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Is the Availability of Immediate Inpatient Postpartum Long-Acting Reversible Contraception (LARC) Associated with a

Allison Hoynes1, Brittany Cox2, Roma Amin2

  • 1From the Grant Family Medicine, OhioHealth, Columbus, OH (AH, RA, JY); Sky Lakes Medical Center, Klamath Falls, OR (BC); Wright State University Boonshoft School of Medicine, Dayton, OH (CMF); Heritage College of Osteopathic Medicine at Ohio University, Dublin, Ohio, USA (AC). allison.hoynes@ohiohealth.com.

Journal of the American Board of Family Medicine : JABFM
|December 19, 2025
PubMed
Summary
This summary is machine-generated.

Immediate postpartum long-acting reversible contraception (IPP-LARC) may reduce rapid repeat pregnancies (RRP). While IPP-LARC availability showed a slight positive association with RRP, patients who chose IPP-LARC had significantly fewer RRPs.

Keywords:
ContraceptivesCounselingDesogestrelDrug ImplantsElectronic Health RecordsEtonogestrelHealth DisparitiesHealth EducationHealth PolicyLong-Acting Reversible ContraceptionMaternal Health ServicesMedicaidObstetricsOhioPerinatal CarePopulation HealthPostpartum PeriodPreconception CarePregnancyPremature BirthPreventive MedicinePublic HealthReproductive HealthWomen's Health

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Area of Science:

  • Reproductive Health
  • Public Health Policy
  • Maternal-Fetal Medicine

Background:

  • Rapid repeat pregnancy (RRP) is linked to adverse perinatal outcomes, including preterm birth and low birth weight.
  • Ohio legislation (SB 332) mandated immediate postpartum long-acting reversible contraception (IPP-LARC) coverage starting April 2017.
  • Our hospital introduced Nexplanon as an IPP-LARC option post-legislation.

Purpose of the Study:

  • To evaluate the association between the availability of IPP-LARC and the rate of RRP following SB 332's passage.
  • To identify factors associated with RRP in adolescents and adults delivering at our institution.

Main Methods:

  • A retrospective study analyzed data from 726 patients before and after IPP-LARC availability.
  • Electronic health records and state registry data were used to examine sociodemographic and perinatal care variables.
  • The association between RRP and these variables was determined.

Main Results:

  • Only 62 out of 368 patients opted for Nexplanon (IPP-LARC).
  • The adjusted mean probability of RRP was 6% for patients with IPP-LARC versus 20% for those without.
  • Gravidity and vaginal delivery were negatively associated with RRP, while age at delivery was inversely associated.

Conclusions:

  • IPP-LARC availability was positively, though not significantly, associated with RRP.
  • Despite low uptake, patients utilizing IPP-LARC experienced lower rates of RRP.
  • Enhanced patient education and provider support are crucial for optimizing IPP-LARC utilization in vulnerable populations.