Table 4.
Comparison of Barriers Affecting Routine and Immediate Postpartum LARC Provision “Quite a Bit” or “a Great Deal” Among Wisconsin Providers Who Report Providing Both Contraceptive Care and Prenatal Care or Obstetrical Deliverya
| Ob-gyn (n=358) | Family Medicine (n=86) | Midwifery (n=111) | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Routine | IPP | P-valueb | Routine | IPP | P-valueb | Routine | IPP | P-valueb | |
| Barriers impacting both routine and IPP LARC | |||||||||
| Lack of skill in insertion | 0.8% | 13.8% | <.0001 | 8.1% | 35.9% | <.0001 | 11.7% | 34.2% | <.0001 |
| Lack of familiarity with insurance policies | 1.7% | 10.6% | <.0001 | 3.5% | 16.7% | <.0001 | 7.2% | 22.5% | .001 |
| Cost of device | 3.4% | 8.5% | <.0001 | 5.8% | 7.7% | .63 | 14.4% | 20.7% | .13 |
| Challenges with reimbursement | 3.1% | 16.3% | <.0001 | 8.1% | 9.0% | .85 | 16.2% | 22.5% | .24 |
| Personal or religious beliefs | 0.6% | 0.9% | .62 | 2.3% | 1.3% | .62 | 3.6% | 6.3% | .35 |
| Low patient interest | 3.9% | 28.7% | <.0001 | 11.6% | 16.7% | .35 | 10.8% | 36.0% | <.0001 |
| Lack of eligible patients | 2.0% | 9.4% | <.0001 | 3.5% | 5.1% | .60 | 1.8% | 6.3% | .09 |
| Lack of time for counseling | 0.6% | 5.9% | <.0001 | 1.2% | 5.1% | .14 | .9% | 2.7% | .31 |
| Devices not available on-site | 3.4% | 52.5% | <.0001 | 7.0% | 50.0% | <.0001 | 18.0% | 59.5% | <.0001 |
| Barriers unique to IPP LARC | |||||||||
| Group practice call schedule rotation | N/A | 16.4% | N/A | N/A | 3.9% | N/A | N/A | 13.5% | N/A |
| Coordination of LARC services with delivery facility | N/A | 37.8% | N/A | N/A | 34.6% | N/A | N/A | 46.0% | N/A |
| Delivery facility prohibition of LARC | N/A | 31.4% | N/A | N/A | 35.9% | N/A | N/A | 27.0% | N/A |
| Policies in my organization or practice related to immediate postpartum LARC | N/A | 23.8% | N/A | N/A | 24.4% | N/A | N/A | 30.6% | N/A |
Abbreviations: IPP, immediate postpartum; LARC, long-acting reversible contraceptive; N/A, Not applicable.
a
Providers who answered zero LARC barriers (n = 3) were excluded from routine columns; providers who answered zero IPP LARC barriers (n = 28) were excluded from IPP columns.
b
Chi-square test of difference by LARC insertion period.