title: Feasibility and acceptability of introducing routine antenatal contraceptive counselling and provision of contraception after delivery: the APPLES pilot evaluation.
abstract: OBJECTIVE
  To determine the feasibility and acceptability of routine antenatal contraceptive counselling and contraception provision including long-acting reversible contraception (LARC) postpartum.
  
  
  METHODS
  Health service research evaluation.
  
  
  METHODS
  Community antenatal clinics and hospital maternity settings in National Health Service, Scotland UK.
  
  
  METHODS
  Women booked for antenatal care.
  
  
  METHODS
  Contraceptive counselling with a community midwife (22 weeks' gestation) and provision of contraception (with facilitated access to LARC methods) prior to discharge from maternity hospital. Evaluation consisted of (i) self administered questionnaire (32-34 weeks) of women's views of antenatal contraceptive counselling, (ii) database review of contraceptive methods provided at discharge, and (iii) focus groups with midwives and obstetricians.
  
  
  METHODS
  Women's views on antenatal contraceptive counselling. Secondary outcomes included (i) uptake of LARC methods and (ii) barriers and facilitators to providing antenatal counselling and contraception.
  
  
  RESULTS
  There were 1369 women in the cohort. Questionnaires were distributed to 1064 women (78%) and completed by 794 (75%). In all, 78% of respondents (n = 621) discussed contraception antenatally with a community midwife and 74% (n = 461) found this helpful. Although 43% of respondents (n = 341) were planning to use LARC, only 9% of the cohort (118 of 1369) received LARC prior to discharge. Community midwives indicated that antenatal contraceptive counselling was now embedded in their role, but hospital staff indicated that workloads impacted upon ability to provide contraception for women.
  
  
  CONCLUSIONS
  Antenatal contraceptive counselling, delivered by community midwives, is feasible and highly acceptable to women. However, providing contraception and LARC for women before they are discharged home remains a challenge.
  
  
  CONCLUSIONS
  Giving contraceptive advice antenatally is feasible and acceptable.
authors.affiliation: Chalmers Sexual Health Clinic, NHS Lothian, Edinburgh, UK.|Simpson Centre for Reproductive Health, NHS Lothian, Royal Infirmary of Edinburgh, UK.
authors.forename: S T
authors.initials: ST
authors.lastname: Cameron
authors.affiliation: Chalmers Sexual Health Clinic, NHS Lothian, Edinburgh, UK.
authors.forename: A
authors.initials: A
authors.lastname: Craig
authors.affiliation: Public Health, NHS Lothian Waverley Gate, Edinburgh, UK.
authors.forename: J
authors.initials: J
authors.lastname: Sim
authors.affiliation: Public Health, NHS Lothian Waverley Gate, Edinburgh, UK.
authors.forename: A
authors.initials: A
authors.lastname: Gallimore
authors.affiliation: Simpson Centre for Reproductive Health, NHS Lothian, Royal Infirmary of Edinburgh, UK.
authors.forename: S
authors.initials: S
authors.lastname: Cowan
authors.affiliation: Simpson Centre for Reproductive Health, NHS Lothian, Royal Infirmary of Edinburgh, UK.
authors.forename: K
authors.initials: K
authors.lastname: Dundas
authors.affiliation: Chalmers Sexual Health Clinic, NHS Lothian, Edinburgh, UK.
authors.forename: R
authors.initials: R
authors.lastname: Heller
authors.affiliation: Public Health, NHS Lothian Waverley Gate, Edinburgh, UK.
authors.forename: D
authors.initials: D
authors.lastname: Milne
authors.affiliation: Public Health, NHS Lothian Waverley Gate, Edinburgh, UK.
authors.forename: F
authors.initials: F
authors.lastname: Lakha
mesh_terms: D000328:Adult; D003270:Contraceptive Agents / Q000008:administration & dosage*; D003376:Counseling / Q000706:statistics & numerical data*; D005193:Family Planning Services / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005260:Female; D017144:Focus Groups; D006801:Humans; D008880:Midwifery; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010353:Patient Education as Topic / Q000379:methods*; D010865:Pilot Projects; D049590:Postpartum Period; D011247:Pregnancy; D011295:Prenatal Care; D012606:Scotland; D013997:Time Factors; D055815:Young Adult
chemical_list: D003270:Contraceptive Agents
keywords: Antenatal contraceptive counselling; long-acting reversible contraception; postpartum contraception