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Long-Acting Reversible Contraception

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41. Long-acting reversible contraceptive use in the post-abortion period among women seeking abortion in mainland China: intentions and barriers (PubMed)

Long-acting reversible contraceptive use in the post-abortion period among women seeking abortion in mainland China: intentions and barriers This study aimed to describe the intentions of and barriers to the use of long-acting reversible contraceptives (LARCs) in the post-abortion period among women seeking abortion in mainland China.A cross-sectional study was conducted from July 2015 to December 2015 using a waiting room questionnaire. A total of 381 women seeking abortions were recruited

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2018 Reproductive health

42. High parity predicts use of long-acting reversible contraceptives in the extended postpartum period among women in rural Uganda (PubMed)

High parity predicts use of long-acting reversible contraceptives in the extended postpartum period among women in rural Uganda The use of implants and Intra-uterine devices (IUD) during the post-partum period is very low in Uganda especially in rural settings. Long-acting reversible contraceptives (LARC) are known to be the most cost-effective for prevention of unintended pregnancy and unsafe abortions. This study aimed at determining the factors associated with long-acting reversible (...) contraceptive use among women in the extended postpartum period in rural Uganda.We conducted a household-based, cross-sectional study among 400 women in two rural communities in Mityana district, central Uganda. Eligible women were aged 15 to 45 years who had childbirth within 12 months of study enrollment in September 2014. The outcome variable was self-reported use of a LARC method, either IUD or implants in the extended postpartum period. The main independent variables were previous childbirths (parity

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2018 Contraception and Reproductive Medicine

43. Ongoing barriers to immediate postpartum long-acting reversible contraception: a physician survey (PubMed)

Ongoing barriers to immediate postpartum long-acting reversible contraception: a physician survey 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 (...) 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.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.

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2018 Contraception and Reproductive Medicine

44. Induced Abortion in a Population Entitled to Free-of-Charge Long-Acting Reversible Contraception. (PubMed)

Induced Abortion in a Population Entitled to Free-of-Charge Long-Acting Reversible Contraception. To study the rate of induced abortion in a population in whom long-acting reversible contraceptive (LARC) methods are offered free of charge as part of primary health care services.We conducted a register-based cohort study on females aged 15-44 years in the city of Vantaa, Finland. We assessed the rate of abortion among females entitled to LARC methods free of charge by survival analysis in four

2018 Obstetrics and Gynecology

45. Availability of long-acting reversible contraceptives in Los Angeles County clinics through a Medicaid state plan amendment program. (PubMed)

Availability of long-acting reversible contraceptives in Los Angeles County clinics through a Medicaid state plan amendment program. To assess the availability of long acting reversible contraceptive (LARC) methods in Los Angeles County through providers participating in a California State Medicaid State Plan Amendment Program called Family Planning, Access, Care and Treatment (Family PACT).This was a cross-sectional telephone survey utilizing "secret shopper" methodology. From 855 Family PACT

2018 Contraception

46. Prenatal intent and postpartum receipt of long-acting reversible contraception among women receiving medication-assisted treatment for opioid use disorder. (PubMed)

Prenatal intent and postpartum receipt of long-acting reversible contraception among women receiving medication-assisted treatment for opioid use disorder. Many women with opioid use disorder (OUD) do not use highly effective postpartum contraception such as long-acting reversible contraception (LARC). We evaluated factors associated with prenatal intent and postpartum receipt of LARC among women receiving medication-assisted treatment (MAT) for OUD.This was a retrospective cohort study of 791 (...) pregnant women with OUD on MAT who delivered at an academic institution without immediate postpartum LARC services between 2009 and 2012. LARC intent was defined as a documented plan for postpartum LARC during pregnancy and LARC receipt was defined as documentation of LARC placement by 8 weeks postpartum. We organized contraceptive methods into five categories: LARC, female sterilization, short-acting methods, barrier methods and no documented method. Multivariable logistic regression identified

2018 Contraception

47. Effective, recommended, underutilized: a review of the literature on barriers to adolescent usage of long-acting reversible contraceptive methods. (PubMed)

