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Contraception. 2014 Jul;90(1):66-71. doi: 10.1016/j.contraception.2014.02.007. Epub 2014 Feb 26.

Routine counseling about intrauterine contraception for women seeking emergency contraception.

Author information

1
University of Pittsburgh, Department of Medicine; University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology; University of Pittsburgh, Department of Obstetrics, Gynecology and Reproductive Sciences. Electronic address: schwarzeb@upmc.edu.
2
University of Pittsburgh, Department of Medicine.
3
University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology.
4
University of Pittsburgh, Department of Obstetrics, Gynecology and Reproductive Sciences.

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.

KEYWORDS:

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

[Indexed for MEDLINE]

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