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Contraceptive Personal Assistant Services to increase the use of long-acting, reversible contraceptives among postpartum women

Kate Simmons, Oregon Health and Science University, 2011
See also executive summary and publication in Contraception.

Project abstract

Objective: To determine whether personalized support from a contraceptive personal assistant can increase the use of LARC methods at 3 months postpartum, and to identify barriers that prevent the use of LARCs within the postpartum period.

Background: Use of effective contraception in the postpartum period could reduce unintended pregnancies and improve obstetric outcomes. Unfortunately, contraceptive intention at the time of delivery often does not translate into actual usage. Among women intending to use an IUD for postpartum contraception, only about 26-29% of women follow through with placement by 6 months 9, 10. The hypothesis of this study is that a number of logistical barriers prevent use of LARC methods among women who specifically express a desire for these methods at hospital discharge, and that offering personal assistance designed to anticipate and address these barriers (using currently available social and medical assistance) will increase the rates of LARC usage at 3 months postpartum.

Study design: The proposed study is a randomized, controlled trial of 50 women who desire LARC. Study group I will receive standard counseling and follow up for postpartum contraception. Study group II will receive the intervention, a “personal assistant” who will offer not only the standard counseling but also contraceptive services including personalized contraception education, navigating insurance coverage, referral to agencies with low-cost or sliding scale services, scheduling of the appointment for placement, and help arranging child care and transportation. This is a feasibility study to provide an estimate of effect size and cost for the intervention.

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