Contraception最新文献

{"title":"OHIO ABORTION SEEKERS CHALLENGED BY TWO-VISIT REQUIREMENT ARE LIKELY TO REPORT MORE CHALLENGES OVERALL","authors":"A Kirkendall,&nbsp;M Bornstein,&nbsp;K Rivlin,&nbsp;A Norris Turner,&nbsp;M Davoodifar,&nbsp;T Odum,&nbsp;D Bessett","doi":"10.1016/j.contraception.2024.110607","DOIUrl":"10.1016/j.contraception.2024.110607","url":null,"abstract":"<div><h3>Objectives</h3><div>Ohio, like many restrictive states, requires abortion patients to present in-person for two appointments 24-hours apart. This study seeks to understand which, if any, patient-reported challenges are associated with the two-visit requirement.</div></div><div><h3>Methods</h3><div>1,361 participants seeking abortion care in Ohio completed an online survey between April 2020 and July 2021. Survey questions addressed challenges experienced, delayed expenses, and actions taken to cover costs. Responses of those who indicated making multiple trips for their abortion care was a challenge were compared to those who did not experience this challenge.</div></div><div><h3>Results</h3><div>29.4% of participants were challenged by the multiple trips requirement. Participants reporting this challenge were demographically similar by race, sexuality, and gender to those not reporting this challenge. Participants challenged by multiple visits reported twice as many challenges overall than those who were not challenged by multiple trips (mean=4.0 vs. 2.1, p&lt;0.01). Participants challenged by multiple trips took more actions to cover costs (mean=1.1 vs. 0.8 for those not challenged by multiple visits, p&lt;0.01). Overall, 28.5% of participants delayed expenses to cover costs, including 37.8% of those challenged by multiple visits and 24.7% of those not challenged by multiple visits (p&lt;0.01). The number of delayed expenses was greater for those challenged by multiple visits (mean=0.7 vs. 0.4, p&lt;0.01).</div></div><div><h3>Conclusions</h3><div>Many Ohioans seeking abortion identified the two-visit requirement as a challenge. The two-visit requirement occurs in conjunction with, and likely exacerbates, other challenges, especially financial stressors. Patients should be allowed to work with their care providers to determine the right number of visits for them.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110607"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ABORTION PATIENTS’ AWARENESS AND UNDERSTANDING OF AN EARLY PREGNANCY ABORTION BAN AND ACCESS TO IN-STATE CARE","authors":"K White,&nbsp;W Arey,&nbsp;AD Beasley,&nbsp;A Chatillon,&nbsp;C Chadwick,&nbsp;A Dane’el,&nbsp;O Leyser-Whalen,&nbsp;T Weitz","doi":"10.1016/j.contraception.2024.110612","DOIUrl":"10.1016/j.contraception.2024.110612","url":null,"abstract":"<div><h3>Objectives</h3><div>Explore We aimed to explore pregnant Texans’ awareness and understanding of a 2021 state law prohibiting abortion after detectable embryonic cardiac activity when navigating to abortion care.</div></div><div><h3>Methods</h3><div>We recruited Texans who obtained out-of-state abortion care after implementation of Senate Bill 8 (SB8) by providing flyers to abortion facilities in seven states and using online ads. Between October 2021 and February 2022, we conducted in-depth telephone interviews with English-speaking participants ≥15 years of age to explore their experiences seeking care. We used inductive and deductive codes in our thematic analysis describing participants’ understanding of how the law limited abortions.</div></div><div><h3>Results</h3><div>Most of the 65 participants discovered their pregnancy soon after a missed period, and less than half had heard of SB8 prior to pregnancy. Those who identified their pregnancy early and heard SB8 changed when an abortion could be obtained described the stress of scheduling appointments to confirm whether they could secure in-state care; a few felt rushed to make a decision. Having heard SB8 described as a six-week ban, participants were upset and frustrated to learn they were ineligible for in-state care because clinicians dated their pregnancy from weeks since last menstrual period (vs conception), there was evidence of cardiac activity before six weeks gestation, or cardiac activity appeared between ultrasound visits.</div></div><div><h3>Conclusions</h3><div>Pregnant Texans’ limited awareness of SB8 and the disjuncture between their understanding of the law and how it applied in early pregnancy increased time pressures and logistical burdens during their process seeking abortion care.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110612"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"STUDENT EXPERIENCES WITH EMERGENCY CONTRACEPTION AND PREFERENCES FOR ON-CAMPUS VENDING MACHINES","authors":"S Knifton,&nbsp;M Quasebarth,&nbsp;V Manthena,&nbsp;L Hasselbacher","doi":"10.1016/j.contraception.2024.110648","DOIUrl":"10.1016/j.contraception.2024.110648","url":null,"abstract":"<div><h3>Objectives</h3><div>Vending machines that sell emergency contraception (EC) at discounted prices are becoming increasingly common on US college campuses. These machines facilitate convenient and timely access for college students by mitigating common barriers to obtaining EC. Limited research has investigated students’ attitudes toward this resource.