Postpartum Contraception at Bridgeport Hospital [1R

Abstract

INTRODUCTION: ACOG supports immediate postpartum LARC provision as a means to reduce unintended and short interval pregnancies. Immediate postpartum contraception became routinely available at Bridgeport Hospital in 2016. The aim is to determine uptake, choice, and continued use of postpartum contraception at our institution. METHODS: Using an EPIC-generated list of all deliveries at Bridgeport Hospital for calendar years 2015 and 2017. Institutional IRB waiver was obtained. After sorting for only clinic service deliveries we performed a systematic chart review of each patient looking at demographic data, pregnancy and delivery information, contraceptive choice antepartum and postpartum, and pregnancies within one year of delivery. Data collection for 2017 in still ongoing. RESULTS: In 2015 and 2017, there were 326 and 202 Bridgeport Hospital OB/GYN Clinic deliveries, respectively. The demographic characteristics were similar for both cohorts. 92% in 2015 of patients had antepartum counseling on contraception compared to 97% in 2017. In 2015, 44% desired a LARC and 59% received one. Comparatively, in 2017, 53% desired a LARC and 92% received one. Over 80% of patients returned for a postpartum visit. Among patients who had their IUD or implant removed, 75% were for side effects. The percentage of short interval pregnancies in 2015 was 12% and 13% in 2017. CONCLUSION: LARCs were the most often requested contraception, and antepartum counseling has improved. Our hospital policy allowing immediate postpartum LARCs led to the majority of patients receiving their desired method. Whether this has led to a reduction in short interval pregnancies requires further investigation.