Abstract
Study Objective
To compare immediate postpartum insertion of the contraceptive implant to placement
at the 6-week postpartum visit among adolescent and young women.
Design
Non-blinded, randomized controlled trial.
Setting and Participants
Postpartum adolescents and young women ages 14-24 years who delivered at an academic
tertiary care hospital serving rural and urban populations in North Carolina.
Interventions
Placement of an etonogestrel-releasing contraceptive implant before leaving the hospital
postpartum, or at the 4-6 week postpartum visit.
Main Outcome Measures
Contraceptive implant use at 12 months postpartum.
Results
Ninety-six participants were randomized into the trial. Data regarding use at 12 months
were available for 64 participants, 37 in the immediate group and 27 in the 6-week
group. There was no difference in use at 12 months between the immediate group and
the 6-week group (30 of 37, 81% vs 21 of 27, 78%; P = .75). At 3 months, the immediate group was more likely to have the implant in place
(34 of 37, 92% vs 19 of 27, 70%; P = .02).
Conclusion
Placing the contraceptive implant in the immediate postpartum period results in a
higher rate of use at 3 months postpartum and appears to have similar use rates at
12 months compared with 6-week postpartum placement. Providing contraceptive implants
to adolescents before hospital discharge takes advantage of access to care, increases
the likelihood of effective contraception in the early postpartum period, appears
to have no adverse effects on breastfeeding, and might lead to increased utilization
at 1 year postpartum.
Key Words
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Article info
Publication history
Published online: August 23, 2016
Footnotes
The authors indicate no conflicts of interest.
Present address for Erika E. Levi: Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, Bronx, New York.
Present address for Matthew L. Zerden: Department of Obstetrics and Gynecology, WakeMed Health and Hospitals, Raleigh, North Carolina.
Present address for Antoinette Danvers: Department of Obstetrics and Gynecology, Columbia University School of Medicine, New York, New York.
Identification
Copyright
© 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.
