Abstract
Objectives: We compare Oregon school-based health centers (SBHCs) with community health centers (CHCs) as sources of contraceptive counseling and long-acting reversible contraception (LARC) for adolescents. We describe adolescent populations served, time trends in LARC provision, and the role of Title X.
Highlights
We interviewed 43 participants (21 patients, 22 providers) who received or provided obstetric care in Illinois Catholic hospitals
After adjusting for age, race/ethnicity, cesarean delivery, and rural location, the odds of postpartum and interval tubal ligation after delivery at Catholic vs non-Catholic hospital were 95% lower and 23% higher respectively
Illinois Medicaid-enrollees who deliver at Catholic hospitals face significant disparities in use of post-partum tubal ligation (PPTL), though odds of interval tubal ligation within one year of delivery increase modestly
Summary
Because obese women have intrauterine contraception expulsion rates double that of non-obese women, we investigated the association of increasing obesity and expulsion risk with levonorgestrel 52 mg intrauterine system (IUS) use. Scheduled follow-up visits occurred at one, three, and six months after insertion and every six months thereafter For this analysis, we included women with a body mass index (BMI) ≥30 kg/m2 and at least one 28-day cycle of follow-up. We evaluated expulsion rates over time through 6 years in persons with BMI 30.0-39.9 kg/m2 and ≥40 kg/m2 using Fisher exact testing. Cumulative expulsion rates in persons with BMI 30.0-39.9 kg/m2 and ≥40 kg/m2 did not differ at 1 year (15/339 [4.4%] vs 7/92 [7.6%], respectively, p=0.28) or 6 years (21/339 [6.2%] vs 10/92 [10.9%], respectively, p=0.17). Conclusions: obese women experience higher IUS expulsion rates than non-obese women, we did not identify a significant difference in risk as BMI increases when evaluating just obese women
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