Bedsider for Postpartum Contraception Counseling

Jennifer Bromley, MD and Karen Garancher, MD

Wake Forest Baptist Health in Winston-Salem, North Carolina

This study evaluated using the Bedsider website in postpartum contraceptive counseling. Thirty-nine women were counseled about contraceptive options using Bedsider in the hospital after delivery. A standardized script was used for contraceptive counseling using an iPad with the Bedsider website and emphasizing long-acting contraceptives. The script also reviewed the risks of short interpregnancy interval and the specific challenges in postpartum contraceptive options. Patients completed a survey in the hospital following this counseling and were asked to complete a second survey at their 6 week postpartum visit. Individual patient’s contraceptive choices before and after counseling and the likelihood they would change their decision after counseling were analyzed.

Patients were pleased with the addition of Bedsider to their contraceptive counseling. After receiving counseling about contraceptive options using Bedsider, 73% indicated a desire to use a LARC method for future contraception, as compared to 32% interested in LARC before counseling. Only 2% of the cohort had used a LARC method prior to the index pregnancy. A statistically significant number of patients changed from not wanting a LARC method prior to counseling to wanting a LARC method after counseling. 46% of patients were lost to follow-up after the initial hospital encounter. At the postpartum visit, 89% of remaining patients chose a LARC. Major barriers to contraception were access, both to care and to affordable options. Many patients did not have insurance and could not afford LARCs.

One of the challenges encountered during the study was that postpartum patients were busy with family and their newborn, restricting their ability to focus on contraceptive counseling. In the future, the investigators plan to introduce Bedsider during routine prenatal visits and to improve access to LARC methods by providing immediate postpartum placement in the hospital prior to discharge.

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