</div></div><div><h3>Methods</h3><div>Currently enrolled students at a private university in Illinois were recruited via flyers and listservs to complete an electronic survey on EC accessibility between November 2023 and February 2024. Anonymous survey responses were recorded via RedCap and exported to Microsoft Excel and SPSS for analysis.</div></div><div><h3>Results</h3><div>372 students completed the survey. The majority of participants identified as cisgender women (73.1%), straight (45.8%), White (52.6%), and as undergraduate (60.1%). Results found that over one-third (38.2%) of participants had previously purchased EC. Nearly 20% of these participants found the experience difficult, mainly due to the high cost of EC. Over half (56.4%) of participants had concern about being noticed or having to interact with staff when obtaining EC at a store or at student health clinic. Most (90.4%) participants reported that they would use an on-campus EC vending machine if they needed EC. Less than half (43.6%) indicated that they would be willing to spend more than $20 for EC.</div></div><div><h3>Conclusions</h3><div>EC vending machines are a practical solution to increase EC accessibility on college campuses and support students’ reproductive and educational goals, especially in the face of increasing abortion restrictions. To best address student concerns, ensuring that EC is low-cost and machines are placed in an accessible, but confidential, location is crucial.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110648"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ADVANCING INNOVATIVE MEASUREMENT OF PREGNANCY PREFERENCES WITH A SHORT-FORM DESIRE TO AVOID PREGNANCY SCALE","authors":"I Muñoz,&nbsp;BW Bullington,&nbsp;MR Wilson,&nbsp;CH Rocca","doi":"10.1016/j.contraception.2024.110577","DOIUrl":"10.1016/j.contraception.2024.110577","url":null,"abstract":"<div><h3>Objectives</h3><div>The Desire to Avoid Pregnancy (DAP) Scale represents an important step forward for pregnancy “intention” measurement. The 14-item psychometric instrument captures pregnancy preferences prospectively across domains (cognitive, affective, consequences) and allows for nuance, uncertainty, and ambivalence. However, a DAP short-form scale is needed to reduce respondent burden and facilitate integration of this rigorous, person-centered measure into future research and surveillance.</div></div><div><h3>Methods</h3><div>We used state-representative data from &gt;30,000 self-identified women, aged 18-44 years, from nine diverse US states (Surveys of Women, 2017–2023) to develop a four-item version of the DAP scale (DAP-4). After splitting the dataset in half, stratified by state, we used classical test theory and item response theory methods to iteratively identify a reduced item set that maintained construct validity (eg, included items across conceptual domains and were worded negatively and positively), internal structure validity (eg, monotonicity), and external validity (eg, no differential item functioning), while maintaining reasonable internal consistency reliability. Scale properties were retested on the second half of the dataset.</div></div><div><h3>Results</h3><div>The DAP-4 included two items in the cognitive domain and one each in the affective and practical consequences domains, and items worded in both directions. The internal consistency was high for a short-form (alpha=0.83), covered the full range of respondent pregnancy preferences, and met criteria for internal structure validity. We found no evidence of differential item functioning by age, race and ethnicity, relationship status or parity, and high correlation with the longer DAP scale (0.96).</div></div><div><h3>Conclusions</h3><div>A short-form DAP that maintains psychometric rigor is now available to measure pregnancy preferences.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110577"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TRANSGENDER, NONBINARY, AND GENDER-EXPANSIVE EXPERIENCES WITH TELEHEALTH MEDICATION ABORTION AND IMPLICATIONS FOR HEALTH EQUITY IN THE US","authors":"A Becker,&nbsp;SM Shuster,&nbsp;LR Koenig,&nbsp;J Ko,&nbsp;UD Upadhyay","doi":"10.1016/j.contraception.2024.110572","DOIUrl":"10.1016/j.contraception.2024.110572","url":null,"abstract":"<div><h3>Objectives</h3><div>Transgender, nonbinary, and gender-expansive (TGE) patients need abortion care. However, little is known about TGE patients’ experiences with telehealth abortion care, a growing mode of abortion service post-<em>Dobbs</em>.</div></div><div><h3>Methods</h3><div>We conducted 13 in-depth interviews with TGE patients of three US virtual abortion clinics — Choix, Hey Jane, and Abortion on Demand — who obtained telehealth abortion care between April 2021 and January 2024. Interviews were transcribed and analyzed abductively using Dedoose.