Table 3.

Key themes and representative quotes from interviews with providers

Theme	Quote
Providers understood that barriers to postpartum care and contraception reflect the intersection of the women’s needs and contexts, insurance coverage, and the ability of the health care delivery system to respond	I think the biggest challenge is insurance coverage of long-acting contraception. People that are on labor and delivery either have insurance that [isn’t accepted] or if they have state health insurance, they’re unable to get those devices placed before they leave the hospital. [Obstetrics and Gynecology] Working in a clinic where our patients have socioeconomic and other social challenges, sometimes transportation is an issue. Sometimes childcare is an issue. They may not be able to get to the clinic or just may be so overwhelmed with whatever it is that’s going on in their household to be able to get to the clinic. [Certified Nurse Midwife]
Lack of care continuity is a major issue in women’s receipt of postpartum care and postpartum contraception	I think in the resident clinic particularly, it’s difficult to be able to follow the patients to make sure they come, because there’s such a large volume of patients who deliver in the resident clinics and they need to come back for post-partum visits and nobody is really assigned to follow them. [Obstetrics and Gynecology] By the time they deliver, I don’t have any of their notes, so I don’t even know what they’ve talked about with their [provider]. Sometimes I’ll come on, the patient delivered two days ago, and she’s going home today. She may or may not have had conversations with her previous provider at the place where she didn’t deliver. I mean, most likely, these people on the floor who now knew nothing about her and just did her delivery probably haven’t talked to her about contraception. Sometimes, by the time I come on, it’s almost too late. [Obstetrics and Gynecology]
Long-acting reversible contraception has strong provider support, but providers are aware of the barriers associated with LARC use	I haven’t started doing IUDs ‘cause I don’t feel like I have enough experience. I like to do them when I have some backup…I think people are doing a lot of Depo Provera, and of course, the major problem with Depo is the people don’t come back. If we could be putting Nexplanon instead, it would be great. [Pediatrics] If we knew that we had insurance coverage for all LARC, and we knew that we could bill for LARC separately from the delivery encounter, then we probably would be more likely to place immediate postpartum LARC, and that would increase uptake by decreasing the number of visits that the patient has…I try my best to figure out ways, and talk to them about getting the LARC with me, but I can see where it’s hard. I can see where there are many barriers. [Obstetrics and Gynecology]
There is provider support for the use of a Reproductive Life Planning Tool in a variety of care settings	I think it gets the conversation going because I do think those can be uncomfortable conversations for some people. I think that it helps move the conversation in the right direction. [Certified Nurse Midwife] In general, I think it’s a great idea to have a reproductive life plan. I think it’s a great idea. I think it’s important because it helps women think about more than just the immediate and putting their current pregnancy in a more long-term context. I think it’s important to talk about contraception in the context of either trying to avoid any future pregnancies or trying to help her plan the timing for her next pregnancy…It’s [RLPT] not like that panacea. It’s not the only thing, but I think it’s a good starting point for discussion about long-term planning with regards to contraception. [Obstetrics and Gynecology]
There is provider support for the Well-Baby Visit to be linked to contraceptive counseling and care although there was no endorsement for a specific way for this to occur	I think it can definitely be done. I think it’s probably a good idea for patients, but I think there are a number of things logistically that would have to be worked out. [Obstetrics and Gynecology] I think it could be definitely beneficial. There’s already so much that we have to do within our Well-Baby care. I just wonder if it will be very overwhelming, or if there’ll even be time to really discuss those issues… I think there would be some pushback because of feasibility and time. I think that maybe a better way to do it would be to link up OB care and pediatric care better, so that we can directly refer someone, through OB/GYN, for that particular care. [Pediatrics]