Abstract
Impact of prenatal contraceptive counselling on immediate postpartum intrauterine device use
Highlights
Data from the National Survey of Family Growth indicates that 70% of pregnancies within the first postpartum year are unintended [1]
The initial control population consisted of 209 individuals, four of whom were removed from the control group after further review: 1 received an Immediate post-partum (IPP) intrauterine devices (IUD), 1 was unable to be identified by chart review, 1 had an emergency postpartum hysterectomy for post-partum haemorrhage, and 1 patient had a pregnancy that ended in fetal demise
There were no significant differences between the IPP IUD case vs. control groups in terms of obstetric and demographic characteristics (Table 1)
Summary
Data from the National Survey of Family Growth indicates that 70% of pregnancies within the first postpartum year are unintended [1]. When conception occurs within 12 months of a prior delivery, risks of adverse pregnancy outcomes are elevated, including preterm deliveries, low birth weight infants, preterm rupture of membranes, utero-placental bleeding, and uterine scar rupture for those attempting a trial of labor after caesarean [2,3], yet the majority of people encounter barriers in accessing preferred postpartum contraception [4]. While the spectrum of pregnancy intendedness is fluid [5], healthcare providers play a critical role in ensuring reproductive health and autonomy by offering contraceptive counselling to all and ensuring each person is able to access their preferred, medically-appropriate method. The American College of Obstetricians and Gynaecologists (ACOG) recommends counselling prenatally about the option of IPP IUD placement, defined as IUD placement with 10 minutes of placental delivery [9] and strongly encourages the practice of providing longacting reversible (LARC) methods, including IUDs and subdermal implants, in the postpartum period [10]. IPP IUDs are not widely disseminated in clinical practice and little is known about how prenatal counselling strategies impact use
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