Conference Coverage
Brief educational intervention promotes postpartum LARC use
Major finding: Twenty-three percent of women who received the intervention changed their contraceptive method choice, with 94% of those choosing a...
NEW ORLEANS – A postpartum educational script about long-acting reversible contraceptive methods appears to increase interest in those methods, but access may be limited for some women, findings from a randomized controlled trial suggest.
Long-acting reversible contraceptive (LARC) use after the 6-week postpartum visit in 400 women who received the " LARC Script " intervention and 400 controls who did not receive the intervention did not differ significantly (17.6% vs. 13.3%, respectively), but interest in LARC use among those not using a LARC method at follow-up did differ significantly between the groups (31.2% vs. 25.8%), Dr. Jennifer H. Tang reported at the annual meeting of the American College of Obstetricians and Gynecologists.
These findings suggest that the LARC Script is effective, but that barriers – such as financial and provider barriers – may be limiting uptake of LARC use, said Dr. Tang of the University of North Carolina at Chapel Hill.
Study subjects were 800 women aged 14-45 years who were recruited post partum between May 2011 and January 2012 and randomized to the intervention and control groups prior to discharge. A 20-item baseline survey lasting about 10 minutes was administered to all participants; the 1-minute intervention consisting of information about LARC was administered to intervention group subjects, with follow-up surveys conducted at 1-2 weeks (to confirm the 6-week visit) and at 6 weeks to assess outcomes.
About 40% of the subjects were Hispanic, median parity was two, and about a third had no insurance. Only a third of subjects were trying to conceive when they became pregnant, and 20% reported using some form of contraceptive to prevent pregnancy when they became pregnant. Most (80%) were not interested in becoming pregnant again, Dr. Tang said.
Approximately 40% of pregnancy intervals in the United States are less than 18 months, and intervals of 18 months or less are associated with poorer pregnancy outcomes. Thus, the findings of this study suggest a need for additional study to identify barriers to LARC access, she said.
"We need to look into reasons why women who want to receive LARC aren’t actually getting it," she said.
This study was funded by the Fellowship in Family Planning. Dr. Tang reported having no disclosures.