Effective, recommended, underutilized: a review of the literature on barriers to adolescent usage of long-acting reversible contraceptive methods. Teenage pregnancy rates in the United States remain at epidemic proportions. To help stem the tide of adolescent pregnancy, both the American Academy of Pediatrics and American College of Obstetricians and Gynecologists have released policy statements that long-acting reversible contraceptives (LARC) be considered the first-line option (...) for contraception in adolescents. Despite the recommendations and efficacy, LARCs are utilized by less than 5% of American teens. The purpose of this review is to elucidate the barriers to adolescent access to LARC, which are broken down into provider, patient, and cultural barriers.Recent literature suggests that shortcomings in physician training in LARC method counseling and placement begin as early as medical school and are further augmented by the clinical cost and logistical difficulty of device placement

2018 Current Opinion in Pediatrics

48. Patient-Perceived Autonomy and Long-Acting Reversible Contraceptive Use: A Qualitative Assessment in a Midwestern, University Community (PubMed)

Patient-Perceived Autonomy and Long-Acting Reversible Contraceptive Use: A Qualitative Assessment in a Midwestern, University Community Long-acting reversible contraceptives (LARCs) are the most effective contraceptives and are first-line recommendations for most women. However, young women use these methods at relatively low rates. Given concern with contraceptive coercion, an underexamined factor contributing to LARC attitudes is women's perceived reproductive and bodily autonomy in regard (...) to LARC. We conducted focus group discussions and interviews regarding LARC perceptions and knowledge with 50 women between the ages of 18 and 29. We used a modified grounded theory approach to analyze young women's impressions of autonomy in relation to contraceptives more generally and LARC more specifically, both among ever-users and never-users. Four themes emerged regarding women's perceived autonomy with LARC. Control over pregnancy, active participation versus external agent, control over

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2018 BioResearch open access

49. Unintended pregnancy and subsequent postpartum long-acting reversible contraceptive use in Zimbabwe (PubMed)

Unintended pregnancy and subsequent postpartum long-acting reversible contraceptive use in Zimbabwe The postpartum period is an opportune time for contraception adoption, as women have extended interaction with the reproductive healthcare system and therefore more opportunity to learn about and adopt contraceptive methods. This may be especially true for women who experience unintended pregnancy, a key target population for contraceptive programs and programs to eliminate mother-to-child HIV (...) this association differed by women's HIV status. Finally, we examined the association between pregnancy intention and changes in contraception from the pre- to postpartum periods.Findings suggest that women who reported that their pregnancy was unintended adopted less modern (all non-traditional) contraceptive methods overall, but adopted long-acting reversible contraception (LARC) more frequently than women reporting an intended pregnancy (OR 1.41; CI 1.18, 1.68). Among HIV-positive women, this relationship

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2018 BMC women's health

50. Medicaid and receipt of interval postpartum long-acting reversible contraception. (PubMed)

Medicaid and receipt of interval postpartum long-acting reversible contraception. We sought to evaluate the impact of insurance type on receipt of an interval postpartum LARC, controlling for demographic and clinical factors.This is a retrospective cohort study of 1072 women with a documented plan of LARC for contraception at time of postpartum discharge. This is a secondary analysis of 8654 women who delivered at 20 weeks or beyond from January 1, 2012, through December 31, 2014, at an urban

2018 Contraception

51. Continuation of long-acting reversible contraceptives among Medicaid patients. (PubMed)

Continuation of long-acting reversible contraceptives among Medicaid patients. Our objective was to compare continuation and complication rates of subdermal etonogestrel implants and intrauterine devices (IUDs) using Medicaid insurance claims.We performed a retrospective cohort study using insurance claims data for 15- to 44-year-old subjects receiving implants or IUDs from 2012 to 2015 in a Medicaid managed care organization in Washington, DC, and Maryland. We performed a planned Kaplan-Meier (...) survival analysis for long-acting reversible contraceptive (LARC) continuation, defined as the absence of a claim for LARC removal, during periods of continuous insurance plan enrollment.Three thousand one hundred three subjects received 1335 implants and 1970 IUDs, with implants more common than IUDs among subjects 15-19 years old (rate ratio=2.42), and implants less common than IUDs for subjects 20-44 years old (rate ratio=0.54). Implants had higher continuation rates at 1 year than IUDs (81.0% vs

2018 Contraception

52. ACOG Committee Opinion No. 735 Summary: Adolescents and Long-Acting Reversible Contraception: Implants and Intrauterine Devices. (PubMed)

