title: Six-month and 1-year continuation rates following postpartum insertion of implants and intrauterine devices.
abstract: OBJECTIVE
  Studies show immediate postpartum (PP) insertion increases use of contraceptive implants and intrauterine devices (IUDs). Our objective was to compare the satisfaction and continuation rates of the two types of devices at 6 months and 1 year following PP insertion.
  
  
  METHODS
  We enrolled 133 women in a prospective cohort study following immediate PP insertion of an implant or IUD at two academic hospitals during 8 months of 2011. Subjects completed an enrollment survey during hospital admission and a follow-up phone survey 6 months and 1 year PP.
  
  
  RESULTS
  At 6 months PP, 72% of subjects provided follow-up information. Implant users were more likely to be using the originally-placed device (40/41, 98% vs. 45/55, 82%, p=0.02); nine women reported IUD expulsions. When accounting for replacement of expelled IUDs, IUD continuation at 6 months was 89% yielding similar continuation rates between groups (p=0.12). At 1 year PP, 51% provided follow-up. Of those, 82% still had a LARC method in place with similar continuation by device type (84% for implants, 81% for IUDs, p=0.96). Overall, satisfaction was similarly high in both groups.
  
  
  CONCLUSIONS
  Due to IUD expulsion, implants had a higher continuation rate than IUDs six months following immediate PP insertion. After replacement of expelled IUDs, continuation and satisfaction were similar for both devices at 6 months and 1 year.
  
  
  CONCLUSIONS
  Placement of implants and IUDs immediately PP can lead to high satisfaction. Despite early IUD expulsions, continuation rates were similar to those placed outside of the immediate PP period.
authors.affiliation: Gynecology and Obstetrics, Johns Hopkins Institution, 600 North Wolfe Street, Phipps 279 Baltimore, MD, USA, 21287. Electronic address: iwoo30@gmail.com.
authors.forename: Irene
authors.initials: I
authors.lastname: Woo
authors.affiliation: Gynecology and Obstetrics, Johns Hopkins Institution, 600 North Wolfe Street, Phipps 279 Baltimore, MD, USA, 21287.
authors.forename: Sara
authors.initials: S
authors.lastname: Seifert
authors.affiliation: Howard University College of Medicine, 520 W St North West, Washington DC, USA, 20059.
authors.forename: Dacia
authors.initials: D
authors.lastname: Hendricks
authors.affiliation: Department of Family Planning, John Hopkins Bayview Medical Center, 4940 Eastern Ave Baltimore, MD, USA, 21224.
authors.forename: Roxanne M
authors.initials: RM
authors.lastname: Jamshidi
authors.affiliation: Department of Family Planning, John Hopkins Bayview Medical Center, 4940 Eastern Ave Baltimore, MD, USA, 21224.
authors.forename: Anne E
authors.initials: AE
authors.lastname: Burke
authors.affiliation: Department of Family Planning, John Hopkins Bayview Medical Center, 4940 Eastern Ave Baltimore, MD, USA, 21224.
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Fox
mesh_terms: D000328:Adult; D003267:Contraception / Q000379:methods / Q000706:statistics & numerical data*; D003271:Contraceptive Agents, Female / Q000627:therapeutic use*; D004343:Drug Implants / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007433:Intrauterine Device Expulsion; D007434:Intrauterine Devices / Q000009:adverse effects / Q000706:statistics & numerical data*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D049590:Postpartum Period; D011247:Pregnancy; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D003271:Contraceptive Agents, Female; D004343:Drug Implants
keywords: Long acting reversible contraception; contraception compliance; contraception continuation; postpartum contraception