Immediate Postpartum LARC

What is immediate postpartum LARC?

Immediate postpartum LARC refers to LARC initiation after delivery before hospital discharge

  • ACOG supports¬†immediate postpartum LARC insertion as a best practice, recognizing its role in preventing rapid repeat pregnancy and unintended pregnancy.

Immediate postpartum LARC:

  • Should be offered as an effective option for postpartum contraception
  • Can reduce unintended pregnancy and lengthen interpregnancy intervals

Women should be counseled prenatally about immediate postpartum LARC, including its:

  • Advantages
  • Risk of IUD expulsion
  • Contraindications and alternatives to allow for informed decision making

Definitions: timing of LARC placement

1. Immediate Postplacental

Placement within 10 minutes of delivery of placenta

2. Immediate Postpartum

Placement during hospital admission for delivery

3. Postpartum

Placement within 6 weeks of delivery

4. Interval Placement

Placement 6 weeks or later following delivery

What are some benefits of Immediate Postpartum LARC?

  1. Unintended pregnancy remains a significant issue in the U.S. and LARC methods can decrease unintended pregnancy and lengthen interpregnancy intervals
  2. Patient is still in the midst of care and placement can be convenient for both woman and clinician
  3. Time limit on postpartum insurance coverage for some women after hospital discharge
  4. Women are known not to be pregnant and many are motivated to avoid short-interval pregnancy
  5. Cost-effective despite higher IUD expulsion rates
  6. Women using LARC methods have high satisfaction and continuation rates as compared to oral contraceptive pill users
  7. Up to 40% of women do not attend the postpartum visit
  8. Up to 75% of women who plan to use an IUD postpartum do not obtain it
  9. Some women may attend the postpartum visit, but encounter barriers to receiving LARC, such as inability to pay, clinicians or clinics not offering LARC, or need for a repeat visit for placement