Perspectives of obstetricians and midwives on the provision of immediate postpartum intrauterine devices: A qualitative service evaluation

Nicola Boydell, Michelle Cooper, Sharon Cameron, Anna Glasier, Shiona Coutts, Frances McGuire, Jeni Harden

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Immediate postpartum intrauterine device (PPIUD) insertion is safe and effective but largely unavailable in Europe. Data on maternity staff views on the provision and implementation of PPIUD services are limited. The objective of this qualitative evaluation was to explore the views and experiences of obstetricians and midwives providing PPIUD within a UK maternity setting, in order to identify areas for improvement and inform service provision in other areas.
Methods: Qualitative health services research within two public maternity hospitals in Lothian (Edinburgh and surrounding region), UK. Interviews with 30 maternity staff (n= 8 obstetricians; n=22 midwives) involved in PPIUD provision. Data were analysed thematically.
Results: Maternity staff were positive about the benefits of PPIUD for women. Midwives reported initial concerns about PPIUD safety, and the impact on workload; these views shifted following training, and as PPIUD was embedded into practice. Having a large pool of PPIUD trained staff was identified as an important factor in successful service implementation. Having PPIUD champions was important to address staff concerns, encourage training uptake, and advocate for the service to ensure continued resourcing.
Conclusions:
PPIUD in maternity services can help address unmet need for effective contraception in the immediate postpartum period. We emphasise the importance of widespread engagement around PPIUD among all healthcare professionals involved in care of women, to ensure staff are informed and supported. Clinical champions and leaders play a key role in amplifying the benefits of PPIUD, and advancing organisational learning.
Original languageEnglish
JournalBMJ Sexual & Reproductive Health
DOIs
Publication statusPublished - 30 Jun 2021

Keywords

  • Postpartum intrauterine device
  • Postpartum intrauterine contraception
  • Postpartum contraception
  • Intrauterine devices
  • Long-acting reversible contraception
  • Health services research
  • Qualitative research

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