Increasing Access to Immediate Postpartum Long-Acting Reversible Contraception on Pregnancy and Contraceptive Outcomes in Patients Seeking Permanent Contraception Postpartum.

Q2 Social Sciences

The Permanente journal Pub Date : 2025-09-23 DOI:10.7812/TPP/24.172

Rebecca Tsai, Elijah Wade, Lue-Yen S Tucker, Cynthia Triplett, Karrie Murphy

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引用次数: 0

Abstract

Introduction: To evaluate the impact of increasing access to immediate postpartum (IPP) long-acting reversible contraceptions (LARCs) on pregnancy and contraceptive outcomes in patients that desired permanent contraception prior to delivery.

Methods: This retrospective cohort study compared patients aged > 18 years at gestational age 24 weeks 0 days and above, who desired permanent contraception before and after an organization-wide intervention to increase access to IPP LARCs. The authors collected demographic information, birth control method documented at discharge, LARC usage within 3 months of delivery, LARC type, and unintended pregnancy 1 year after delivery. Patients specified whether their pregnancies were unintended at time of first pregnancy-related care. Patients who obtained permanent contraception during their delivery encounter were excluded. Mann-Whitney and χ² tests were used to assess group differences.

Results: The authors reviewed 1607 patient records (846 preintervention; 761 postintervention). The cohorts were similar in age, body mass index, parity, and gestational age at delivery. Out of the 846 preintervention patients, 183 (22%) underwent LARC placement (39 [21%] arm implant; 144 [79%] intrauterine device), and 16 (1.9%) patients had a 1-year interval unintended pregnancy. Out of the 761 postintervention patients, 190 (25%) underwent LARC placement (54 [28%] arm implant; 136 [72%] intrauterine device), and 7 (0.9%) patients had a 1-year interval unintended pregnancy.

Discussion: With increased access to IPP LARCs, patients who did not obtain desired permanent contraception were more likely to utilize LARCs at 3 months postpartum and less likely to have another pregnancy within 1 year.

Conclusion: Patients unable to receive requested postpartum permanent contraception appear to benefit from increased access to IPP LARCs.

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增加获得产后立即长效可逆避孕对寻求产后永久避孕的患者妊娠和避孕结果的影响。

前言：评估增加产后立即（IPP）长效可逆避孕药（LARCs）对希望在分娩前永久避孕的患者妊娠和避孕结局的影响。方法：本回顾性队列研究比较了胎龄24周0天及以上的bb0 ~ 18岁患者，这些患者在全组织干预前后希望永久避孕，以增加IPP LARCs的可及性。作者收集了人口统计信息、出院时记录的节育方法、分娩3个月内LARC的使用情况、LARC类型和分娩后1年的意外妊娠。患者在第一次妊娠相关护理时指明其是否意外怀孕。在分娩过程中获得永久性避孕措施的患者被排除在外。采用Mann-Whitney检验和χ2检验评价组间差异。结果：作者回顾了1607例患者的记录（干预前846例，干预后761例）。这些队列在年龄、体重指数、胎次和分娩时的胎龄方面相似。在846例干预前患者中，183例（22%）接受了LARC植入（39例[21%]手臂植入；144例[79%]宫内节育器），16例（1.9%）患者发生了1年间隔的意外妊娠。在761例干预后患者中，190例（25%）接受了LARC植入（54例[28%]手臂植入；136例[72%]宫内节育器），7例（0.9%）患者发生了1年间隔的意外妊娠。讨论：随着IPP LARCs的使用增加，未获得所需永久避孕措施的患者更有可能在产后3个月使用LARCs，而在1年内再次怀孕的可能性更小。结论：无法接受产后永久避孕的患者似乎受益于IPP LARCs的增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

The Permanente journal Medicine-Medicine (all)

CiteScore

2.20

自引率

0.00%

发文量