Obstetrician–Gynecologists and contraception: long-acting reversible contraception practices and education

California Family Planning Health Care Providers' Challenges to Same-Day Long-Acting Reversible Contraception Provision

“…18,19 As a whole, the program has observed a steady increase in IUD and implant provision. 20 Our findings demonstrate that 42% of the California practices that provide IUDs can offer same-day placement, which is substantially higher than the 7% reported in 2006 among a similar sample 14 and higher than the 13% reported more recently among a national sample of obstetrician-gynecologists, 12 suggesting improvements in health care provider capacity. This change in the ability to offer IUDs in one visit may be a result of new professional guidelines recommending same-day IUD provision 21 in conjunction with health care providers' more favorable views about IUDs.…”

“…This change in the ability to offer IUDs in one visit may be a result of new professional guidelines recommending same-day IUD provision 21 in conjunction with health care providers' more favorable views about IUDs. 12,[22][23][24] However, significant obstacles to same-day provision still exist. Same-day provision was not an option for the large number of practices that did not offer these methods onsite.…”

“…In a national survey, 13% of obstetrician-gynecologists reported that they offered IUDs in a single visit. 12 Similarly, data from family planning clinic directors in Colorado and Iowa indicated that a small minority of agencies typically offered IUDs (18%) or implants (36%) in one visit. Multiple visits were mostly required to conduct screening tests and for patient decision-making.…”

California Family Planning Health Care Providers’ Challenges to Same-Day Long-Acting Reversible Contraception Provision

“…18,19 As a whole, the program has observed a steady increase in IUD and implant provision. 20 Our findings demonstrate that 41% of the California practices that provide IUDs can offer same-day placement, which is substantially higher than the 7% reported in 2006 among a similar sample 14 and higher than the 13% reported more recently among a national sample of obstetrician-gynecologists, 12 suggesting improvements in health care provider capacity. This change in the ability to offer IUDs in one visit may be a result of new professional guidelines recommending same-day IUD provision 21 in conjunction with health care providers' more favorable views about IUDs.…”

Policy change is not enough: engaging provider champions on immediate postpartum contraception

“…For instance, a survey of 1221 obstetricians/gynecologists found that, although almost all offered IUDs, fewer offered implants, with 32% of respondents citing lack of insertion training as a barrier to offering the implant. 12 Additionally, a major system-level barrier to immediate post-partum LARC insertion is its high cost, which historically has not been reimbursed outside of the bundled obstetrics delivery rate. 13,14 To address this, several state Medicaid programs recently established policies and issued guidance to support inpatient reimbursement of LARC insertion and device placement immediately after delivery.…”