Increasing Knowledge of Intrauterine Devices in the Immediate Postpartum Period

The goal of this scholarly project was to increase knowledge about immediate postpartum intrauterine device insertions (IUDs) in the hospital setting among current labor and delivery nurses. To accomplish this goal, an educational module was created about immediate postpartum IUD insertions, which was then presented at a nursing in-service. The training was conducted at an Intermountain hospital in the Salt Lake valley. This training focused on immediate postpartum IUDs was one part of a multifaceted approach to increase contraceptive access in Utah. The broader objective of increasing contraceptive access in Utah was funded in part by the National Institute of Reproductive Health 2016 Utah LARC project. In the United States, approximately half of all pregnancies are unintended; which is defined as an unwanted or mistimed pregnancy. Unintended pregnancies generally result from women who are using no contraceptive method, or more commonly, a contraceptive method inconsistently or incorrectly. One reason for the persistently high U.S. rate of unintended pregnancy is that many reproductive aged women use contraceptive methods such as oral contraceptive pills and condoms, which are less reliable methods with high typical-use failure rates. The utilization of long acting reversible contraceptives, the IUD and implant, has been proven to significantly reduce unintended and short interval pregnancies. Registered nurses on labor and delivery units play an important role in increasing the use of immediate postpartum IUDs and many nurses receive no training about this method of contraception, the procedure and their role in assisting obstetric providers during the insertion of this method. With the increased use of immediate postpartum IUD and implant insertions on labor and delivery units, new and experienced nurses now have an important role in contraceptive counseling and care. The objectives of this scholarly project were as follows: 1) develop a comprehensive educational module regarding immediate postpartum IUD insertion; 2) pilot the educational module with labor and delivery staff at an in-service session at a hospital participating in the 2016 LARC project; 3) develop an educational handout for pregnant women about immediate postpartum IUD insertion; and 4) submit for poster presentation at the 2017 Western Institute of Nursing Conference. The educational module presented was based on information gathered from a literature review of immediate postpartum IUD use and content expert knowledge. An initial in-service was held in a hospital participating in the 2016 LARC project. Revisions were made following the presentation, pre and post-test surveys and analysis of the data collected. The presentation may be disseminated to other hospitals participating in the LARC 2016 project for future use. The educational handout was made available to health care providers during the 2016 Prematurity Prevention Summit on October 24, 2016. Further dissemination of the handout will be made available on the UWNQC website. The poster was accepted for presentation at the WIN 2017 conference and will occur on April 20, 2017 in Denver, Colorado. Ensuring a contraceptive plan is in place during the postpartum period supports decreasing unintended pregnancy rates in the United States. It is vital to educate labor and delivery nurses of their role in supporting immediate postpartum IUD insertions.