Limited Uptake of Planned Intrauterine Devices During the Postpartum Period.
OBJECTIVE
The primary objective of this study was to determine the percentage of women with a documented plan for postpartum intrauterine device (IUD) insertion who had a device inserted within 8 weeks of delivery. The secondary objective was to determine factors associated with successful initiation of postpartum IUDs as planned.


METHODS
We conducted a retrospective chart review of women who had at least one prenatal visit and delivered a viable pregnancy at our academic medical center. Methods of planned and established postpartum contraceptive methods were recorded, as well as demographic information and documented reasons for failure to initiate planned intrauterine contraception.


RESULTS
A total of 110 women planned postpartum IUD placement. Of these women, 84 (76%) presented for at least one postpartum appointment. Only 22.6% (95% confidence interval 13.7-31.5) of those presenting for postpartum follow-up underwent IUD placement within 8 weeks of delivery. Women planning postpartum IUD insertion were just as likely as women with no planned postpartum contraceptive method to fail to establish contraception within 8 weeks (P = 0.55).


CONCLUSIONS
Failure to establish planned postpartum intrauterine contraception occurs frequently, even in a setting with a high rate of postpartum follow-up.
From the Department of Obstetrics and Gynecology, University of California, Irvine, Orange.
Jennifer
J
Salcedo
From the Department of Obstetrics and Gynecology, University of California, Irvine, Orange.
Natalie
N
Moniaga
From the Department of Obstetrics and Gynecology, University of California, Irvine, Orange.
Tabetha
T
Harken
D000328:Adult; D003267:Contraception / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007434:Intrauterine Devices / Q000706:statistics & numerical data*; D049590:Postpartum Period; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology