Immediate Postpartum Long Acting Reversible Contraception Update
The University of Tennessee Medical Center in Knoxville (UTMCK) serves as a pilot site for the TIPQC statewide initiative to provide immediate postpartum long-acting reversible contraceptive (IPPLARC) access with a patient-centered focus. To assess IPPLARC utilization, some of the measures that are tracked include prenatal contraceptive counseling, the patient’s intended contraceptive plan on arrival, and the contraceptive plan the patient had upon discharged. January 15th through August 30th, 2018, 1,968 women delivered, 936 (47.6%) reported prenatal contraceptive counseling, data were missing for 601 (30.5%). Of women who had prenatal contraceptive counseling, 153 (16.3%) changed their plan, 534 (57.1%) obtained planned postpartum contraception, and data were missing for 249 (26.6%). Women who reported prenatal contraceptive counseling obtained intended postpartum contraception more than those without prenatal contraceptive counseling (77.7% vs 5.7%). A total of 216 women reported IPPLARC as their desired plan, data were missing for 62 (28.7%), and 24 (11.1%) of women faced various barriers obtaining IPPLARC, such as insurance and extended time to delivery after rupture of membranes, and changed their plan. Based on available data, when IPPLARC was the intended plan, women with prenatal contraceptive counseling had more success in obtaining IPPLARC than women without prenatal contraceptive counseling (77.3% versus 7.1%). UTMCK data suggest that prenatal contraceptive counseling aids in the success women have in obtaining their desired contraception and IPPLARC.
