Long-Acting Reversible Contraceptives In Vermont: A Survey Based Assessment Of Current Knowledge Of Providers Of Women Of Reproductive Age

摘要

Unintended pregnancies are a long-standing public health issue nationally, with percentages hovering around 50% for at least the last five years. Vermont is doing slightly better than the national average, but is faced with itu27s own challenges due to itu27s rural nature. Agencies and organizations, such as the World Health Organization, March of Dimes and the Vermont Department of Health have made decreasing unintended pregnancies one of their priorities to improve maternal and fetal health outcomes, as well as social and economic opportunities for families. Current evidence-based guidelines call for long- acting reversible contraceptives (LARCs), including intrauterine devices (IUDs) and implants, as the first-line recommendation by healthcare providers for decreasing unintended pregnancies.This study, in collaboration with several Vermont state organizations and agencies, engaged healthcare professionals throughout the state with an electronically disseminated survey aimed at assessing their knowledge of LARCs. The aim of this study was to ascertain whether healthcare professionals caring for women of reproductive age, are using current evidence-based practice guidelines to counsel women in their contraceptive choices.Survey results revealed that the majority of the respondents consider themselves to be knowledgeable about and had received a high level of training in IUD counseling and/or insertion. Areas of uncertainty were primarily about side effects and the insertion and removal processes of the implant, as well as a few categories of medical eligibility. This was especially apparent when results were stratified by urban and rural regions of Vermont.Although there seems to be a high level of provider confidence in knowledge about LARCs and reported counseling of LARCs as first-line, there is a discrepancy between what providers think they know and current evidence based contraception guidelines. Many factors exist that could explain this discrepancy, including but not limited to lack of training, provider bias, and system barriers. This study aims to illuminate gaps in provider knowledge to improve uptake of LARCs and over time make a shift in the numbers of unintended pregnancies in Vermont.