{"title":"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。","authors":"Rebecca Tsai, Elijah Wade, Lue-Yen S Tucker, Cynthia Triplett, Karrie Murphy","doi":"10.7812/TPP/24.172","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>This retrospective cohort study compared patients aged <u>></u> 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 χ<sup>2</sup> tests were used to assess group differences.</p><p><strong>Results: </strong>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.</p><p><strong>Discussion: </strong>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.</p><p><strong>Conclusion: </strong>Patients unable to receive requested postpartum permanent contraception appear to benefit from increased access to IPP LARCs.</p>","PeriodicalId":23037,"journal":{"name":"The Permanente journal","volume":" ","pages":"1-7"},"PeriodicalIF":0.0000,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Increasing Access to Immediate Postpartum Long-Acting Reversible Contraception on Pregnancy and Contraceptive Outcomes in Patients Seeking Permanent Contraception Postpartum.\",\"authors\":\"Rebecca Tsai, Elijah Wade, Lue-Yen S Tucker, Cynthia Triplett, Karrie Murphy\",\"doi\":\"10.7812/TPP/24.172\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>This retrospective cohort study compared patients aged <u>></u> 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 χ<sup>2</sup> tests were used to assess group differences.</p><p><strong>Results: </strong>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.</p><p><strong>Discussion: </strong>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.</p><p><strong>Conclusion: </strong>Patients unable to receive requested postpartum permanent contraception appear to benefit from increased access to IPP LARCs.</p>\",\"PeriodicalId\":23037,\"journal\":{\"name\":\"The Permanente journal\",\"volume\":\" \",\"pages\":\"1-7\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-09-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The Permanente journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.7812/TPP/24.172\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Social Sciences\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Permanente journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.7812/TPP/24.172","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Social Sciences","Score":null,"Total":0}
Increasing Access to Immediate Postpartum Long-Acting Reversible Contraception on Pregnancy and Contraceptive Outcomes in Patients Seeking Permanent Contraception Postpartum.
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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