FAMILY PLANNING: Edited by Paul D. BlumenthalOptimizing postpartum contraception for high-risk obstetric patientsMiller, Hayley E.a; Darmawan, Kelly F.b; Henkel, Andreac Author Information aDivision of Maternal-Fetal Medicine and Obstetrics, Department of Obstetrics and Gynecology bDepartment of Obstetrics and Gynecology cDivision of Family Planning Services and Research, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Palo Alto, California, USA Correspondence to Hayley E. Miller, Center for Academic Medicine, OBGYN, Mail code 5317, Stanford University School of Medicine, 453 Quarry Road, Palo Alto, CA 94304, USA. Tel: +(831) 419 0566; e-mail: [email protected] Current Opinion in Obstetrics and Gynecology 34(6):p 351-358, December 2022. | DOI: 10.1097/GCO.0000000000000816 Buy Metrics Abstract Purpose of review This review will focus on those who are at greatest risk of maternal and neonatal morbidity from a subsequent unplanned or short interval pregnancy and the interventions to increase contraceptive uptake in the postpartum period. Recent findings Populations at highest risk of maternal or neonatal morbidity – those with a history of preterm birth or those with complex medical conditions – are also those at the highest risk for unintended pregnancies attributed to low-efficacy contraceptive failure/ noncontraceptive use, and many are discharged from birth hospitalization without understanding the importance of birth spacing related to their high-risk pregnancies. Current innovative strategies to improve postpartum contraception access and uptake among high-risk populations include utilizing the antenatal period to initiate contraception counseling, developing multidisciplinary teams, and incorporating multimedia-based educational tools. However, ongoing challenges that continue to pose barriers to contraception access include racial and economic disparities and the restructuring of obstetric care during the COVID-19 pandemic. Summary Preventing an unintended short interval pregnancy by providing contraception in the postpartum period is one of the most modifiable risk factors for those at highest risk of subsequent maternal or neonatal morbidity and therefore should be prioritized by clinicians, hospitals, and insurance coverage. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.