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Decision-making regarding immediate vs. interval postpartum levonorgestrel intrauterine device insertion timing.

Abigail Davenport1, Laura Morello2, Kavita Shah Arora3

  • 1Section of Female Pelvic Medicine and Reconstructive Surgery, MedStar Washington Hospital Center, Washington, DC, United States of America. Abigail.patricia.davenport@gmail.com.

Contraception and Reproductive Medicine
|March 20, 2023
PubMed
Summary

Patient decisions on postpartum contraception timing, including immediate postplacental (IPP) levonorgestrel intrauterine device (LNG IUD) insertion, are influenced by convenience and counseling. Understanding these factors can improve contraceptive method selection.

Keywords:
ContraceptionDecision-makingIntrauterine devicePostpartumQualitative

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Area of Science:

  • Reproductive Health
  • Contraception
  • Patient Decision-Making

Background:

  • Postpartum contraception initiation timing is crucial for aligning with reproductive goals.
  • Understanding patient decision-making for immediate postplacental (IPP) versus interval levonorgestrel intrauterine device (LNG IUD) insertion is key.
  • This study explores factors influencing the choice between IPP and interval postpartum LNG IUD insertion.

Purpose of the Study:

  • To explore the decision-making process for immediate postplacental (IPP) levonorgestrel intrauterine device (LNG IUD) insertion.
  • To compare decision-making for IPP LNG IUD insertion versus interval insertion at postpartum follow-up.

Main Methods:

  • Recruited English-speaking postpartum participants receiving either IPP or interval LNG IUD.
  • Conducted semi-structured phone interviews exploring contraception experiences, counseling, and intrapartum factors.
  • Interviewed 20 participants (12 IPP, 8 interval) from September to December 2017.

Main Results:

  • IPP IUD recipients cited convenience, immediate contraception desire, and availability as key decision factors.
  • Interval IUD recipients often researched independently, desired recovery time, and were unaware of IPP options.
  • Comprehensive counseling was preferred; unexpected IUD expulsion impacted future contraceptive desires.

Conclusions:

  • Prior experience, knowledge, and delivery room factors significantly influence postpartum IUD insertion timing decisions.
  • Providers should offer comprehensive counseling regarding IPP and interval LNG IUD options.
  • Addressing patient awareness and recovery needs can optimize contraceptive choices.