Routine counseling about intrauterine contraception for women seeking emergency contraception

Eleanor Schwarz, Melissa Papic, Sara M. Parisi, Erin Baldauf, Rachel Rapkin, Glenn Updike

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Objective: To compare contraceptive knowledge and use among women seeking emergency contraception (EC) before and after an inner-city clinic began providing structured counseling and offering same-day intrauterine device (IUD) or implant placement to all women seeking EC. Study design: For 8 months before and 21 months after this change in clinic policy, women aged 15-45 who wanted to avoid pregnancy for at least 6 months were asked to complete surveys immediately, 3 and 12 months after their clinic visit. In addition, we abstracted electronic medical record (EMR) data on all women who sought EC (n= 328) during this period. We used chi-squared tests to assess pre/post differences in survey and EMR data. Results: Surveys were completed by 186 women. After the clinic began offering structured counseling, more women had accurate knowledge of the effectiveness of IUDs, immediately and 3 months after their clinic visit. In addition, more women initiated IUD or implant use (survey: 40% vs. 17% preintervention, p=0.04; EMR: 22% vs. 10% preintervention, p=0.01), and fewer had no contraceptive use (survey: 3% vs. 17% preintervention, p<0.01; EMR: 32% vs. 68%, p<0.01) in the 3 months after seeking EC. EMR data indicate that when same-day placement was offered, 11.0% of women received a same-day IUD. Of those who received a same-day IUD, 88% (23/26) reported IUD use at 3-months and 80% (12/15) at 12 months. Conclusions: Routine provision of structured counseling with the offer of same-day IUD placement increases knowledge and use of IUDs 3 months after women seek EC. Implications: Women seeking EC from family planning clinics should be offered counseling about highly effective reversible contraceptives with the option of same-day contraceptive placement.

Original languageEnglish (US)
Pages (from-to)66-71
Number of pages6
JournalContraception
Volume90
Issue number1
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Keywords

  • Contraceptive counseling
  • Copper IUD
  • Emergency contraception
  • Intrauterine contraception
  • Same day
  • Title X

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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