Abstract
BACKGROUND: The postpartum period is a critical window for addressing women's contraceptive needs. Sub-Saharan African immigrant and refugee women living in the United State face unique barriers to postpartum contraception due to cultural norms, religious beliefs, migration-related challenges, and systemic inequalities, yet there is limited evidence on their postpartum contraceptive preferences and use. This scoping review mapped the existing literature on postpartum contraception among this population and identified key factors influencing uptake. METHODS: Following Joanna Briggs Institute guidelines, we conducted a scoping review of studies published in English from January 2000-June 2024. Eligible studies focused on sub-Saharan African immigrant and refugee women aged 15-49 living in the US, and examined postpartum contraception, including predisposing factors, facilitators, and barriers. A systematic search of five databases (PubMed/MEDLINE, PsychInfo, CINAHL, EMBASE, Global Health Database) identified 410 studies; 10 studies were included. Data were coded and synthesized thematically using the PEN-3 Model as an analytic framework; findings were interpreted through an intersectionality lens. RESULTS: Postpartum contraceptive behaviors were shaped by predisposing factors, facilitators, and barriers. Cultural and religious norms favored natural methods like lactational amenorrhea, due to religious support for birth spacing but not limiting. Migration experiences were influential barriers, with challenges including language barriers, limited health literacy, and loss of insurance, postpartum. Facilitators were inclusive Medicaid policies, long-acting methods availability, and culturally sensitive counseling. CONCLUSIONS: Culturally responsive, equity-focused policies are essential to meet the postpartum contraceptive needs of sub-Saharan African immigrant and refugee women. Expanding Medicaid coverage, training providers in cultural competency, and engaging community leaders can improve access and trust.