This study by Eggebroten et al. (AJOG, 2017) aimed to evaluate the insertion, expulsion, and 6-month continuation of immediate postpartum copper T380 intrauterine devises (IUDs), levonorgestrel IUDs, and contraceptive implants.
Prospective Observational Trial
350 women had an IUD or implant inserted immediately after delivery, and enrolled in a 6-month follow-up. 27% received copper IUDs, 38% received levonorgestrel IUDs, and 35% received implants, with most women (93%) receiving their contraception of choice. 90% of participants were Hispanic, 87% were multiparous, 87% reported a household income of <$24,000 a year, and 77% delivered vaginally. 89% of the women completed the 6-month follow-up. 17% of levonorgestrel IUD users reported expulsions, compared to 4% of copper IUD users, with an adjusted hazard ratio for expulsion was 5.8 (confidence interval, 1.3-26.4). Mode of delivery did not affect expulsion rates. 14 of the 21 women who experienced IUD expulsions requested a LARC replacement. The 6 month device continuation rate was ≥80% among all device types. Levonorgestrel IUDs had higher expulsion rates than the copper IUD, but both had high success rates. The authors conclude that an immediate postpartum LARC program is highly effective and provides women with a convenient way to receive their contraception of choice before leaving the hospital.
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