Research

Provision of postpartum long-acting reversible contraception: A quality improvement intervention with pre- and postintervention evaluation.
Abstract
Background. Unintended pregnancies remain an important health challenge in South Africa (SA) and worldwide. Improving access to
contraception and long-acting reversible contraception in particular, may reduce the number of unintended pregnancies.
Objective. To determine the impact of a training and supportive mentoring programme on postpartum uptake of long-acting reversible
contraceptive (LARC) methods.
Methods. A quality-of-care improvement intervention with pre- and post-intervention evaluation of LARC uptake was conducted
at a midwife-led, on-site obstetric unit in the Eastern Cape, SA. Midwives were trained in contraceptive counselling and postpartum
etonorgestrel implant insertion. The researcher provided counselling and postpartum intrauterine device (IUD) insertion services.
Results. In the 10 weeks prior to the intervention, neither the IUD nor the implant were provided in the unit. In the 10 weeks after the
intervention, uptake of the IUD was n=27/289 (9.3%) and the implant n=21/289 (7.3%). Use of no contraception or condoms increased
from n=22/273 (8.1%) to n=41/289 (14.2%) (p<0.02). The increase was accounted for by a change in staff in the last 4 weeks of the
intervention period (n=33/105 (31.4%) v. n=8/184 (4.4%) during the first 6 weeks; p<0.00).
Conclusion. Competing responsibilities of maternity staff may limit the contraceptive options offered to postpartum women. A
programme of training and supportive supervision resulted in a substantial increase in levels of LARC uptake. Strategies are needed to
institutionalise comprehensive postpartum contraceptive provision nationally.
Authors' affiliations
E E Wynne, Department of Obstetrics and Gynaecology, Walter Sisulu University; Eastern Cape Department of Health, South Africa
G J Hofmeyr, Department of Obstetrics and Gynaecology, Walter Sisulu University; Eastern Cape Department of Health, South Africa; Department of Obstetrics and Gynaecology, University of Botswana, Gaborone, Botswana
Full Text

Cite this article
Article History
Date published: 2022-06-22
Article Views
Full text views: 716
Comments on this article
*Read our policy for posting comments hereby Anne Cedillo (2023-01-26)
by Addie Trumble (2023-01-26)
by Shalanda Delgado (2023-01-26)
by Louise Ferretti (2023-01-26)
by Nydia Glaze (2023-01-26)
by Alysa Ocampo (2023-01-26)
by Casey Finn (2023-01-26)
by Flossie Vasquez (2023-01-26)
by Randy Blaxland (2023-01-26)
by Charity Tew (2023-01-26)
by Austin Meares (2023-01-26)
by Kendall McBurney (2023-01-26)
by Jonah Franco (2023-01-26)
by Rory Xiong (2023-01-26)
by Emelia Young (2023-01-26)
by Jolene Gentle (2023-01-26)
by Dominga Trainor (2023-01-26)
by Emilio Kroger (2023-01-26)
by Samual Beavis (2023-01-26)
by Romeo Allard (2023-01-26)
by Mari Lindberg (2023-01-26)
by Albert Sifuentes (2023-01-26)
by Raymundo Keefe (2023-01-26)
by Samuel Paulson (2023-01-26)
by Clint McSharry (2023-01-26)
by Manuel Beatty (2023-01-26)
by Isaac Tunbridge (2023-01-26)
by Stormy Veasley (2023-01-26)
by Adam Dodson (2023-01-26)
by Addie Trumble (2023-01-26)
by Traci Ehrlichmann (2023-01-26)
by Carmel Spangler (2023-01-26)
by Phillipp Sedillo (2023-01-26)
by Mira Pinkerton (2023-01-26)
by Sam Cook (2023-01-26)
by Heike Macaulay (2023-01-26)
by Rubye Mairinger (2023-01-26)
by Selene Fay (2023-01-26)
by Hamish Moritz (2023-01-26)
by Bernard Wehner (2023-01-26)
by Fred Hoyt (2023-01-26)
by Darrel Nathan (2023-01-26)
by Kina Beem (2023-01-26)
by Israel Bickford (2023-01-26)
by Lucille Humffray (2023-01-26)
by Nellie Hyam (2023-01-26)
by Josette Lipscomb (2023-01-26)
by Dina Veal (2023-01-26)
by Albert Sifuentes (2023-01-26)
by Nellie Hyam (2023-01-26)
by Lonna Whittaker (2023-01-26)
by Shay Mawby (2023-01-26)
by Doris Catron (2023-01-26)
by Mabel Knudsen (2023-01-26)
by Karina Feetham (2023-01-26)
by Beatriz Vigna (2023-01-26)
by Carey Cason (2023-01-26)
by Mark Roland (2023-01-26)
by Octavia Frisina (2023-01-26)
by Agnes Fields (2023-01-26)
by Rosa Culley (2023-01-26)
by Valeria Cockerill (2023-01-26)
by Brianne Taubman (2023-01-26)
by Terra Castiglia (2023-01-26)
by Celina Baca (2023-01-26)
by Lauren Lesage (2023-01-26)
by Lyn Beazley (2023-01-26)
by Marty Ebner (2023-01-26)
by Gilda Bratcher (2023-01-26)
by Julio Hager (2023-01-26)
by Piper Balsillie (2023-01-26)
by Launa Faerber (2023-01-26)
by Rafaela Alves (2023-01-26)
by Roberto Dresner (2023-01-26)
by Will Hoffnung (2023-01-26)
by Marty Ebner (2023-01-26)
by Donnie Cuevas (2023-01-26)
by Roland Kirsch (2023-01-26)
by Connie Macadam (2023-01-26)
by Hannah Eatock (2023-01-26)
by Aisha Noland (2023-01-26)
by Booker Duncombe (2023-01-26)
by Dianne Stedman (2023-01-26)
by Arnoldo Pinkney (2023-01-26)
by Dina Mcclendon (2023-01-26)
by Jame Makowski (2023-01-26)
by Edward Paulk (2023-01-26)
by Terra Castiglia (2023-01-26)
by Deandre Sheridan (2023-01-26)
by Maryann Reinhardt (2023-01-26)
by Eldon Austin (2023-01-26)
by Hanna Combes (2023-01-26)
by Lydia Zimmermann (2023-01-26)
by Rosa Culley (2023-01-26)
by Columbus Fairbridge (2023-01-26)
by Felica Fritz (2023-01-26)
by Stan Leigh (2023-01-26)
by Troy Hilson (2023-01-26)
by Terra Castiglia (2023-01-26)
by Lonna Whittaker (2023-01-26)
by Adam Dodson (2023-01-26)