PMID- 30455978
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220330
IS  - 2055-7426 (Electronic)
IS  - 2055-7426 (Linking)
VI  - 3
DP  - 2018
TI  - Ongoing barriers to immediate postpartum long-acting reversible contraception: a 
      physician survey.
PG  - 23
LID - 10.1186/s40834-018-0078-5 [doi]
LID - 23
AB  - BACKGROUND: Postpartum women are at risk for unintended pregnancy. Access to 
      immediate long-acting reversible contraception (LARC) may help decrease this 
      risk, but it is unclear how many providers in the United States routinely offer 
      this to their patients and what obstacles they face. Our primary objective was to 
      determine the proportion of United States obstetric providers that offer 
      immediate postpartum LARC to their obstetric patients. METHODS: We surveyed 
      practicing Fellows and Junior Fellows of the American College of Obstetricians 
      and Gynecologists (ACOG) about their use of immediate postpartum LARC. These 
      members are demographically representative of ACOG members as a whole and 
      represent all of the ACOG districts. Half of these Fellows were also part of the 
      Collaborative Ambulatory Research Network (CARN), a group of ACOG members who 
      voluntarily participate in research. We asked about their experience with and 
      barriers to immediate placement of intrauterine devices and contraceptive 
      implants after delivery. RESULTS: There were a total of 108 out of 600 responses 
      (18%). Participants practiced in a total of 36 states and/or US territories and 
      their median age was 52 years. Only 26.9% of providers surveyed offered their 
      patients immediate postpartum LARC, and of these providers, 60.7% work in a 
      university-based practice. There was a statistically significant association 
      between offering immediate postpartum LARC and practice type, with the majority 
      of providers working at a university-based practice (p < 0.001). Multiple 
      obstacles were identified, including cost or reimbursement, device availability, 
      and provider training on device placement in the immediate postpartum period. 
      CONCLUSION: The majority of obstetricians surveyed do not offer immediate 
      postpartum long-acting reversible contraception to patients in the United States. 
      This is secondary to multiple obstacles faced by providers.
FAU - Holden, Emily C
AU  - Holden EC
AUID- ORCID: 0000-0001-9568-1045
AD  - 1Obstetrics, Gynecology and Women's Health, Rutgers-New Jersey Medical School, 
      185 South Orange Avenue, E-level, Newark, NJ 07103 USA. ISNI: 0000 0000 8692 
      8176. GRID: grid.469131.8
FAU - Lai, Erica
AU  - Lai E
AD  - 1Obstetrics, Gynecology and Women's Health, Rutgers-New Jersey Medical School, 
      185 South Orange Avenue, E-level, Newark, NJ 07103 USA. ISNI: 0000 0000 8692 
      8176. GRID: grid.469131.8
FAU - Morelli, Sara S
AU  - Morelli SS
AD  - 1Obstetrics, Gynecology and Women's Health, Rutgers-New Jersey Medical School, 
      185 South Orange Avenue, E-level, Newark, NJ 07103 USA. ISNI: 0000 0000 8692 
      8176. GRID: grid.469131.8
AD  - 2Reproductive Endocrinology and Infertility, University Reproductive Associates, 
      214 Terrace Avenue, Hasbrouck Heights, NJ 07604 USA. GRID: grid.488614.7
FAU - Alderson, Donald
AU  - Alderson D
AD  - 3Rutgers University Biostatistics and Epidemiology Services Center, Rutgers 
      University, 65 Bergen St, Newark, NJ 07103 USA. ISNI: 0000 0004 1936 8796. GRID: 
      grid.430387.b
FAU - Schulkin, Jay
AU  - Schulkin J
AD  - 4Department of Obstetrics and Gynecology, University of Washington, Box 356460, 
      Seattle, WA 98195-6460 USA. ISNI: 0000000122986657. GRID: grid.34477.33
FAU - Castleberry, Neko M
AU  - Castleberry NM
AD  - 5American College of Obstetricians and Gynecologists, 409 12th Street, SW, 
      Washington, DC 2002420024-9998 USA. ISNI: 0000 0000 8947 8158. GRID: 
      grid.417943.c
FAU - McGovern, Peter G
AU  - McGovern PG
AD  - 1Obstetrics, Gynecology and Women's Health, Rutgers-New Jersey Medical School, 
      185 South Orange Avenue, E-level, Newark, NJ 07103 USA. ISNI: 0000 0000 8692 
      8176. GRID: grid.469131.8
AD  - 2Reproductive Endocrinology and Infertility, University Reproductive Associates, 
      214 Terrace Avenue, Hasbrouck Heights, NJ 07604 USA. GRID: grid.488614.7
LA  - eng
PT  - Journal Article
DEP - 20181108
PL  - England
TA  - Contracept Reprod Med
JT  - Contraception and reproductive medicine
JID - 101703414
PMC - PMC6222995
OTO - NOTNLM
OT  - Immediate postpartum long-acting reversible contraception
COIS- This study was approved by the Rutgers Health Sciences Institutional Review Board 
      (Newark, NJ). Project number: Pro20170000321. It was initially approved on 
      4/10/17.Not applicable.The authors declare that they have no competing 
      interests.Springer Nature remains neutral with regard to jurisdictional claims in 
      published maps and institutional affiliations.
EDAT- 2018/11/21 06:00
MHDA- 2018/11/21 06:01
PMCR- 2018/11/08
CRDT- 2018/11/21 06:00
PHST- 2018/06/27 00:00 [received]
PHST- 2018/10/09 00:00 [accepted]
PHST- 2018/11/21 06:00 [entrez]
PHST- 2018/11/21 06:00 [pubmed]
PHST- 2018/11/21 06:01 [medline]
PHST- 2018/11/08 00:00 [pmc-release]
AID - 78 [pii]
AID - 10.1186/s40834-018-0078-5 [doi]
PST - epublish
SO  - Contracept Reprod Med. 2018 Nov 8;3:23. doi: 10.1186/s40834-018-0078-5. 
      eCollection 2018.