Increasing LARC Utilization through Standardized Contraception Education
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Abstract
Reducing unintended pregnancy is an important goal for any woman of childbearing age and optimizing contraceptive effectiveness should be a priority for healthcare providers serving this population. One subset of this population at increased need for optimization of contraceptive technologies is women presenting for abortion care. In most cases women presenting for abortion care have been on some method of contraception in the past, and either discontinued use due to side effects or lifestyle, or became pregnant while using contraception. The efficacy, safety, and convenience of long acting reversible contraceptive (LARC) methods have been widely recognized and LARC methods are recognized as first line contraceptives for almost all women of childbearing age. Unfortunately, many barriers such as access, cost, and misconceptions exist in the United States, which prevent optimal use of LARC methods. The purpose of this practice improvement project was to assess current knowledge of available contraceptives in women presenting for abortion care and to determine the efficacy of using a standardized LARC-centric contraceptive method education. Pre- and post-contraceptive education surveys were used to compare contraceptive method decision-making among women who received treatment as usual on the day of their abortion to women receiving a standardized contraceptive method overview. Contraceptive education resulted in increased understanding among patients presenting for abortion care, however, a significant difference between a routine contraceptive education session compared to a standardized contraception education script was not found. Although a statistically significant difference was not found, women who received standardized contraception education did choose LARC methods at a higher rate. In examining how to best educate women in preventing unintended pregnancy, every opportunity should be taken to enhance knowledge of available contraceptive methods before a woman is presenting for abortion. If unintended pregnancy has occurred and abortion is being chosen, education and support before, during, and after the procedure is necessary to ensure understanding.