2015

Background: High parity and advanced maternal age pregnancies are associated with increased risk of maternal death, as well as other adverse outcomes. Most of these pregnancies are unintended reflecting high unmet need. Postpartum family planning offers an opportune time to reach these women, yet there are few counseling tools or other guidance materials to help providers, clients, and their partners discuss these risks and consider effective contraceptive methods to prevent these high-risk pregnancies.

Methodology: Global data on the association of high parity pregnancies and advanced maternal age pregnancies with maternal mortality/morbidity will be presented. Prevalence data will also be presented. A literature search for counseling tools or guidance materials for high parity and/or advanced maternal age clients, undertaken as part of the 2013 USAID Behavior Change Evidence Summit, will be described, along with preliminary findings from message development and testing for this population group.

Results: Effective family planning methods to prevent unintended high parity and advanced maternal age pregnancies, along with newly developed counseling tools for advanced maternal age and high parity women, will be presented. Integrated birthing and postpartum family planning approaches are making these methods accessible to women who wish to limit future pregnancies, during the immediate postpartum period.

Conclusion: Reaching women of high parity or advanced maternal age with guidance and counseling to advance their understanding of the risks of these types of pregnancies, while helping them make a voluntary and informed decision about use of contraception to prevent these risks, and making these methods available in the postpartum period, should be a high priority in all reproductive health service delivery programs. This will contribute to the achievement of global goals.