Abstract
Objective
To assess the impact of contraceptive counseling on the uptake of long-acting reversible
contraception (LARC), namely, intrauterine devices and the contraceptive implant,
by 3 months postpartum among women with a recent preterm birth.
Design
We enrolled patients in a single-blinded, one-to-one, randomized, controlled trial
to assess the impact of enhanced family planning counseling immediately after a viable
preterm birth in the inpatient setting. Participants received either structured counseling
with an emphasis on LARC by a family planning specialist (intervention) or routine
postpartum care (control). We followed participants to the primary outcome of LARC
use 3 months postpartum.
Results
We followed 121 participants for 3 months. Primary outcome data were available for
119 participants (61 intervention, 58 control). We found no demographic differences
between the groups. Participants in the intervention group were significantly more
likely to use LARC at 3 months postpartum compared with controls (51% vs. 31%; p < .05). For every six women who received the counseling intervention, one additional
woman was using a LARC method at 3 months.
Conclusions
After a preterm birth, brief LARC-focused, structured counseling before hospital discharge
significantly increased LARC method use at 3 months postpartum.
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Biography
Leah N. Torres, MD, MS, is a generalist obstetrician/gynecologist practicing in Salt Lake City, Utah. She completed her Family Planning Fellowship at the University of Utah in 2014 and has special interest and focus in this area of her practice.
Biography
David K. Turok, MD, MPH, an Associate Professor of Obstetrics and Gynecology at the University of Utah, directs the Family Planning Division. He is an active clinician, educator, and researcher focused on improving access to and developing new methods of contraception.
Biography
Erin A. S. Clark, MD is an Associate Professor of Obstetrics and Gynecology at the University of Utah Health Sciences Center. She serves as Chief of the Division of Maternal-Fetal Medicine. Her research focuses on preterm birth and neurodevelopmental sequelae.
Biography
Jessica N. Sanders, PhD, MSPH, is an Assistant Professor in the Department of Obstetrics and Gynecology at the University of Utah. She is the Director of Family Planning Research.
Biography
Emily M. Godfrey, MD, MPH, is an Associate Professor of Family Medicine and Obstetrics and Gynecology at the University of Washington. She graduated from the University of Rochester Family Planning Fellowship in 2003. Her research interests include contraceptive counseling in the clinical setting.
Article info
Publication history
Published online: July 04, 2018
Accepted:
May 7,
2018
Received in revised form:
April 30,
2018
Received:
November 28,
2017
Footnotes
The Society of Family Planning Research Fund provided funding for the study. David Turok serves on advisory boards for Allergan, Bayer, Pharmanest, and Teva. He is a consultant for Bioceptive and a speaker for Allergan, Medicines 360, Merck, and Teva. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Identification
Copyright
© 2018 Jacobs Institute of Women's Health. Published by Elsevier Inc.
