Bring back the tubal: An intervention to provide postpartum tubal ligation in the underserved population

Welch, Eva K.; Lindberg, Mary; Mauney, Donald; McLeod, Francine

doi:10.1080/07399332.2020.1805747

Cited by 1 publication

(1 citation statement)

References 29 publications

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“…These types of barriers lend themselves to hospital-initiated quality improvement projects. In one hospital, maternity care providers, nursing, and anesthesia participated in educational sessions regarding postpartum tubal ligation [16 ▪▪ ]. Comparing the first and latter 6 months after study initiation, fulfillment of postpartum tubal ligation requests increased from 39 to 54%.…”

Section: Hospital-level Barriersmentioning

confidence: 99%

Postpartum permanent contraception: updates on policy and access

Henkel

Beshar²,

Goldthwaite³

2021

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of reviewTo describe barriers to provision of postpartum permanent contraception at patient, hospital, and insurance levels. Recent findingsPermanent contraception remains the most commonly used form of contraception in the United States with the majority of procedures performed during birth-hospitalization. Many people live in regions with a high Catholic hospital market share where individual contraceptive plans may be refused based on religious doctrine. Obesity should not preclude an individual from receiving a postpartum tubal ligation as recent studies find that operative time is clinically similar with no increased risk of complications in obese compared with nonobese people. The largest barrier to provision of permanent contraception remains the federally mandated consent for sterilization for those with Medicaid insurance. State variation in enforcement of the Medicaid policy additionally contributes to unequal access and physician reimbursement. Although significant barriers exist in policy that will take time to improve, hospital-based interventions, such as listing postpartum tubal ligation as an 'urgent' procedure or scheduling interval laparoscopic salpingectomy prior to birth-hospitalization discharge can make a significant impact in actualization of desired permanent contraception for patients. SummaryUnfulfilled requests for permanent contraception result in higher rates of unintended pregnancies, loss of self-efficacy, and higher costs. Hospital and federal policy should protect vulnerable populations while not preventing provision of desired contraception.

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Section: Hospital-level Barriersmentioning

confidence: 99%