Lactation Clinical Trial
Official title:
Immediate Versus Interval Postpartum Use of the Levonorgestrel Contraceptive Implants: a Randomized Controlled Trial
This study will evaluate if immediate postpartum placement of a levonorgestrel (LNG) contraceptive implant within 5 days of delivery improves implant utilization at 6 months postpartum compared to implant placement at 6-8 weeks postpartum among women in Uganda.
Waiting until 6 weeks postpartum to initiate contraception puts women at risk for unintended
pregnancy and short birth intervals. Short birth intervals of less than 18 months are
associated with an increased risk of preterm delivery and low birth weight infants.
Subdermal implants are advantageous for the postpartum period because they are long-acting,
reversible, and highly effective, and they do not contain estrogen or require intrauterine
placement. In observational studies postpartum continuation rates have been shown to be
greater than 95% after 6 months and 86-87% after 1 year in US populations. Implants are not
routinely available during the immediate postpartum period in Uganda, and availability could
improve the contraceptive method mix for postpartum women in that country. The results of
this study may support increasing access to a form of immediate postpartum LARC (long acting
reversible contraception) in a developing country.
This is a randomized, controlled trial of the association between immediate postpartum
contraceptive implant placement and implant utilization at 6 months postpartum among women in
Uganda. This study will compare the proportion of women using the Levonorgestrel
contraceptive implant at 6 months after delivery in women randomized to insertion within 5
days of delivery (immediate insertion) or 6 weeks after delivery (delayed insertion). The
study population is women who have a delivery at Mulago hospital in Kampala, Uganda and
choose a contraceptive implant for postpartum contraception.
The investigators plan to enroll 202 women who are planning to receive a postpartum
Levonorgestrel contraceptive implant after delivery to find out whether the timing of
postpartum administration of the implant (prior to hospital discharge or 6 weeks after
delivery) affects implant utilization, satisfaction with the implant, vaginal bleeding or
breastfeeding.
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