Post-partum Implanon offers long-term contraception for high risk women

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1. Two-thirds of women who had an implanon placed immediately post-partum used the birth control method for the entirety of its 3-year lifespan. 

2. Continuation rates were higher in women at highest risk for recurrent pregnancy, including adolescents and those with poor prenatal care. 

Evidence Rating Level: 2 (Good)           

Study Rundown: This study found that the continuation rate for women who received an implanon, a 3-year long-acting reversible contraceptive method (LARC), immediately post-partum was over 66% at 3 years. Compliance rates were even higher in women who were most at risk for recurrent pregnancy, including adolescents and those with poor prenatal care. This is the first study to include behavioral variables, such as number of prenatal care visits, in the evaluation of characteristics associated with contraceptive continuation. One strength of this study is a high follow-up rate (>70%). Limitations include a relatively small sample size and lack of a control group. Future studies might try to replicate findings with a larger, multi-centered cohort and compare continuation rates between women who received post-partum implanon with other non-LARC methods.

Click to read the study in Contraception

Relevant Reading: Rapid repeat pregnancy in adolescents: do immediate postpartum contraceptive implants make a difference?

In-Depth [retrospective cohort]: Researchers collected data from electronic medical records for all women at an urban, academic medical center who had an etonogestrel contraceptive implant (Implanon) placed immediately postpartum between January 2008 and March 2009. The primary outcome was continuation rates at 1, 2, and 3 years (the lifetime of the implant). Secondary outcomes included characteristics of women who had the Implanon placed and adverse effects that led to early discontinuation. Of the 262 women, 28.2% were adolescents, 71.8% were multigravid and 38.5% had poor prenatal care (<6 prenatal visits).

The overall continuation rate of implanon at 3 years was 66.3%. 94.5% of adolescents and 94.1% of women with poor prenatal care (<6 visits) retained their Implanon at 1 year, as compared with 87% overall. The most common reason for discontinuation was abnormal bleeding (41%) followed by weight gain (19%).

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