ACOG Committee Opinion No. 735 Summary: Adolescents and Long-Acting Reversible Contraception: Implants and Intrauterine Devices. The phenomenon of adolescent childbearing is complex and far reaching, affecting not only the adolescents but also their children and their community. The prevalence and public health effect of adolescent pregnancy reflect complex structural social problems and an unmet need for acceptable and effective contraceptive methods in this population. In 2006-2010, 82 (...) % of adolescents at risk of unintended pregnancy were currently using contraception, but only 59% used a highly effective method, including any hormonal method or intrauterine device. Long-acting reversible contraceptives (LARC) have higher efficacy, higher continuation rates, and higher satisfaction rates compared with short-acting contraceptives among adolescents who choose to use them. Complications of intrauterine devices and contraceptive implants are rare and differ little between adolescents and women

2018 Obstetrics and Gynecology

53. ACOG Committee Opinion No. 735: Adolescents and Long-Acting Reversible Contraception: Implants and Intrauterine Devices. (PubMed)

ACOG Committee Opinion No. 735: Adolescents and Long-Acting Reversible Contraception: Implants and Intrauterine Devices. The phenomenon of adolescent childbearing is complex and far reaching, affecting not only the adolescents but also their children and their community. The prevalence and public health effect of adolescent pregnancy reflect complex structural social problems and an unmet need for acceptable and effective contraceptive methods in this population. In 2006-2010, 82 (...) % of adolescents at risk of unintended pregnancy were currently using contraception, but only 59% used a highly effective method, including any hormonal method or intrauterine device. Long-acting reversible contraceptives (LARC) have higher efficacy, higher continuation rates, and higher satisfaction rates compared with short-acting contraceptives among adolescents who choose to use them. Complications of intrauterine devices and contraceptive implants are rare and differ little between adolescents and women

2018 Obstetrics and Gynecology

54. Quality of care in family planning services in rural Mozambique with a focus on long acting reversible contraceptives: a cross-sectional survey. (PubMed)

Quality of care in family planning services in rural Mozambique with a focus on long acting reversible contraceptives: a cross-sectional survey. In Mozambique, both the government and partners have undertaken efforts over the last decade to improve FP (family planning) services, especially through training health care providers and promoting the uptake of LARCs (Long Acting Reversible Contraceptives). Despite this, uptake of FP methods has not increased significantly. This study aims to examine (...) information through outreach activities had better knowledge than those counselled at a facility.Our study highlights that only a minority of the women received information regarding LARCs during the consultation and that usage is almost non-existent. Counseling about all types of contraceptives during the consultation is sub-optimal, resulting in poorly informed clients. Multifaceted long-term interventions, focusing on both users and providers, are needed to improve uptake of contraceptives (including

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2018 BMC Women's Health

55. Feasibility of Immediate Postpartum Long-acting Reversible Contraception Implementation

Feasibility of Immediate Postpartum Long-acting Reversible Contraception Implementation Feasibility of Immediate Postpartum Long-acting Reversible Contraception Implementation - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies (...) before adding more. Feasibility of Immediate Postpartum Long-acting Reversible Contraception Implementation The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03774797 Recruitment Status : Enrolling by invitation First Posted : December 13, 2018 Last Update Posted : December 13, 2018 Sponsor: University

2018 Clinical Trials

56. Unintended pregnancy and subsequent postpartum long-acting reversible contraceptive use in Zimbabwe. (PubMed)

Unintended pregnancy and subsequent postpartum long-acting reversible contraceptive use in Zimbabwe. The postpartum period is an opportune time for contraception adoption, as women have extended interaction with the reproductive healthcare system and therefore more opportunity to learn about and adopt contraceptive methods. This may be especially true for women who experience unintended pregnancy, a key target population for contraceptive programs and programs to eliminate mother-to-child HIV (...) this association differed by women's HIV status. Finally, we examined the association between pregnancy intention and changes in contraception from the pre- to postpartum periods.Findings suggest that women who reported that their pregnancy was unintended adopted less modern (all non-traditional) contraceptive methods overall, but adopted long-acting reversible contraception (LARC) more frequently than women reporting an intended pregnancy (OR 1.41; CI 1.18, 1.68). Among HIV-positive women, this relationship

