Personalized contraceptive assistance and uptake of long-acting, reversible contraceptives by postpartum women: a randomized, controlled trial

Barriers to Receiving Long-acting Reversible Contraception in the Postpartum Period

“…The barriers to LARC that we identified (requirements for additional visits, missed appointments, not having the LARC of choice available, and financial constraints) are similar to those reported by others (Glazer, Wolf, & Gorby, 2011;Secura et al, 2014;Ogburn, Espey, & Stonehocker, 2005;Simmons, Edelman, Li, Yanit, & Jensen, 2013; U.S. Department of Health and Human Services, 2012). In a recent review of barriers for adolescents interested in LARC, reported mean out-of-pocket expenses for those without insurance for a LARC device and insertion exceeded $1,000 (Eisenberg, McNicholas, & Peipert, 2013).…”

“…barriers to LARC by allocating postpartum women to receiving a personal assistant to facilitate contraception compared with standard care, and the study concluded that the personal assistant did not increase LARC uptake (Simmons et al, 2013). The study found that key barriers to LARC initiation included inaccurate provider counseling, financial limitation, and challenges with postpartum clinic visits and scheduling.…”

“…Interventions to overcome barriers to postpartum LARC have been attempted with varying success (Baldwin & Edelman, 2013;Chen et al, 2010;Simmons et al, 2013;Tang et al, 2014;Tocce, Sheeder, & Teal, 2012). None of these studies included interventions that would eliminate specifically the most common barriers encountered in our subgroup analysis.…”

Do Knowledge and Attitudes Regarding Intrauterine Devices Predict Interest in Their Use?

“…The stages -precontemplation, contemplation, preparation, action, and maintenance -represent a developmental sequence of behavior change, though the path to change is not necessarily linear. As relevant to IUD decision-making, much research has focused on action, particularly on IUD use and uptake (Romer & Teal, 2013;Secura, Allsworth, Madden, Mullersman, & Peipert, 2010;Simmons, Edelman, Li, Yanit, & Jensen, 2013). Examining IUD interest provides the opportunity to understand an alternative stage of the cognitive process in which contraceptive decisions are made.…”

Interpregnancy care

“…It can equally support effective use of contraceptive methods, particularly among women who need support to achieve healthy interpregnancy intervals. 32,33 Interconception care also has been used to provide support for families following a perinatal loss (e.g., fetal or infant death). 34 At the core of these efforts is a focus on women with prior adverse pregnancy outcomes using approaches similar to those in disease management programs, including intensive care coordination and effective treatment for underlying medical issues.…”