Postpartum contraceptive access for uninsured women in Baltimore
Awarded 2018
Complex Family Planning Fellowship Research
Jill Edwardson, MD
Johns Hopkins University

At our institution, a grant providing donated, no-cost LARC for eligible women ended in September 2017.  Of note, the primary beneficiaries of this program were uninsured, undocumented postpartum Hispanic women.  Since the program ended, patients have been referred to outside providers to obtain LARC, and specifically Nexplanon, which was the most popular LARC choice of women in the program.  Given these new barriers to accessing LARC, we hypothesize that a smaller proportion of postpartum LARC program-eligible women will receive LARC compared to those who delivered during the LARC program.  We will perform a retrospective cohort study comparing a group of LARC program-eligible women who delivered during and after the program.  The primary aim is to determine the difference in Nexplanon initiation between these two groups by the postpartum visit (within 6 weeks) and at 6 months postpartum.  Additional study objectives include comparing the use of any LARC or hormonal contraceptive at 6 months postpartum and rates of pregnancy within 6 months postpartum between the two groups.  We will also identify barriers to and enablers for LARC program-eligible women to receiving postpartum contraception.  Eligible women will be identified via the electronic medical record and will be contacted by phone and in person via our hospital’s pediatric practice and offered participation in the study.  All women will be compensated for survey completion.