Albert Einstein College of Medicine of Montefiore Medical Center, 1825 Eastchester Rd., Bronx, NY, 10461.
Albert Einstein College of Medicine of Montefiore Medical Center, 1825 Eastchester Rd., Bronx, NY, 10461.
Contraception. 2018 May;97(5):411-414. doi: 10.1016/j.contraception.2018.01.017. Epub 2018 Feb 8.
Nurses play an integral role in intrapartum and postpartum patient education. This exploratory study aims to assess the attitudes, knowledge, and practices of labor and delivery and postpartum nurses regarding contraception and evaluate for changes in these measures 1 year after an institutional initiative allowing routine availability of immediate postpartum long-acting reversible contraception (LARC).
In 2014, Montefiore Medical Center began to routinely offer comprehensive immediate postpartum contraception. The initiative included education and feedback sessions for labor and delivery and postpartum nurses on contraception, including immediate postpartum initiation of LARC. Nurses completed anonymous surveys at the beginning of the initiative (n=59) and at 1 year (n=56). We compared baseline and 1 year survey results of contraceptive knowledge, attitudes and practices using χ test, Fisher's Exact Test, or t test as appropriate.
Nurses who stated they counseled patients on contraception "always" or "most of the time" increased from 27/59 (46%) to 40/56 (71%) (p=.005). The number of nurses who would recommend the intrauterine device and implant for postpartum contraception increased from 1/59 (2%) to 18/56 (32%) (p<.0001). Attitudes towards injectable contraception and breastfeeding remained negative; 27/59 nurses (46%) at baseline and 34/56 (61%) at 1 year agreed with the statement "DMPA [depot medroxyprogesterone acetate] has a negative effect on breastfeeding."
Experience working in a location with routine access to immediate postpartum contraception is associated with increased awareness among nurses of postpartum contraceptive options, especially LARC, and increased contraceptive counseling. Concerns about the impact of hormonal contraception on breastfeeding, specifically DMPA, are persistent and prevalent.
Labor and delivery and postpartum nurses' knowledge regarding immediate postpartum contraception, particularly LARC methods, may change with exposure to routine access to these methods. This exposure may also impact nurses' practices of providing patient counseling on what methods are appropriate for postpartum women.
护士在分娩期和产后患者教育中发挥着重要作用。本探索性研究旨在评估分娩和产后护士对避孕的态度、知识和实践，并评估在机构允许常规提供即时产后长效可逆避孕（LARC）后 1 年，这些措施的变化。
2014 年，Montefiore 医疗中心开始常规提供全面的即时产后避孕。该倡议包括对分娩和产后护士进行避孕教育和反馈会议，包括即时产后开始使用 LARC。护士在该倡议开始时（n=59）和 1 年后（n=56）完成了匿名调查。我们使用 χ2 检验、Fisher 精确检验或 t 检验比较了避孕知识、态度和实践的基线和 1 年调查结果。
表示经常或大部分时间为患者提供避孕咨询的护士从 27/59（46%）增加到 40/56（71%）（p=.005）。愿意推荐宫内节育器和植入物作为产后避孕的护士人数从 1/59（2%）增加到 18/56（32%）（p<.0001）。对避孕针和母乳喂养的态度仍然是负面的；59 名护士中有 27 名（46%）在基线时和 56 名中有 34 名（61%）在 1 年后同意“DMPA（醋酸甲羟孕酮）对母乳喂养有负面影响”的说法。
在能够常规获得即时产后避孕的地方工作的经验与护士对产后避孕选择的认识增加有关，特别是 LARC 和增加的避孕咨询。对激素避孕，特别是 DMPA，对母乳喂养的影响的担忧仍然存在且普遍。
分娩和产后护士对即时产后避孕的知识，特别是 LARC 方法，可能会随着对这些方法的常规获得的接触而改变。这种接触也可能影响护士对产后妇女适用哪些方法进行患者咨询的做法。
