May 10 (UPI) -- Researchers at the University of Michigan show that access to long-lasting, reversible contraception immediately after childbirth is not keeping up the demand.
Repeat pregnancy too close to the birth of a first baby can be dangerous and has an increased risk of adverse outcomes for mother and baby including miscarriage, preterm birth and stillbirth. Increased access to in-hospital reversible contraception, and insurance coverage for it, can help prevent unintended and repeat pregnancies too close to prior births.
The rate of intrauterine devices, or IUDs, and other contraceptive implants after childbirth have increased dramatically from 1.86 per 10,000 deliveries in 2008 to 13.5 per 10,000 deliveries in 2013.
Researchers found that 96 percent of inpatient postpartum IUDs were placed at urban teaching hospitals, which suggested that the option was not available to women who delivered at urban non-teaching and rural hospitals.
"Getting an IUD right after childbirth may be more convenient and less painful than insertion at a later office visit," Dr. Michelle Moniz, an assistant professor of obstetrics and gynecology at the University of Michigan Medical School, said in a press release. "But we found that access to this service varies greatly depending on where a woman delivers her baby. Maternity clinicians and policymakers should strive to ensure that women have access to the full range of contraceptive options after childbirth and that they are able to make an informed, voluntary, personal choice about whether and when to have another child."
Previous studies have shown women are less likely to show up to follow-up appointments to get their preferred method of birth control after childbirth because of obstacles such as lack of childcare, transportation and other impediments.
Research also shows women are four times more likely to have adequate birth spacing using IUDs, implants or tubal sterilization than women using a barrier or no method of birth control.
IUDs inserted right after birth are at a slightly higher risk of falling out compared to IUDs inserted four to eight weeks postpartum, however, the risk of complications such as infection or injury are very low with both types of placement and is more cost-efficient.
The study was published in Obstetrics & Gynecology.