The negative impact of COVID‐19 on contraception and sexual and reproductive health: Could immediate postpartum LARCs be the solution?

Sheffield, Jill; Townsend, John; Hoope‐Bender, Petra ten; Elliott, Megan; Starrs, Ann; Serour, Gamal I.; Askew, Ian; Musinguzi, Jotham; Arulkumaran, Sabaratnam; Regan, Lesley; Makins, Anita

doi:10.1002/ijgo.13237

Cited by 26 publications

(22 citation statements)

References 15 publications

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“…6 Integration of family planning services with child immunisation services (one of the most equitable and well used health services around the world), or offering family planning immediately post-partum rather than after 6 weeks, can provide unique platforms to integrate family planning and reproductive health care. [6][7] Global and national authorities should consider classifying family planning as an essential health service and emphasising prompt port and customs clearances and distribution logistics for contraceptives. 6 Additionally, ensuring the continuity of funding, including domestic public financing, for family planning services and supplies is crucial.…”

Section: Family Planning In Covid-19 Times: Access For Allmentioning

confidence: 99%

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Family planning in COVID-19 times: access for all

Temmerman¹

2021

The Lancet Global Health

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Section: Family Planning In Covid-19 Times: Access For Allmentioning

confidence: 99%

mentioning

confidence: 99%

Family planning in COVID-19 times: access for all

Temmerman¹

2021

The Lancet Global Health

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“…LARC methods tout their high efficacy at preventing pregnancy, their extended duration of protection, their lower levels of user error, and their suitability during the postpartum period. 4 These perceived advantages over shorter-acting contraceptive methods have led to the rise of the 'LARC-first' approach to contraceptive service provision, in which implants and/or IUDs are presented as the first and best options for most users, with shorteracting methods and fertility awareness-based methods presented last or not at all. 1 5 6 The LARC-first model to contraceptive service provision has been implemented both throughout the Global North and Global South.…”

Section: Bmj Global Healthmentioning

confidence: 99%

‘I haven’t heard much about other methods’: quality of care and person-centredness in a programme to promote the postpartum intrauterine device in Tanzania

et al. 2021

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BackgroundProgrammes promoting the postpartum intrauterine device (PPIUD) have proliferated throughout South Asia and sub-Saharan Africa in recent years, with proponents touting this long-acting reversible contraceptive (LARC) method’s high efficacy and potential to meet contraceptive unmet need. While critiques of LARC-first programming abound in the Global North, there have been few studies of the impact of LARC-centric programmes on patient-centred outcomes in the Global South.MethodsHere, we explore the impact of a PPIUD intervention at five Tanzanian hospitals and their surrounding satellite clinics on quality of contraceptive counselling and person-centred care using 20 qualitative in-depth interviews with pregnant women seeking antenatal care at one of those clinics. Using a modified version of the contraceptive counselling quality framework elaborated by Holt and colleagues, we blend deductive analysis with an inductive approach based on open coding and thematic analysis.ResultsInterpersonal aspects of relationship building during counselling were strong, but a mix of PPIUD intervention-related factors and structural issues rendered most other aspects of counselling quality low. The intervention led providers to emphasise the advantages of the IUD through biased counselling, and to de-emphasise the suitability of other contraceptive methods. Respondents reported being counselled only about the IUD and no other methods, while other respondents reported that other methods were mentioned but disparaged by providers in relation to the IUD. A lack of trained providers meant that most counselling took place in large groups, resulting in providers’ inability to conduct needs assessments or tailor information to women’s individual situations.DiscussionAs implemented, LARC-centric programmes like this PPIUD intervention may decrease access to person-centred contraceptive counselling and to accurate information about a broad range of contraceptive methods. A shift away from emphasising LARC methods to more comprehensive, person-centred contraceptive counselling is critical to promote contraceptive autonomy.

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“…Patients with severe COVID‐19 disease who are taking CHC will usually have treatment discontinued because they would likely be admitted for hospital care. Overall, it might be worth considering the use of long‐acting reversible contraceptives (LARC) or progestin‐based medications for hormonal suppression in COVID‐19‐positive patients 17 . Third, due to the complexity and multifactorial components of CPP, a multidisciplinary approach should be offered to the patient, 18–20 thus applying trauma‐informed care, 21,22 and a shared decision model using a biopsychosocial approach 5,23 .…”

Section: How To Approach Cpp Patientsmentioning

confidence: 99%