Timing of postpartum intrauterine device placement: a cost-effectiveness analysis

Washington, Chantel I.; Jamshidi, Roxanne; Thung, Stephen; Nayeri, Unzila A.; Caughey, Aaron B.; Werner, Erika F.

doi:10.1016/j.fertnstert.2014.09.032

Cited by 119 publications

(98 citation statements)

References 17 publications

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“…5–7 These methods have failure rates of <1% for 3–10 years, depending on the method. 8,9 Although only an estimated 11% of parous US women, 15–44 years old, use LARC, 10 use among postpartum women is higher (7–31%).…”

mentioning

confidence: 99%

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

Okoroh

Kane

Gee

et al. 2018

American Journal of Obstetrics and Gynecology

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Rates of short-interval pregnancies that result in unintended pregnancies remain high in the United States and contribute to adverse reproductive health outcomes. Long-acting reversible contraception methods have annual failure rates of <1%, compared with 9% for oral contraceptive pills, and are an effective strategy to reduce unintended pregnancies. To increase access to long-acting reversible contraception in the immediate postpartum period, several State Medicaid programs, which include those in Iowa and Louisiana, recently established reimbursement policies to remove the barriers to reimbursement of immediate postpartum long-acting reversible contraception insertion. We used a mixed-methods approach to analyze 2013–2015 linked Medicaid and vital records data from both Iowa and Louisiana and to describe trends in immediate postpartum long-acting reversible contraception provision 1 year before and after the Medicaid reimbursement policy change. We also used data from key informant interviews with state program staff to understand how provider champions affected policy uptake. We found that the monthly average for the number of insertions in Iowa increased from 4.6 per month before the policy to 6.6 per month after the policy; in Louisiana, the average number of insertions increased from 2.6 per month before the policy to 45.2 per month. In both states, the majority of insertions occurred at 1 academic/teaching hospital. In Louisiana, the additional increase may be due to the engagement of a provider champion who worked at both the state and facility level. Recruiting, training, engaging, and supporting provider champions, as facilitators, with influence at state and facility levels, is an important component of a multipart strategy for increasing successful implementation of state-level Medicaid payment reform policies that allow reimbursement for immediate postpartum long-acting reversible contraception insertions.

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mentioning

confidence: 99%

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

Okoroh

Kane

Gee

et al. 2018

American Journal of Obstetrics and Gynecology

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“…There is evidence from the USA to support the cost-effectiveness of providing PPIUC20 and its availability aligns with many of the current sexual health strategies in the UK 21–23. Demonstrating local service need and identifying key clinician ‘champions’ to present local data on the benefits of a PPIUC service may assist in prioritising the agenda and securing appropriate funding support.…”

Section: Discussionmentioning

confidence: 80%

Community sexual health providers’ views on immediate postpartum provision of intrauterine contraception

Cooper

Boydell

Heller

et al. 2018

BMJ Sex Reprod Health

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Community sexual health providers were positive towards PPIUC implementation, and perceived their role predominantly in the aftercare of women. Several clinical and practical challenges were identified, some of which differ from those previously expressed by other groups. Stakeholder involvement is key to successful implementation of PPIUC, and wider recognition of potential barriers can assist in developing strategies to overcome these.

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“…3,[13][14][15][16] The decreasing of the expulsion rate requires good technical skills during the insertion of the IUD (insertion in uterine fundus with the right instrument, Kelly forceps) and an early follow-up allowing the detection of spontaneous expulsion of the IUD, and the implementation of contraception in order to avoid undesirable pregnancies.…”

Section: Follow-up and Side Effectsmentioning

confidence: 99%

Immediate postpartum insertion of intrauterine devices: experience of maternity ward of the university and teaching hospital of Treichville, Abidjan

Guié

Dia

Okon

et al. 2016

Int J Reprod Contracept Obstet Gynecol

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Timing of postpartum intrauterine device placement: a cost-effectiveness analysis

Cited by 119 publications

References 17 publications

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

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

Community sexual health providers’ views on immediate postpartum provision of intrauterine contraception

Immediate postpartum insertion of intrauterine devices: experience of maternity ward of the university and teaching hospital of Treichville, Abidjan

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