2018 BMC Women's Health

57. The Effect of Peer Education in Dispelling Myths and Misconceptions about Long-Acting Reversible Contraception among Ethiopian Youth. (PubMed)

The Effect of Peer Education in Dispelling Myths and Misconceptions about Long-Acting Reversible Contraception among Ethiopian Youth. Robust evidence, including systematic reviews and recommendations from the 2016 Lancet Commission on Adolescent Health and Wellbeing, does not wholly support the unambiguous endorsement of peer-led community-based interventions. This study evaluated the effectiveness of an intensive three-day training for peer educators (PE) on dispelling myths and misconceptions (...) about long-acting reversible contraceptives (LARCs) among Ethiopian youth. Post-training, PEs conducted demand-generation activities with their peers to encourage LARCs referrals. A convenience purposive sampling technique was used to select 20 health centers where peer educators referred clients: 10 each in Amhara and Tigray regions. The health centers were randomly allocated to the intervention (five) and non-intervention (five) study arms. Data were abstracted from the peer educators' monthly

2018 African journal of reproductive health Controlled trial quality: uncertain

58. Postabortion long-acting reversible contraception desire in women counselled using Bedsider.org versus standard counselling: a randomised trial. (PubMed)

Postabortion long-acting reversible contraception desire in women counselled using Bedsider.org versus standard counselling: a randomised trial. 29972363 2018 12 07 2515-2009 2018 May 30 BMJ sexual & reproductive health BMJ Sex Reprod Health Postabortion long-acting reversible contraception desire in women counselled using Bedsider.org versus standard counselling: a randomised trial. bmjsrh-2017-200047 10.1136/bmjsrh-2017-200047 Sonalkar Sarita S Department of Obstetrics and Gynecology (...) Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA. Borgatta Lynn L Quorum Review, Inc., Seattle, Washington, USA. eng K12 HD001265 HD NICHD NIH HHS United States Journal Article 2018 05 30 England BMJ Sex Reprod Health 101715577 2515-1991 counseling internet post-abortion contraception Competing interests: None declared. 2019 11 30 2018 7 5 6 0 2018 7 5 6 0 2018 7 5 6 0 aheadofprint 29972363 bmjsrh-2017-200047 10.1136/bmjsrh-2017-200047

2018 BMJ Sexual & Reproductive Health Controlled trial quality: uncertain

59. Comparison of an additional early visit to routine postpartum care on initiation of long-acting reversible contraception: a randomized trial. (PubMed)

Comparison of an additional early visit to routine postpartum care on initiation of long-acting reversible contraception: a randomized trial. To investigate whether an early 3-week postpartum visit in addition to the standard 6-week visit increases long-acting reversible contraception (LARC) initiation by 8 weeks postpartum compared to the routine 6-week visit alone.We enrolled pregnant and immediate postpartum women into a prospective randomized, non-blinded trial comparing a single 6-week (...) postpartum visit (routine care) to two visits at 3 and 6 weeks postpartum (intervention), with initiation of contraception at the 3-week visit, if desired. All participants received structured contraceptive counseling. Participants completed surveys in-person at baseline and at the time of each postpartum visit. A sample size of 200 total participants was needed to detect a 2-fold difference in LARC initiation (20% vs. 40%).Between May 2016 and March 2017, 200 participants enrolled; outcome data

2018 Contraception Controlled trial quality: uncertain

60. Not seeking yet trying long-acting reversible contraception: a 24-month randomized trial on continuation, unintended pregnancy, and satisfaction. (PubMed)

Not seeking yet trying long-acting reversible contraception: a 24-month randomized trial on continuation, unintended pregnancy, and satisfaction. To measure the 24-month impact on continuation, unintended pregnancy and satisfaction of trying long-acting reversible contraception (LARC) in a population seeking short-acting reversible contraception (SARC).We enrolled 916 women aged 18-29 who were seeking pills or injectables in a partially randomized patient preference trial. Women with strong (...) unintended pregnancy over 24months. Despite participants' initial desires to begin short-acting regimens, they had high satisfaction with LARC. Voluntary decisions to try LARC will benefit large proportions of typical SARC users.Even women who do not necessarily view LARC as a first choice may have a highly satisfying experience and avoid unintended pregnancy if they try it.Copyright © 2018 Elsevier Inc. All rights reserved.

2018 Contraception Controlled trial quality: predicted high

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