</div></div><div><h3>Results</h3><div>The direct-to-patient telehealth model for abortion reduced barriers for trans and nonbinary patients. Many interviewees appreciated the ability to avoid entering an abortion clinic, a space typically associated with “women’s health.” Telehealth allowed patients to circumvent potential gender discrimination or uncomfortable gender-related interactions with providers and other patients, which they expected from in-person care. Patients appreciated the option to either report their preferred name and/or pronouns on intake forms or to not disclose their gender identity altogether — particularly for those who received care through asynchronous secure messaging without any face-to-face interaction. TGE Interviewees also appreciated the increased privacy, anonymity, reduced logistics, and speed of telehealth.</div></div><div><h3>Conclusions</h3><div>Telehealth abortion care is highly acceptable and beneficial for TGE patients, as they benefit from an at-home experience coupled with reduced gender discrimination. Findings can help direct gender-affirming abortion care in-person and via virtual clinics.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110572"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PUBLIC SUPPORT FOR REPORTING AND PUNISHING PEOPLE WHO USE ALCOHOL OR DRUGS WHILE PREGNANT","authors":"S Auerbach,&nbsp;SCM Roberts,&nbsp;LJ Ralph,&nbsp;S Kaller,&nbsp;R Schroeder,&nbsp;MA Biggs","doi":"10.1016/j.contraception.2024.110564","DOIUrl":"10.1016/j.contraception.2024.110564","url":null,"abstract":"<div><h3>Objectives</h3><div>Given increased criminalization of pregnant people and erosion of abortion rights, we need a better understanding of the extent of public support for reporting or punishing people for using alcohol or drugs while pregnant.</div></div><div><h3>Methods</h3><div>We administered a national probability-based online survey (December 2021-January 2022) to English- and Spanish-speaking people assigned female at birth (AFAB, ages 15-49) or male at birth (AMAB, ages 18-49) regarding their attitudes about punishing or reporting pregnant people who use alcohol or drugs and whether abortions performed within or outside the healthcare system should be legal. We used weighted analyses to estimate national support for reporting (reporting to police, to child protective services (CPS) and punishing (paying a fine, going to jail) pregnant people who use alcohol or drugs and their association with views on abortion legality.</div></div><div><h3>Results</h3><div>Among the 7,016 AFAB and 360 AMAB survey respondents, most supported reporting pregnant people for using alcohol or drugs to the police (57.6% AFAB, 54.8% AMAB) and CPS (69.1% AFAB, 71.3% AMAB); while fewer respondents supported punishing people with a fine (40.2% AFAB, 40.3% AMAB) or jail (31.3% AFAB, 35.1% AMAB). Support for reporting and punishing people for using alcohol or drugs while pregnant was associated with believing abortion, within or outside the healthcare system, should be illegal (OR 3.0, 95%CI 2.6-3.4 AFAB; OR 1.8, 95%CI 0.9-3.2 AMAB).</div></div><div><h3>Conclusions</h3><div>Public support for criminalizing alcohol and drug use during pregnancy is high and largely associated with views on abortion legality.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110564"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ABORTION-RELATED COSTS AS CATASTROPHIC HEALTH EXPENDITURES AND THEIR ASSOCIATIONS WITH IN-STATE OR OUT-OF-STATE TRAVEL TO ABORTION CARE","authors":"O Wasser,&nbsp;L Ralph,&nbsp;S Kaller,&nbsp;MA Biggs","doi":"10.1016/j.contraception.2024.110559","DOIUrl":"10.1016/j.contraception.2024.110559","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to estimate the proportion of people seeking abortion whose out-of-pocket abortion-related costs constitute a catastrophic health expenditure (CHE) and whether these are associated with in-state or out-of-state travel for care.</div></div><div><h3>Methods</h3><div>In 2019, we surveyed people aged 15–45 seeking abortion in four clinics located in abortion-supportive states that serve many out-of-state patients. We calculated participants’ out-of-pocket abortion-related costs (procedure, transportation, accommodation, childcare, previous appointments, missed work, and other expenses) and assessed whether these costs were financially catastrophic by applying a 40% threshold to their estimated non-subsistence monthly household income, based on published methods (Zuniga et al, 2020). Using multivariable Poisson regressions, we examined associations between traveling in-state or out-of-state for care and experiencing abortion-related costs as CHE.</div></div><div><h3>Results</h3><div>784 people (of 1,092 approached) completed the survey; 675 responded to the abortion-related costs questions. We found that 42% of participants experienced out-of-pocket abortion-related costs as financially catastrophic. Patients who traveled out-of-state for care were significantly more likely to experience abortion-related costs as CHE (65%, adjusted Prevalence Ratio (aPR) 2.24, 95% confidence interval (CI) 1.67-3.00) than in-state patients (32%). Individuals who resided more than 100 miles from the clinic (aPR 2.05, 95% CI 1.54-2.74) or sought abortion beyond 13 weeks’ gestation (aPR 1.80, 95% CI 1.30-2.51) were also significantly more likely to experience abortion as CHE, compared to their counterparts.</div></div><div><h3>Conclusions</h3><div>Out-of-pocket costs for abortion care are financially catastrophic for many abortion patients, especially those traveling out-of-state. The adverse impact on people’s financial well-being is likely exacerbated post-<em>Dobbs v Jackson Women’s Health Organization</em>, where more people are traveling for abortion care.