{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T07:12:30Z","timestamp":1773990750256,"version":"3.50.1"},"reference-count":10,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p>\n            Objective\u2003Increasing availability of immediate postpartum long-acting reversible contraception (LARC) has added contraceptive alternatives to bilateral tubal ligation (BTL) in the immediate postpartum period. The resultant access to long-term contraception has provided patients with improved control over the timing of pregnancies. Our objective is to evaluate changes in the utilization of immediate postpartum contraceptive methods over a 10-year period and its association with interpregnancy interval (IPI).<\/jats:p><jats:p>\n            Study Design\u2003Retrospective cohort study of 36,445 patients delivered at a single academic hospital center from 2012 to 2020. Deliveries &lt;23 weeks gestation and patients who underwent a cesarean hysterectomy or postpartum hysterectomy for obstetric indications were excluded. The primary outcome was the utilization of postpartum BTL, intrauterine devices, contraceptive implants, and Depo-Provera over the study time period. The secondary outcomes were IPI and interdelivery interval (IDI). Outcomes were compared using appropriate tests of trend. We adjusted for significant covariates as assessed in baseline characteristics.<\/jats:p><jats:p>\n            Results\u2003A total of 35,281 patients were included in our study. Groups were different in baseline characteristics including age, race\/ethnicity, parity, BMI, insurance status, comorbidity risk, and attendance at postpartum exam. Over the study period, there was a significant difference in utilization of Depo-Provera, LARC, intrauterine device (IUD), and implant (p\u2009&lt;\u20090.001). There was a significant increase in IPI (p\u2009&lt;\u20090.001) and IDI (p\u2009&lt;\u20090.001).<\/jats:p><jats:p>\n            Conclusion\u2003We observed a significant increase in utilization of immediate postpartum LARC over the study period which corresponded to a significant increase in IPI and IDI. Our findings emphasize the importance of the availability of immediate postpartum contraception as well as its effectiveness in improving family planning options for reproductive-aged patients. We found significantly increased IPI and IDI associated with increased utilization of long-acting reversible contraceptives immediately postpartum. Our findings emphasize the importance of providers offering these options to patients as well as being comfortable initiating immediate postpartum contraception.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0044-1789279","type":"journal-article","created":{"date-parts":[[2024,9,3]],"date-time":"2024-09-03T23:13:11Z","timestamp":1725405191000},"page":"428-434","source":"Crossref","is-referenced-by-count":3,"title":["Utilization of Immediate Postpartum Contraception and Its Association with Interpregnancy Interval: 10-Year Experience at a Single Center"],"prefix":"10.1055","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6011-8161","authenticated-orcid":false,"given":"Macie L.","family":"Champion","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health at the University of Alabama at Birmingham, Birmingham, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah E.","family":"Beebe","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health at the University of Alabama at Birmingham, Birmingham, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina T.","family":"Blanchard","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health at the University of Alabama at Birmingham, Birmingham, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"Boozer","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health at the University of Alabama at Birmingham, Birmingham, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian M.","family":"Casey","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health at the University of Alabama at Birmingham, Birmingham, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akila","family":"Subramaniam","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health at the University of Alabama at Birmingham, Birmingham, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,9,3]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1186\/s12978-021-01289-3","article-title":"The impact of US policy on contraceptive access: a policy analysis","volume":"18","author":"L ET Swan","year":"2021","journal-title":"Reprod Health"},{"key":"ref2","volume-title":"Contraceptive Needs and Services, 2010","author":"J JZM Frost","year":"2013"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"e32","DOI":"10.1097\/AOG.0000000000001587","article-title":"Committee Opinion No. 670: Immediate postpartum long-acting reversible contraception","volume":"128","author":"American College of Obstetricians and Gynecologists' Committee on Obstetric Practice","year":"2016","journal-title":"Obstet Gynecol"},{"issue":"86","key":"ref5","first-page":"1","article-title":"Current contraceptive use and variation by selected characteristics among women aged 15\u201344: United States, 2011\u20132013","author":"K Daniels","year":"2015","journal-title":"Natl Health Stat Rep"},{"issue":"05","key":"ref6","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1097\/AOG.0000000000001094","article-title":"Changes in use of long-acting reversible contraceptive methods among U.S. women, 2009\u20132012","volume":"126","author":"M L Kavanaugh","year":"2015","journal-title":"Obstet Gynecol"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"127.e1","DOI":"10.1016\/j.ajog.2011.08.004","article-title":"Postpartum intrauterine device insertion and postpartum tubal sterilization in the United States","volume":"206","author":"M K Whiteman","year":"2012","journal-title":"Am J Obstet Gynecol"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.jclinepi.2007.11.008","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"61","author":"E Von Elm","year":"2008","journal-title":"J Clin Epidemiol"},{"issue":"06","key":"ref10","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1097\/AOG.0000000000000841","article-title":"Contraception after delivery and short interpregnancy intervals among women in the United States","volume":"125","author":"K White","year":"2015","journal-title":"Obstet Gynecol"},{"issue":"09","key":"ref11","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1007\/s10995-021-03180-w","article-title":"Analysis of postpartum uptake of long-acting reversible contraceptives before and after implementation of Medicaid reimbursement policy","volume":"25","author":"M Smith","year":"2021","journal-title":"Matern Child Health J"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"886.e1","DOI":"10.1016\/j.ajog.2019.11.1282","article-title":"Coverage of immediate postpartum long-acting reversible contraception has improved birth intervals for at-risk populations","volume":"222","author":"A Liberty","year":"2020","journal-title":"Am J Obstet Gynecol"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0044-1789279.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T23:31:15Z","timestamp":1740439875000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0044-1789279"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,3]]},"references-count":10,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2025,2,24]]},"published-print":{"date-parts":[[2025,3]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0044-1789279","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,3]]}}}