Evaluating effects of Structured Contraceptive Counseling to increase use of long-acting reversible contraception among women postpartum

Unintended pregnancies are sources of poor health and economic vulnerability among women and cause strain on societies through healthcare visits and costs.

Increased use of effective contraception, especially long-acting reversible contraception (LARC,  intrauterine devices and contraceptive implants), reduces the risk of unintended pregnancy and abortions.

Annually approximately 115 000 women give birth in Sweden and 2.5% of these women will have an abortion within 12-24 months postpartum.

This project aims at increasing postpartum use of LARC to reduce the numbers of unintended pregnancies and abortions.In a large cluster-randomized trial, funded by Forte, we evaluated Structured Contraceptive Counselling (SCC)in Stockholm.

We could show a significantly higher LARC use among women receiving SCC, and fewer pregnancies among women seeking an abortion. Women and healthcare providers (HCPs) were highly satisfied with the SCC.

In this project, consisting of two studies, we wish to 1: map postpartum use of different contraceptive methods, through a review of medical records of women who gave birth in 2019.

And 2: evaluate the effects of prepartum SCC  on use of LARC at 6 months postpartum, but also on the change in LARC prescription rates among HCPs before and after SCC was implemented.This project could increase postpartum LARC use, and subsequently, reduce the rate of unintended pregnancies and abortions.

Potentially 2800 abortions per year can be prevented, improving reproductive health and resulting in large societal savings.

Results will increase equity by the empowerment of women and increase the possibility to complete education, participate in working life and thus increase income.

Covid 19 aspects: Increased LARC use, that doesn’t require annual check-ups, result in fewer physical health care visits.