Are Wisconsin resident physicians trained in immediate postpartum long acting reversible contraception?

To characterize perceived proficiency in immediate postpartum long-acting reversible contraception (LARC) provision among resident physicians in obstetrics and gynecology and family medicine in Wisconsin.

We queried 254 Wisconsin obstetrics and gynecology or family medicine residents about competency and attitudes regarding family planning services via a confidential electronic survey. We used logistic regression to identify factors associated with the primary outcome of self-reported proficiency in immediate postpartum LARC.

We recruited participants from 3 of 3 (100%) obstetrics and gynecology and 9 of 15 (60%) family medicine residency programs, achieving a 74% response rate among trainees (187/254 individuals). Seven of 12 programs (58%) offered immediate postpartum LARC training [100% (3/3) obstetrics and gynecology; 44% (4/9) family medicine]. Forty-eight percent of residents [68% (27/40) obstetrics and gynecology and 60/141 (43%) family medicine, p < 0.01)] reported immediate postpartum LARC proficiency (subdermal implant placement: 48%; immediate postpartum intrauterine device (IUD) placement: 16%). Residents (versus interns), who were younger, training in a program without religious affiliation, and who hoped to provide immediate postpartum LARC provision in practice, were more likely to report subdermal implant proficiency. Interns and family medicine trainees were less likely to report immediate postpartum IUD proficiency.

Only 44% of participating family medicine programs provide immediate postpartum LARC training. Two-thirds of obstetrics and gynecology residents report proficiency in immediate postpartum LARC, compared to fewer than half of family medicine residents. Given that many Wisconsin counties do not have a practicing obstetrician/gynecologist, improving immediate postpartum LARC training among family medicine residents is paramount.

STATEMENT: Family medicine physicians provide a significant portion of obstetric care, especially in rural areas. Family medicine residency programs should be supported to ensure that all trainees are proficient in placing subdermal implants and family physicians planning to provide obstetric care are trained in postpartum IUD placement.