Factors Associated With and Barriers to Receiving Inpatient Long-Acting, Reversible Contraception [1C

Abstract

INTRODUCTION: Factors associated with inpatient long-acting, reversible contraception (LARC) placement and potential barriers to inpatient LARC placement during the immediate postpartum period are largely unknown. The objective of this study was to determine factors associated with LARC placement and barriers to LARC placement during the post-partum hospitalization. METHODS: We identified 3072 deliveries at an urban, academic hospital between January 1, 2017 and July 31, 2018. We randomly selected 218 cases that received a LARC and 218 controls that did not receive a LARC. We excluded 68 patients <18 years of age or in a system requiring outpatient contraception planning. We look at bivariate relationships between patient characteristics and inpatient LARC placement. Chi-square tests and Fisher's Exact tests were used to assess statistical significance. RESULTS: Recipients of LARC were younger (mean age of 28 versus 29.5, p<0.01). Admission by Family Medicine providers (OR 0.10, 95% CI 0.02-0.45), lack of recorded prior contraception plan (OR 0.25, 95% CI 0.17-0.39), and delivery complications (OR 0.48, 95% CI 0.32-0.71) were associated with lower odds of receiving LARC placement. Single marital status was associated with higher odds of receiving LARC placement (OR 1.50, 95% CI 1.03-2.19). CONCLUSION: Findings suggest that provider specialty, which may be confounded by prior procedural training, and lack of prior contraception planning present significant barriers to immediate LARC placement.