Abstract
Provision of immediate postpartum intrauterine device (PPIUD) insertion within maternity settings can overcome many of the barriers faced by women in accessing this method after childbirth. Uptake of PPIUD can help reduce the risk of a subsequent unintended pregnancy and improve spacing between births. PPIUD insertion is not yet routinely available in the UK and evidence to support the practical implementation of the service in this setting is lacking. Shared learning and experience of providers may assist in the wider availability of PPIUD. A routine PPIUD service has been successfully established within a public maternity setting in Edinburgh (UK) and this article utilizes an implementation framework to discuss the approach.
Highlights
It is estimated that at least one-third of births in the UK are not intended at conception.[1]
Provision of immediate postpartum intrauterine device (PPIUD) insertion within maternity settings can overcome many of the barriers faced by women in accessing this method after childbirth
Uptake of PPIUD can help reduce the risk of a subsequent unintended pregnancy and improve spacing between births
Summary
It is estimated that at least one-third of births in the UK are not intended at conception.[1]. In the 2 years prior to PPIUD service arrival, routine prenatal contraceptive counselling was introduced to the region in conjunction with increased awareness and general training in postpartum contraceptive methods for maternity staff At this time, more than half (58%) of those women who expressed desire for a postpartum IUD did not attend a follow-up appointment for insertion,[22] reflecting findings from other studies that the additional visit for insertion was a significant barrier to uptake.[18] This provided justification to introduce PPIUD within a maternity culture already geared toward enhanced contraceptive services. Vaginal PPIUD available across all sites Full PPIUD implementation: 900+ women have received PPIUD to date
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