Reliance on the postpartum visit to protect women from rapid repeat unplanned pregnancy is ineffective given that 50% of women do not attend these visits and many women have had intercourse prior. Long-acting reversible contraceptive (LARC) devices, both intrauterine contraceptives (IUC) and subdermal implants, can be placed immediately following delivery.METHODS:
Women who had LARCs placed immediately after vaginal or cesarean delivery from 9/2013 to 6/2015 were contacted via phone and an anonymous survey given that included questions regarding satisfaction with timing of contraception placement, pain scores for device placement, complications or issues with their chosen LARC.RESULTS:
161 of the 323 qualified women completed surveys, including 83 IUC and 78 implant placements. There was no significant difference between rates of being satisfied/highly satisfied between IUC and implant (68.7% vs 78.2%, P=.34) or in those who would recommend their procedure to a friend (70.3% vs 81.7%, P=.16). More IUC users wished they had their device placed at delayed interval (32.5% vs 16.7%, P=.03). Overall pain scores were low, however, significantly fewer women in the implant group reported low pain scores (94% vs 84.6%, P=.09). More women reported significant complications after immediate IUC insertion than implant (10.9% vs 0%, P<.001).CONCLUSION:
Immediate placement of LARC is correlated with high satisfaction rates, with the majority of users recommending the procedure to a friend. Implant users were had more issues after placement resulting in removal, but IUC users reported more complications. Immediate LARC placement is a satisfying and low-pain experience for women regardless of device.