Objective
Study Design
Results

Conclusion
Appendix
Demographic, hospital and clinical factors | Unadjusted odds ratio (95% CI)for LARC at delivery | Adjusted odds ratio (95% CI)for LARC at delivery |
---|---|---|
Risk factors | ||
Hospital region | ||
Northeast | Ref | Ref |
Midwest | 0.65 (0.63–0.67) | 0.73 (0.71–0.76) |
South | 0.58 (0.57–0.60) | 0.56 (0.54–0.57) |
West | 0.72 (0.70–0.74) | 0.78 (0.75–0.81) |
Hospital location and teaching status | ||
Urban, nonteaching | Ref | Ref |
Urban, teaching | 13.59 (12.93–14.28) | 6.11 (5.81–6.43) |
Rural | 1.18 (1.07–1.30) | 0.75 (0.68–0.83) |
Hospital bed size | ||
Small | Ref | Ref |
Medium | 1.05 (1.01–1.10) | 1.38 (1.32–1.44) |
Large | 1.84 (1.77–1.91) | 2.97 (2.86–3.09) |
Age category | ||
15–19 y old | 1.37 (1.32–1.42) | 1.74 (1.67–1.80) |
20–24 y old | 1.19 (1.15–1.22) | 1.20 (1.17–1.24) |
25–29 y old | Ref | Ref |
30–34 y old | 0.80 (0.78–0.83) | 0.89 (0.86–0.91) |
35–39 y old | 0.78 (0.75–0.81) | 0.79 (0.76–0.83) |
40–54 y old | 0.76 (0.70–0.82) | 0.67 (0.62–0.73) |
Maternal race | ||
Non-Hispanic White | Ref | Ref |
Non-Hispanic Black | 4.79 (4.65–4.94) | 2.06 (2.00–2.13) |
Hispanic | 3.26 (3.17–3.36) | 1.84 (1.78–1.90) |
Other | 2.34 (2.25–2.44) | 1.71 (1.64–1.78) |
Unknown | 0.46 (0.43–0.49) | 1.48 (1.40–1.57) |
Payer | ||
Medicare | 8.66 (7.92–9.46) | 5.30 (4.83–5.80) |
Medicaid | 5.69 (5.53–5.86) | 3.59 (3.48–3.71) |
Private insurance | Ref | Ref |
Self-pay | 2.84 (2.65–3.04) | 2.72 (2.54–2.92) |
No charge | 1.98 (1.44–2.71) | 2.98 (2.17–4.10) |
Other | 1.83 (1.67–2.00) | 1.78 (1.63–1.95) |
ZIP code-income quartile | ||
First quartile | 4.83 (4.66–5.02) | 1.64 (1.58–1.71) |
Second quartile | 2.32 (2.23–2.42) | 1.25 (1.20–1.31) |
Third quartile | 1.91 (1.83–1.99) | 1.20 (1.15–1.25) |
Fourth quartile | Ref | Ref |
Year of delivery | ||
2000 | Ref | Ref |
2001 | 0.72 (0.48–1.09) | 0.76 (0.50–1.14) |
2002 | 0.56 (0.37–0.87) | 0.58 (0.38–0.89) |
2003 | 0.40 (0.25–0.65) | 0.35 (0.22–0.57) |
2004 | 0.52 (0.34–0.81) | 0.46 (0.30–0.72) |
2005 | 0.51 (0.33–0.80) | 0.43 (0.28–0.67) |
2006 | 0.42 (0.26–0.67) | 0.33 (0.20–0.52) |
2007 | 0.83 (0.57–1.21) | 0.64 (0.44–0.94) |
2008 | 2.65 (1.96–3.60) | 2.06 (1.52–2.79) |
2009 | 2.55 (1.87–3.47) | 1.65 (1.21–2.25) |
2010 | 15.28 (11.65–20.03) | 9.91 (7.54–13.01) |
2011 | 7.56 (5.72–9.99) | 4.80 (3.64–6.34) |
2012 | 17.63 (13.46–23.10) | 13.04 (9.95–17.09) |
2013 | 20.24 (15.47–26.49) | 14.87 (11.35–19.47) |
2014 | 31.48 (24.12–41.09) | 20.73 (15.87–27.08) |
2015 | 47.45 (36.41–61.84) | 31.51 (24.16–41.10) |
2016 | 70.33 (54.02–91.57) | 46.52 (35.70–60.62) |
2017 | 110.50 (84.93–143.77) | 70.40 (54.05–91.68) |
2018 | 146.46 (112.61–190.50) | 92.66 (71.16–120.64) |
2019 | 180.50 (138.80–234.73) | 113.97 (87.55–148.36) |
Obstetrical factors | ||
Multiple gestation | 1.28 (1.19–1.37) | 1.19 (1.11–1.28) |
Medical comorbidities | ||
Pregestational diabetes mellitus | 3.42 (3.21–3.64) | 1.71 (1.60–1.83) |
Obesity | 5.19 (5.04–5.33) | 1.74 (1.69–1.79) |
Chronic hypertension | 2.80 (2.65–2.96) | 1.44 (1.36–1.53) |
References
- Committee Opinion No. 670: immediate postpartum long-acting reversible contraception.Obstet Gynecol. 2016; 128: e32-e37
- National Quality Forum perinatal and reproductive health 2015–2016 final report.(Available at:)
- Immediate postpartum long-acting reversible contraception: review of insertion and device reimbursement policies.Womens Health Issues. 2021; 31: 523-531
- Special report: implementing immediate postpartum LARC in Florida.Am J Obstet Gynecol. 2020; 222: S906-S909
- Statewide quality improvement initiative to implement immediate postpartum long-acting reversible contraception.Am J Obstet Gynecol. 2020; 222: S910.e1-S910.e8
Article Info
Publication History
Publication stage
In Press Journal Pre-ProofFootnotes
M.E.D. had a senior leadership role in the American College of Obstetricians and Gynecologists II’s Safe Motherhood Initiative, which received unrestricted funding from Merck for Mothers. T.W. serves as a consultant on the medical advisory board for Delfina, Inc. The other authors do not report any potential conflict of interest.
The authors report no funding for this study.
This analysis was deemed exempt by the Columbia University Institutional Review Board (AAAE8144).