Trends in Contraceptive Choices Among Patients Delayed in Receiving Bilateral Tubal Ligation Because of the COVID-19 Pandemic [ID: 1371694

Abstract

INTRODUCTION: The COVID-19 pandemic led to a decline in access to elective surgeries and contraceptive care. Today, there remains a backlog of patients awaiting elective female sterilization. The use of alternative contraception during delays has yet to be explored. To address this gap, patients awaiting sterilization were surveyed to evaluate trends in contraception usage. METHODS: Patients at Ben Taub Hospital who desired tubal ligation between March 2020 and July 2022 were called and asked to complete a 23-question survey, which assessed obstetric history, current contraceptive usage, and demographics. Patients were called up to three times, and descriptive statistics were analyzed. RESULTS: Of 217 patients, 123 consented to the survey (56%). Respondents almost entirely identified as Black, Indigenous, and people of color (BIPOC), with 83% of surveys administered in Spanish. The average age was 36. While awaiting sterilization, 85% used an alternative form of contraception, with Depo-Provera (Depo) and oral contraceptive pills (OCPs) being the most common. 28.5% of Depo users endorsed missing injections. Thirty-eight percent of patients using OCPs reported missing doses. Thirty-two percent reported undesirable side effects of their contraceptive, such as pain or irregular bleeding. Overall, 58% were satisfied with their current contraceptive method with 89% still desiring tubal ligation. In total, there were six unplanned pregnancies. CONCLUSION: Despite extensive COVID-19-related delays in sterilization, most patients still desired the procedure. Patients most commonly chose Depo and OCPs for contraception to bridge the delay, as opposed to long-acting reversible contraceptives.