Harrison Margo S, Bunge-Montes Saskia, Rivera Claudia, Jimenez-Zambrano Andrea, Heinrichs Gretchen, Scarbro Sharon, Juarez-Colunga Elizabeth, Bolanos Antonio, Asturias Edwin, Berman Stephen, Sheeder Jeanelle
University of Colorado, Mail Stop B198-2, Academic Office 1, 12631 E. 17th Avenue, Rm 4211, Aurora, Denver, CO, 80045, USA.
Fundación para la Salud Integral de los Guatemaltecos (FSIG), Quetzaltenango, Guatemala.
Trials. 2019 Nov 21;20(1):639. doi: 10.1186/s13063-019-3735-3.
Postpartum contraception is important to prevent unintended and closely spaced pregnancies following childbirth.
This study is a cluster-randomized trial of communities in rural Guatemala where women receive ante- and postnatal care through a community-based nursing program. When nurses visit women for their postpartum visit in the intervention clusters, instead of providing only routine care that includes postpartum contraceptive education and counseling, the nurses will also bring a range of barrier, short-acting, and long-acting contraceptives that will be offered and administered in the home setting, after routine clinical care is provided.
A barrier to postpartum contraception is access to medications and devices. Our study removes some access barriers (distance, time, cost) by providing contraception in the home. We also trained community nurses to place implants, which are a type of long-acting reversible contraceptive method that was previously only available in the closest town which is about an hour away by vehicular travel. Therefore, our study examines how home-based delivery of routinely available contraceptives and the less routinely available implant may be associated with increased uptake of postpartum contraception within 3 months of childbirth. The potential implications of this study include that nurses may be able to be trained to safely provide contraceptives, including placing implants, in the home setting, and provision of home-based contraception may be an effective way of delivering an evidence-based intervention for preventing unintended and closely spaced pregnancies in the postpartum period.
Clinicaltrials.gov, NCT04005391. Retrospectively registered on 1 July 2019.
产后避孕对于预防分娩后意外怀孕和间隔过短的怀孕至关重要。
本研究是在危地马拉农村社区进行的一项整群随机试验，当地妇女通过一项基于社区的护理项目接受产前和产后护理。在干预组中，当护士对妇女进行产后访视时，除了提供包括产后避孕教育和咨询在内的常规护理外，护士还将携带一系列屏障、短效和长效避孕药具，在提供常规临床护理后，于家中提供并发放这些药具。
产后避孕的一个障碍是获得药物和药具。我们的研究通过在家中提供避孕措施消除了一些获取障碍（距离、时间、成本）。我们还培训社区护士放置植入剂，这是一种长效可逆避孕方法，以前只能在距离约一小时车程的最近城镇获得。因此，我们的研究探讨了在家中提供常规可用的避孕药具和较少常规使用的植入剂与分娩后3个月内产后避孕使用率增加之间的关联。这项研究的潜在影响包括，护士可能能够接受培训，在家中安全地提供避孕药具，包括放置植入剂，并且在家中提供避孕措施可能是一种有效的方式，可提供基于证据的干预措施，以预防产后意外怀孕和间隔过短的怀孕。
Clinicaltrials.gov，NCT04005391。于2019年7月1日追溯注册。
