Effect of an educational script on postpartum contraceptive use: a randomized controlled trial.
OBJECTIVE
Short interpregnancy intervals are associated with adverse perinatal outcomes. Increased postpartum use of long-acting reversible contraception (LARC) could reduce short interpregnancy intervals. Therefore, the primary objective of our study was to evaluate if a postpartum educational script about LARC (LARC script) could increase postpartum LARC utilization at the 6-week postpartum visit.


METHODS
We completed a randomized controlled trial (1:1) of 800 postpartum women in Raleigh, North Carolina. Women were recruited from the postpartum unit and randomized to receive (intervention) or not receive (control) the LARC script prior to hospital discharge. We conducted follow-up phone interviews to assess LARC use after their 6-week postpartum visit. We used Pearson's chi-squared test to compare LARC use between arms.


RESULTS
Between May 2011 and January 2012, 400 women were randomized to each arm. Three hundred sixty-nine women (92.3%) in each arm were successfully contacted after their 6-week postpartum visit. LARC use was reported by 17.6% and 13.3% of women in the intervention and control arms, respectively (p=.103).


CONCLUSIONS
The LARC script did not increase LARC utilization at the 6-week postpartum visit. Future studies should evaluate interventions that address both educational and systematic barriers to postpartum LARC uptake.


CONCLUSIONS
Use of a postpartum educational script focused on the intrauterine device and contraceptive implant did not increase their utilization after the 6-week postpartum visit. Future studies should evaluate interventions that address both educational and systematic barriers to postpartum contraceptive uptake.
Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC 27523, USA. Electronic address: jennifer_tang@med.unc.edu.
Jennifer H
JH
Tang
Department of Biostatistics, University of North Carolina, Chapel Hill, NC 27523, USA.
Rosalie C
RC
Dominik
Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC 27523, USA.
Matthew L
ML
Zerden
Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC 27523, USA.
Sarah B
SB
Verbiest
Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC 27523, USA; Department of Obstetrics and Gynecology, WakeMed Health and Hospitals, Raleigh, NC, USA.
Seth C
SC
Brody
Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC 27523, USA.
Gretchen S
GS
Stuart
D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D001294:Attitude to Health; D003268:Contraception Behavior; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D003692:Delayed-Action Preparations / Q000008:administration & dosage; D017135:Desogestrel / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D016304:Hospitals, Private; D006801:Humans; D007434:Intrauterine Devices; D008425:Maternal Behavior; D008875:Middle Aged; D009657:North Carolina; D010353:Patient Education as Topic / Q000379:methods*; D049590:Postpartum Period; D016037:Single-Blind Method; D055815:Young Adult
D003271:Contraceptive Agents, Female; D003692:Delayed-Action Preparations; C044815:etonogestrel; D017135:Desogestrel
Contraception; Contraceptive implant; Intrauterine device; Patient education; Reversible