Exposure to routine availability of immediate postpartum LARC

effect on attitudes and practices of labor and delivery and postpartum nurses

Nerys C. Benfield, Felicia Hawkins, Laurie Ray, Andrea McGowan, Ketty Floyd, Dawn Africa, Myrta Barreto, Erika E. Levi

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objectives: Nurses play an integral role in intrapartum and postpartum patient education. This exploratory study aims to assess the attitudes, knowledge, and practices of labor and delivery and postpartum nurses regarding contraception and evaluate for changes in these measures 1 year after an institutional initiative allowing routine availability of immediate postpartum long-acting reversible contraception (LARC). Study design: In 2014, Montefiore Medical Center began to routinely offer comprehensive immediate postpartum contraception. The initiative included education and feedback sessions for labor and delivery and postpartum nurses on contraception, including immediate postpartum initiation of LARC. Nurses completed anonymous surveys at the beginning of the initiative (n=59) and at 1 year (n=56). We compared baseline and 1 year survey results of contraceptive knowledge, attitudes and practices using χ2 test, Fisher's Exact Test, or t test as appropriate. Results: Nurses who stated they counseled patients on contraception “always” or “most of the time” increased from 27/59 (46%) to 40/56 (71%) (p=.005). The number of nurses who would recommend the intrauterine device and implant for postpartum contraception increased from 1/59 (2%) to 18/56 (32%) (p<.0001). Attitudes towards injectable contraception and breastfeeding remained negative; 27/59 nurses (46%) at baseline and 34/56 (61%) at 1 year agreed with the statement “DMPA [depot medroxyprogesterone acetate] has a negative effect on breastfeeding.” Conclusions: Experience working in a location with routine access to immediate postpartum contraception is associated with increased awareness among nurses of postpartum contraceptive options, especially LARC, and increased contraceptive counseling. Concerns about the impact of hormonal contraception on breastfeeding, specifically DMPA, are persistent and prevalent. Implications: Labor and delivery and postpartum nurses' knowledge regarding immediate postpartum contraception, particularly LARC methods, may change with exposure to routine access to these methods. This exposure may also impact nurses' practices of providing patient counseling on what methods are appropriate for postpartum women.

Original languageEnglish (US)
JournalContraception
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Contraception
Postpartum Period
Nurses
Contraceptive Agents
Breast Feeding
Health Knowledge, Attitudes, Practice
Medroxyprogesterone Acetate
Counseling
Intrauterine Devices
Patient Education
Education

Keywords

  • Contraception counseling
  • LARC
  • Nurses
  • Postpartum contraception

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Exposure to routine availability of immediate postpartum LARC : effect on attitudes and practices of labor and delivery and postpartum nurses. / Benfield, Nerys C.; Hawkins, Felicia; Ray, Laurie; McGowan, Andrea; Floyd, Ketty; Africa, Dawn; Barreto, Myrta; Levi, Erika E.

In: Contraception, 01.01.2018.

Research output: Contribution to journalArticle

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abstract = "Objectives: Nurses play an integral role in intrapartum and postpartum patient education. This exploratory study aims to assess the attitudes, knowledge, and practices of labor and delivery and postpartum nurses regarding contraception and evaluate for changes in these measures 1 year after an institutional initiative allowing routine availability of immediate postpartum long-acting reversible contraception (LARC). Study design: In 2014, Montefiore Medical Center began to routinely offer comprehensive immediate postpartum contraception. The initiative included education and feedback sessions for labor and delivery and postpartum nurses on contraception, including immediate postpartum initiation of LARC. Nurses completed anonymous surveys at the beginning of the initiative (n=59) and at 1 year (n=56). We compared baseline and 1 year survey results of contraceptive knowledge, attitudes and practices using χ2 test, Fisher's Exact Test, or t test as appropriate. Results: Nurses who stated they counseled patients on contraception “always” or “most of the time” increased from 27/59 (46{\%}) to 40/56 (71{\%}) (p=.005). The number of nurses who would recommend the intrauterine device and implant for postpartum contraception increased from 1/59 (2{\%}) to 18/56 (32{\%}) (p<.0001). Attitudes towards injectable contraception and breastfeeding remained negative; 27/59 nurses (46{\%}) at baseline and 34/56 (61{\%}) at 1 year agreed with the statement “DMPA [depot medroxyprogesterone acetate] has a negative effect on breastfeeding.” Conclusions: Experience working in a location with routine access to immediate postpartum contraception is associated with increased awareness among nurses of postpartum contraceptive options, especially LARC, and increased contraceptive counseling. Concerns about the impact of hormonal contraception on breastfeeding, specifically DMPA, are persistent and prevalent. Implications: Labor and delivery and postpartum nurses' knowledge regarding immediate postpartum contraception, particularly LARC methods, may change with exposure to routine access to these methods. This exposure may also impact nurses' practices of providing patient counseling on what methods are appropriate for postpartum women.",
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AB - Objectives: Nurses play an integral role in intrapartum and postpartum patient education. This exploratory study aims to assess the attitudes, knowledge, and practices of labor and delivery and postpartum nurses regarding contraception and evaluate for changes in these measures 1 year after an institutional initiative allowing routine availability of immediate postpartum long-acting reversible contraception (LARC). Study design: In 2014, Montefiore Medical Center began to routinely offer comprehensive immediate postpartum contraception. The initiative included education and feedback sessions for labor and delivery and postpartum nurses on contraception, including immediate postpartum initiation of LARC. Nurses completed anonymous surveys at the beginning of the initiative (n=59) and at 1 year (n=56). We compared baseline and 1 year survey results of contraceptive knowledge, attitudes and practices using χ2 test, Fisher's Exact Test, or t test as appropriate. Results: Nurses who stated they counseled patients on contraception “always” or “most of the time” increased from 27/59 (46%) to 40/56 (71%) (p=.005). The number of nurses who would recommend the intrauterine device and implant for postpartum contraception increased from 1/59 (2%) to 18/56 (32%) (p<.0001). Attitudes towards injectable contraception and breastfeeding remained negative; 27/59 nurses (46%) at baseline and 34/56 (61%) at 1 year agreed with the statement “DMPA [depot medroxyprogesterone acetate] has a negative effect on breastfeeding.” Conclusions: Experience working in a location with routine access to immediate postpartum contraception is associated with increased awareness among nurses of postpartum contraceptive options, especially LARC, and increased contraceptive counseling. Concerns about the impact of hormonal contraception on breastfeeding, specifically DMPA, are persistent and prevalent. Implications: Labor and delivery and postpartum nurses' knowledge regarding immediate postpartum contraception, particularly LARC methods, may change with exposure to routine access to these methods. This exposure may also impact nurses' practices of providing patient counseling on what methods are appropriate for postpartum women.

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