We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Immediate Postpartum Contraception: A Survey Needs Assessment of a National Sample of Midwives.
- Authors
Moniz, Michelle H.; Roosevelt, Lee; Crissman, Halley P.; Kobernik, Emily K.; Dalton, Vanessa K.; Heisler, Michele H.; Low, Lisa Kane
- Abstract
Introduction Immediate postpartum long-acting, reversible contraception (LARC)-providing intrauterine devices (IUDs) and contraceptive implants immediately following birth-is an effective strategy to prevent unintended pregnancies and improve birth spacing. We measured US certified nurse-midwives' (CNMs') and certified midwives' (CMs') knowledge, training needs, current practice, and perceived barriers to providing immediate postpartum LARC. Methods We invited currently practicing CNM and CM members of the American College of Nurse-Midwives to complete an online survey about their knowledge and experience with the use of LARC and analyzed eligible questionnaires using descriptive statistics. Results Of 4609 eligible midwives, 794 responded (17% response rate). Most were female (99.5%) and non-Hispanic white (92.1%), with 45.0% attending births in urban settings. Responses revealed multiple knowledge gaps related to IUD expulsion rates and appropriateness of immediate postpartum LARC in certain clinical scenarios. Only 10.1% of respondents reported feeling confident to insert an immediate postpartum IUD and 43.3% an implant. Many reported desiring additional training in immediate postpartum IUD (63.5%) and implant (22.8%) insertion; few reported access to such training (IUD, 19.9%; implant, 15.2%). Most respondents had never inserted an immediate postpartum IUD (90.7%) or implant (86.8%). The most commonly cited barriers to immediate postpartum LARC provision were that it is not standard practice (IUD, 40.9%; implant, 39.0%) or is not available (IUD, 27.8%; implant, 34.8%) at one's institution and feeling inadequately trained (IUD, 26.5%; implant, 10.7%). Discussion Nine in 10 midwife respondents have never inserted an IUD or implant immediately postpartum, but more than half indicated they would like the opportunity to provide these services. Our findings highlight opportunities to enhance the immediate postpartum LARC-related knowledge and skills of the midwife workforce. They also suggest that logistic and institutional barriers to immediate postpartum LARC access must be removed in order to make this evidence-based reproductive health service available to all women who desire it.
- Subjects
UNITED States; BIRTHING centers; CONFIDENCE; CONFIDENCE intervals; CONTRACEPTION; CONTRACEPTIVE drugs; CONTROLLED release drugs; HEALTH services accessibility; HOSPITALS; INTERNET; INTRAUTERINE contraceptives; METROPOLITAN areas; MIDWIVES; NEEDS assessment; POSTNATAL care; PROFESSIONS; PUERPERIUM; QUESTIONNAIRES; RESEARCH funding; RURAL conditions; SCALE analysis (Psychology); SUBURBS; SURVEYS; MIDWIFERY; HEALTH insurance reimbursement; PROFESSIONAL practice; INFORMATION needs; CROSS-sectional method; AMERICAN College of Nurse-Midwives; DATA analysis software; WORK experience (Employment); DESCRIPTIVE statistics; ODDS ratio
- Publication
Journal of Midwifery & Women's Health, 2017, Vol 62, Issue 5, p538
- ISSN
1526-9523
- Publication type
Article
- DOI
10.1111/jmwh.12653