American Journal of Obstetrics and Gynecology
ResearchGeneral gynecologyPostpartum intrauterine device insertion and postpartum tubal sterilization in the United States
Section snippets
Materials and Methods
We used data from the Nationwide Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP) for 2001–2008.10 The Healthcare Cost and Utilization Project is a family of health care databases developed through a federal-state-industry partnership sponsored by the Agency for Healthcare Research and Quality in which state partners contribute data. The NIS is the largest all-payer inpatient care database in the United States and contains data on 7-8 million hospital stays from
Results
During 2001-2008, the estimated rate of IUD insertions that were performed during delivery hospitalizations in the United States was 0.27 per 10,000 deliveries; by contrast, the rate of postpartum tubal sterilization was 770.67 per 10,000 deliveries. The rate of postpartum IUD insertion increased linearly from 0.10 per 10,000 deliveries in 2001-2002 to 0.55 per 10,000 deliveries in 2007-2008 (P for trend, < .001; Figure). A quadratic trend was detected in the rate of postpartum tubal
Comment
The American College of Obstetricians and Gynecologists recently stated that the immediate postpartum period is a particularly favorable time for IUD insertion.12 Although we found that the rate of postpartum IUD insertion in the United States increased from 2001-2002 to 2007-2008, it remains a rare practice and occurs at a rate markedly lower than that of postpartum tubal sterilization. These findings suggest that postpartum IUD insertion is underutilized, particularly for some subgroups.
We
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2023, American Journal of Obstetrics and GynecologyUpdate on incidence of inpatient tubal ligation and long-acting reversible contraception in the United States
2022, American Journal of Obstetrics and GynecologyCitation Excerpt :Those who are younger or have noncommercial insurance are more likely to receive LARC, whereas those who have a cesarean delivery are more likely to have a tubal ligation. Postpartum LARC insertion rates have risen considerably over the past 2 decades—from 0.01 per 1000 births from 2001 to 2002, to 7.5 per 1000 births in our analysis.5 Variation in LARC receipt by geographic region and insurance type may point to barriers for some patient populations.
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2022, American Journal of Obstetrics and GynecologyMaking the financial case for immediate postpartum intrauterine device: a budget impact analysis
2022, American Journal of Obstetrics and GynecologyCitation Excerpt :Although immediate postpartum IUD placement (typically defined as placement within 10 minutes of delivery of the placenta)11 results in a higher rate of expulsion than delayed placement, people who plan on delayed placement often do not attend the postpartum visit or receive an IUD.12–20 Although the uptake of postpartum IUDs is increasing, their use in the United States remains low relative to other methods of contraception.21–23 A 2017 survey by the ACOG found that only 19% of its members reported offering immediate postpartum IUDs.24
The authors report no conflict of interest.
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Reprints not available from the authors.
Cite this article as: Whiteman MK, Cox S, Tepper NK, et al. Postpartum intrauterine device insertion and postpartum tubal sterilization in the United States. Am J Obstet Gynecol 2012;206:127.e1-7.