Dr Sharon Cameron, University of Edinburgh/Royal Infirmary of Edinburgh: Post Placental Intrauterine contraception (PPIUC): Health Service Evaluation

£146,890 over 24 months 

A woman’s fertility can return soon after childbirth but looking after a young baby and recovering from childbirth can mean that contraception is a low on a mother’s list of priorities at that time. There is evidence that a significant proportion of women have an unintended pregnancy in the year after childbirth. Some of these will end in termination or may lead to short spaces between babies. Short intervals between birth and becoming pregnant again (less than one year) can place the baby at higher risk of being born prematurely. One of the most effective methods of contraception is Intrauterine contraception (IUC), which includes the copper intrauterine device (coil) and levonorgestrel releasing intrauterine system (mirena). IUC is placed in the womb and requires a health care provider to insert it. The need for an appointment to have IUC inserted is a barrier to obtaining this method at any time, but particularly for mothers occupied with the requirements of looking after a young baby and recovering from childbirth This project examines the provision of IUC to women who want to use this method- immediately after giving birth when they are still in the maternity service. This is common in many parts of the world but not yet routinely offered in the UK. Yet there is evidence that significant numbers of women in the UK might be keen to use IUC after birth and to have it provided immediately after delivery. As part of the study will train obstetricians and midwives in a region of the UK (NHS Lothian: Edinburgh and surrounding region) to provide IUC for women after birth. We will determine how popular this is amongst women and we will interview women about their experiences, satisfaction, and continued use of IUC. We will determine the views and experiences of obstetricians and midwives about providing the IUC service. The information that we gather will enable us to determine if, and how this service could be rolled out to other NHS maternity services within United Kingdom. Why does this matter? Ultimately we would hope that by helping women access one of the most highly effective methods of contraception more easily after birth (IUC), we can help prevent more unintended pregnancies for women and also improve spacing between pregnancies with better chances for babies of being born at the correct time.

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