Personalized contraceptive assistance and uptake of long-acting, reversible contraceptives by postpartum women: A randomized, controlled trial

Katharine B. Simmons, Alison B. Edelman, Hong Li, Keenan E. Yanit, Jeffrey T. Jensen

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)45-51
Number of pages7
JournalContraception
Volume88
Issue number1
DOIs
StatePublished - Jul 1 2013

Keywords

  • Family planning
  • Intrauterine device
  • Long-acting reversible contraception
  • Postpartum contraception

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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