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Increasing the uptake of postpartum long-acting reversible contraception: A novel approach at the well baby visit

Sadia Haider, MD, MPH, University of Illinois at Chicago

Project abstract

Background: Postpartum (PP) women are at risk of unintended pregnancy with 10-44% of women having an unintended pregnancy in the first PP year1. The typical PP follow-up recommended by the American College of Obstetricians and Gynecologists (ACOG) is a 4-6 week visit including contraception counseling and provision. In our target population of women using Medicaid in Illinois, only 60% of women attend a PP visit2. Unintended pregnancy can be reduced by increased access to PP contraception; however, few alternatives to this model have been studied.

Objectives: To determine if an innovative intervention offering women contraception counseling and provision at one of their infant's well baby visits (WBV) within the first four months of life increases utilization of long-acting reversible contraception (LARC) (i.e. subdermal implant, levonorgestral and copper intrauterine devices).

Methods: A randomized control trial (RCT) of women presenting for a WBV and not already using LARC will be conducted. Women in the intervention group will receive comprehensive contraception counseling and provision at the time of the WBV, including LARC methods if desired. The control group will receive typical PP care.

Outcomes: It is expected that the intervention will increase the proportion of women using LARC methods at five months PP. Additionally, women in the intervention arm will be more likely to use any form of contraception than women receiving traditional PP care. This study will provide foundational information on a novel approach to increasing access to reproductive health care for PP women.

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