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Long-Acting Reversible Contraception Use after Non-Receipt of Postpartum Permanent Contraception: A Retrospective
Jill M Hagey1, Ambika V Viswanathan2, Brooke W Bullington3
1Division of Women's Community and Population Health, Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina, USA.
Journal of Women'S Health (2002)
|October 22, 2024
Summary
Ten percent of patients not receiving immediate postpartum permanent contraception (PC) chose long-acting reversible contraception (LARC) instead. Those using LARC rarely switch to PC, highlighting the need to fulfill PC requests before discharge.
Area of Science:
- Reproductive Health
- Contraception Research
- Postpartum Care
Background:
- Many patients desiring permanent contraception (PC) postpartum do not receive it.
- Understanding contraceptive choices after unfulfilled PC requests is crucial for effective family planning.
Purpose of the Study:
- To compare long-acting reversible contraception (LARC) versus permanent contraception (PC) use postpartum after an unmet immediate postpartum PC request.
- To analyze contraceptive fulfillment and patient characteristics.
Main Methods:
- Secondary analysis of a retrospective cohort study (2018-2019) across four sites.
- Data abstracted from medical records including demographics, contraceptive plans, fulfillment, reasons for non-fulfillment, and postpartum pregnancy incidence.
Main Results:
- Of 3,013 patients desiring PC, 58.4% received it at discharge, and 4.5% received LARC.
- Within one year postpartum, an additional 217 received PC and 176 received LARC.
- Patients receiving inpatient LARC were more likely to be younger, unmarried, have Medicaid, and have had a vaginal delivery compared to those receiving PC.
Conclusions:
- Ten percent of patients with unmet postpartum PC requests utilize LARC methods by one year postpartum.
- Patients opting for LARC postpartum are unlikely to subsequently receive PC.
- Healthcare institutions should prioritize fulfilling immediate postpartum PC requests prior to hospital discharge.
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