Immediate Postpartum Contraception: Intrauterine Device Insertion

Escobar, Melicia; Shearin, Stacey

doi:10.1111/jmwh.12984

Cited by 12 publications

(17 citation statements)

References 28 publications

(57 reference statements)

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“…Method continuation in the current study was found to be high (86%) at one year of follow-up which is comparable or better than the 55-82% commonly reported by many other published studies [3,20,[27][28][29][30][31]. Moreover, the most vulnerable period for PPIUD discontinuation was that period after the puerperium to six months of delivery (i.e., 43-180 days) contrary to the period of up to 6 weeks post-delivery that is reported to be critical for IUD related complications and removal in some earlier studies [32,33].…”

Section: Discussionsupporting

confidence: 83%

A one-year cohort study of complications, continuation, and failure rates of postpartum TCu380A in Tanzania

Muganyizi

Kimario²,

Paul³

et al. 2020

Reprod Health

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Background Less than 1% of married women in Tanzania use an Intrauterine Contraceptive Device (IUD) for contraception. An initiative by the International Federation of Gynecology and Obstetrics (FIGO) has been in progress since 2015 resulting in escalated method uptake in implementing hospitals. This study investigates failure rate, complications, and risk factors for one-year continuation of TCu380A IUD when used for immediate postpartum contraception under the initiative in Tanzania. Methodology A prospective cohort study of women who had TCu380A insertion within 48 h of delivery in 6 hospitals in Tanzania between 1st December 2017 and 18th April 2018 was conducted. Face to face post insertion interviews were made with 1114 clients before discharge and later through phone calls up to the beginning of 13th month postpartum. Postpartum Intrauterine Device (PPIUD) continuation status, complications, duration of time they stayed with the IUD and the currently used method if PPIUD was discontinued were enquired. The outcome variable was PPIUD continuation at one year of IUD insertion. Data were analyzed using Statistical Product and Service Solutions software (SPSS) for Windows version 20 (IBM SPSS Statistics, Chicago, IL, USA). Results In total 511(45.8%)clients had consented and availed to complete the one-year follow-up. Out of these, 440 still had IUD, giving a one-year continuation rate of 86.1%. Most (63%) IUD discontinuations occurred in the period between 7th week and 6 months of insertion. One-year method expulsion rate was 2.1%. There was one reported pregnancy that gives a method failure rate of about 2 per 1000. The independent risk factors in favor of method continuation at one year were absence of medical or social problem, being a youth (16–24 years), and delivery by Cesarean section. Conclusions The continuation rate when CuT380A is used for immediate postpartum contraception is high, with low complication and failure rates. Some medical and social factors are important for method continuation, hence the need to consider in training, counselling and advocacy.

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Section: Discussionsupporting

confidence: 83%

A one-year cohort study of complications, continuation, and failure rates of postpartum TCu380A in Tanzania

Muganyizi

Kimario²,

Paul³

et al. 2020

Reprod Health

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“…Immediate postpartum LARC refers to either an intrauterine device (IUD; either copper‐ or levonorgestrel‐containing devices) or subdermal etonogestrel implant that is inserted any time after placental expulsion up to 72 hours postpartum regardless of mode of birth . These methods are widely endorsed as safe contraceptive options, with very few contraindications, for those who wish to prevent pregnancy after birth .…”

Section: Immediate Postpartum Larc In the United Statesmentioning

confidence: 99%

“…Emerging guidelines and quality measures emphasize the efficacy of immediate postpartum LARC methods as first‐line contraception, potentially enabling many patients to meet their postpartum reproductive goals . However, although remaining enthusiastic about the potential, authors in the fields of family planning, bioethics, and health policy have cautioned against coercion and have encouraged clinicians to adopt a reproductive justice framework when approaching LARC policies and provision of care .…”

Section: Immediate Postpartum Larc In the United Statesmentioning

confidence: 99%

“…A timeline for education and shared decision making can also be established. Ideally, this should occur prenatally, at any appropriate time during the intrapartum period, and again in the immediate postpartum period prior to insertion . Implementation efforts should also strive to include accessible removal and replacement services and to have a ready back‐up plan if immediate postpartum LARC insertion is contraindicated , to promote autonomy at an institutional level.…”

Section: Addressing Barriersmentioning

confidence: 99%

See 1 more Smart Citation

Midwifery Role in the Provision of Immediate Postpartum Long‐Acting Reversible Contraception: Ensuring Reproductive Justice

Escobar

2019

J Midwife Womens Health

Self Cite

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“…Intrauterine contraceptive device (IUD) is one of the most effective methods for family planning [1]. Available evidence suggest that the timing of IUD insertion immediately postpartum has important implications on acceptance, complications and continuation of the method [1][2][3]. Moreover, studies have shown that the immediate postpartum period provides an ample chance for a convenient and costeffective contraceptive option particularly in settings where women do not usually return for follow-up visits because of distance or socioeconomic reasons [1,2].…”

Section: Introductionmentioning

confidence: 99%

A one-year cohort study of complications, continuation, and failure rates of postpartum TCu380A in Tanzania

Rwegoshora

Muganyizi

Kimario³

et al. 2020

Preprint

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Background: Less than 1% of married women in Tanzania use an Intrauterine Contraceptive Device (IUD) for contraception. An initiative by the International Federation of Gynecology and Obstetrics (FIGO) has been in progress since 2015 resulting in escalated method uptake in implementing hospitals. This study investigates failure rate, complications, and risk factors for one-year continuation of TCu380A IUD when used for immediate postpartum contraception under the initiative in Tanzania Methodology: A prospective cohort study of women who had TCu380A insertion within 48 hours of delivery in 6 hospitals in Tanzania between 1st December 2017 and 18th April 2018 was conducted. Face to face post insertion interviews were made with 1114 clients before discharge and later through phone calls up to the beginning of 13th month postpartum. Postpartum Intrauterine Device (PPIUD) continuation status, complications, duration of time they stayed with the IUD and the currently used method if PPIUD was discontinued were enquired. The outcome variable was PPIUD continuation at one year of IUD insertion. Data were analyzed using Statistical Product and Service Solutions software (SPSS) for Windows version 20 (IBM SPSS Statistics, Chicago, IL, USA). Results: In total 511(45.8%)clients had consented and availed to complete the one-year follow-up. Out of these, 440 still had IUD, giving a one-year continuation rate of 86.1%. Most (63%) IUD discontinuations occurred in the period between 7th week and 6 months of insertion. One-year method expulsion rate was 2.1%. There was one reported pregnancy that gives a method failure rate of about 2 per 1000. The independent risk factors in favor of method continuation at one year were absence of medical or social problem, being a youth (16-24 years), and delivery by Cesarean section. Conclusions: The continuation rate when CuT380A is used for immediate postpartum contraception is high, with low complication and failure rates. Some medical and social factors are important for method continuation, hence the need to consider in training, counselling and advocacy.

show abstract

Immediate Postpartum Contraception: Intrauterine Device Insertion

Cited by 12 publications

References 28 publications

A one-year cohort study of complications, continuation, and failure rates of postpartum TCu380A in Tanzania

A one-year cohort study of complications, continuation, and failure rates of postpartum TCu380A in Tanzania

Midwifery Role in the Provision of Immediate Postpartum Long‐Acting Reversible Contraception: Ensuring Reproductive Justice

A one-year cohort study of complications, continuation, and failure rates of postpartum TCu380A in Tanzania

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