- 作者：Katharine B. Simmonsa ; simmonka@ohsu.edu ; Alison B. Edelmana ; Hong Lib ; Keenan E. Yanita ; Jeffrey T. Jensena
- 关键词：Postpartum contraception ; Long-acting reversible contraception ; Intrauterine device ; Family planning
- 刊名：Contraception
- 出版年：2013
- 出版时间：July, 2013
- 年：2013
- 卷：88
- 期：1
- 页码：45-51
- 全文大小：180 K
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.