Prenatal Video-Based Contraceptive Counseling and Postpartum LARC Uptake: A Randomized Controlled Trial [32A

Abstract

INTRODUCTION: Increasing access to long-acting reversible contraception (LARC) in the postpartum period can improve inter-pregnancy intervals and possibly prevent some of the associated infant and maternal morbidities. Videos are understudied as a tool to improve postpartum LARC use. Our primary goal is to evaluate if a validated, evidence-based, free counseling video during prenatal care increases postpartum LARC use. METHODS: We randomized women receiving prenatal care at an academic obstetric clinic to receive LARC FIRST video contraceptive counseling or routine prenatal care. All participants received information on free LARC methods in the postpartum period. The primary outcome was LARC placement by 12 weeks postpartum, with a secondary outcome of overall contraception use at 12 weeks postpartum. The primary outcome was analyzed using chi-square testing and logistic regression. RESULTS: Eighty-four participants were enrolled. To date, 80 have reached the 12 week postpartum period, of which 63 (78.75%) have completed all follow-up. Thirty were randomized to view the LARC FIRST video; 33 to routine prenatal care. LARC placement by 12 weeks postpartum was 14/30 (46.66%) versus 10/33 (30.30%), respectively. Any contraceptive method use at 12 weeks postpartum was reported by 28/30 (93.33%) and 25/33 (76.76%) participants in the LARC FIRST video versus routine prenatal care groups. We anticipate completing data collection on remaining participants by 10/17/2016. CONCLUSION: Video-based contraception counseling improved postpartum LARC rates with high levels of satisfaction. Widespread use of the LARC FIRST video has the potential to improve prenatal contraceptive counseling and reduce rapid, repeat unintended pregnancy.