BACKGROUND:Many women who intend to use long-acting, reversible contraceptives (LARCs) postpartum do not follow through with initiating use. The objectives of this study were to determine whether support from a contraceptive personal assistant could increase the uptake of LARCs by 3 months postpartum, and to identify risk factors for nonuptake of LARCs among women who planned LARC use. STUDY DESIGN: This is a randomized, controlled trial of 50 low-income postpartum women who desired LARC. The intervention group received telephone contact from a personal assistant who provided contraception education, facilitation of insurance coverage, appointment scheduling and assistance with childcare and transportation. The control group received routine follow up. Women were surveyed immediately and 3 months postpartum regarding contraceptive use and anticipated barriers to LARC use. RESULTS: A similar proportion of women in both groups received LARC [control 16/24 (67%), intervention 18/25 (72%), p=.76]. More primiparous (86.4%) than multiparous (55.5%) women obtained LARC (p=.04). In addition, women with more prenatal visits were more likely to have initiated LARC (odds ratio, 95% confidence interval for each increased visit: 1.50, 1.15-1.96). No other demographic factors were related to LARC uptake. CONCLUSIONS: Providing telephone assistance to help navigate barriers did not increase postpartum uptake of LARCs. A personal history of clinic visit no-shows and/or infrequent prenatal visits were related to poor uptake of LARCs postpartum.
RCT Entities:
BACKGROUND: Many women who intend to use long-acting, reversible contraceptives (LARCs) postpartum do not follow through with initiating use. The objectives of this study were to determine whether support from a contraceptive personal assistant could increase the uptake of LARCs by 3 months postpartum, and to identify risk factors for nonuptake of LARCs among women who planned LARC use. STUDY DESIGN: This is a randomized, controlled trial of 50 low-income postpartum women who desired LARC. The intervention group received telephone contact from a personal assistant who provided contraception education, facilitation of insurance coverage, appointment scheduling and assistance with childcare and transportation. The control group received routine follow up. Women were surveyed immediately and 3 months postpartum regarding contraceptive use and anticipated barriers to LARC use. RESULTS: A similar proportion of women in both groups received LARC [control 16/24 (67%), intervention 18/25 (72%), p=.76]. More primiparous (86.4%) than multiparous (55.5%) women obtained LARC (p=.04). In addition, women with more prenatal visits were more likely to have initiated LARC (odds ratio, 95% confidence interval for each increased visit: 1.50, 1.15-1.96). No other demographic factors were related to LARC uptake. CONCLUSIONS: Providing telephone assistance to help navigate barriers did not increase postpartum uptake of LARCs. A personal history of clinic visit no-shows and/or infrequent prenatal visits were related to poor uptake of LARCs postpartum.
Authors: Kate Coleman-Minahan; Chloe H Dillaway; Caitlin Canfield; Daniela M Kuhn; Katherine S Strandberg; Joseph E Potter Journal: Perspect Sex Reprod Health Date: 2018-12-03
Authors: Abigail Liberty; Kimberly Yee; Blair G Darney; Ana Lopez-Defede; Maria I Rodriguez Journal: Am J Obstet Gynecol Date: 2019-12-14 Impact factor: 8.661
Authors: Lauren B Zapata; Sarah Murtaza; Maura K Whiteman; Denise J Jamieson; Cheryl L Robbins; Polly A Marchbanks; Denise V D'Angelo; Kathryn M Curtis Journal: Am J Obstet Gynecol Date: 2014-08-02 Impact factor: 8.661
Authors: Lydia Furman; Shannon Pettit; Monique S Balthazar; Khalilah Williams; Mary Ann O'Riordan Journal: Eur J Contracept Reprod Health Care Date: 2020-12-09 Impact factor: 1.752