Impact of Long-Acting Reversible Contraceptive Counseling on Postpartum Contraceptive Choice [17G

Abstract

INTRODUCTION: Approximately half of pregnancies occurring in the United States annually are unintended. Long-acting reversible contraceptives (LARCs) could help reduce unintended pregnancy, yet they are used by less than 3% of women in the United States. The objective of this study is to determine if prenatal contraceptive counseling for high-risk pregnant women will impact LARC choice postpartum. METHODS: A prospective cohort study was performed at the Perinatal Center of Women and Children’s Hospital of Buffalo. Patients who presented between ages 18 and 45 and within 34 weeks of gestation were recruited to participate in the study. Our intervention included two prenatal contraceptive counseling sessions. The patient’s choice of a LARC postpartum was compared to both their pre-counseling choice as well as to the choice of a control group who received standard prenatal counseling in the year prior to our intervention. Descriptive data and bivariate analysis were performed using SPSS. P-values less than or equal to .05 were considered significant. RESULTS: A total of 55 pregnant women were recruited. All women had co-morbid conditions, including chronic hypertension, diabetes, and venous thrombo-embolism. Counseling increased the intent for LARC from 27% pre-counseling to 42% post-counseling (P=.011). The intervention group also had higher postpartum LARC intent (42%) compared to control group who received standard counseling (20%) with P=.003. CONCLUSION: Our study suggests that instituting a prenatal contraceptive education program can improve LARC rates in high-risk pregnant women.