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110559"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Copyright info/Contents","authors":"","doi":"10.1016/S0010-7824(24)00412-8","DOIUrl":"10.1016/S0010-7824(24)00412-8","url":null,"abstract":"","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110712"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A QUALITATIVE STUDY EXPLORING PATIENT EXPERIENCES WITH TELEHEALTH AND IN-CLINIC MEDICATION ABORTION: STIGMA, PRIVACY, AND SUPPORT","authors":"M Barnes,&nbsp;E Piqueiras,&nbsp;L Gutierrez-Palominos,&nbsp;R Patil","doi":"10.1016/j.contraception.2024.110621","DOIUrl":"10.1016/j.contraception.2024.110621","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to explore the experiences of people obtaining medication abortion through telemedicine medication abortion and clinic-based medication abortion at a single academic center.</div></div><div><h3>Methods</h3><div>We conducted an exploratory qualitative study utilizing semi-structured teleconference interviews with 23 (9 telemedicine medication abortion and 14 clinic-based medication abortion) patients with a gestational age up to 77 days who obtained a medication abortion between June 2018 and December 2022. Purposive sampling was adopted for the recruitment of participants at a single academic center in California. All interviews were recorded, transcribed, and coded by the authors to generate salient themes via thematic analysis.</div></div><div><h3>Results</h3><div>Participants discussed the effects of abortion stigma from society and social networks, leading to an increased desire for privacy, support, and urgency with time to appointment. Qualitative analysis indicates that telemedicine medication abortion participants preferred the increased privacy afforded via telemedicine. Clinic-based medication abortion participants highlighted the in-clinic environment as more invasive to their privacy, often requiring more people to know about their abortion which increased feelings of unease. Many participants described uncertainty about sharing abortion information with social networks because they (1) did not want to introduce others' opinions into their decision-making and (2) were unclear about how they might feel or react.</div></div><div><h3>Conclusions</h3><div>The results suggest that telemedicine abortion is an important tool to counteract pervasive societal stigma as well as improve accessibility. This study also suggests that abortion stigma (both actual and perceived) significantly impacts patient experiences despite being in a state with protective abortion laws, and improving accessibility and privacy can counteract the stigma associated with abortion care.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110621"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IMMEDIATE POSTPARTUM LEVONORGESTREL (LNG) IUD INSERTION: ANALYSIS OF INSERTION TECHNIQUE AND EXPULSION RATES","authors":"RA Desai,&nbsp;AR Brant,&nbsp;T Pal,&nbsp;M Yao","doi":"10.1016/j.contraception.2024.110639","DOIUrl":"10.1016/j.contraception.2024.110639","url":null,"abstract":"<div><h3>Objectives</h3><div>Prior studies report expulsion rates for immediate postpartum (IPP) IUDs as high as 27%. It is unclear whether modifiable insertion techniques affect the expulsion rate. We examined whether the technique of IPP LNG IUD insertion after vaginal delivery (manual vs device applicator vs ring forceps) was associated with IUD expulsion or other complications by six months postpartum.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of all patients who delivered vaginally and received an IPP LNG IUD (Mirena®) in a multihospital healthcare system from 2019-2022. We identified eligible patients using ICD-10 codes and MAR administration. We manually extracted outcomes and confounding variables: expulsion, IUD complications, use of ultrasound, and obstetrical characteristics. Statistical analysis was performed using chi square tests.</div></div><div><h3>Results</h3><div>We included 647 IPP LNG IUD insertions; 48% (311) were inserted manually, 14% (90) via ring forceps, and 38% (246) via device applicator. The overall expulsion rate was 14.4%. We found no difference in the rate of expulsion between manual, ring forceps, or device applicator insertion (14.8%, 10.0%, and 15.4% respectively; p=0.43), nor was there a difference in the rate of composite IUD complications (13.2%, 10.0%, and 16.7%, respectively; p=0.25). Providers were more likely to use ultrasound with ring forceps (24.4%) and device applicator (22.0%) compared to manual insertion (11.3%; p &lt;0.001).</div></div><div><h3>Conclusions</h3><div>Real world data suggest an LNG IUD expulsion rate of 14% after vaginal delivery. Our study found no difference in rates of IUD expulsion or complication based on insertion technique. These findings should inform pre-delivery long-acting reversible contraception (LARC) counseling and intrapartum practice patterns.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110639"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}