Usher Institute, The University of Edinburgh, Edinburgh, UK
Chalmers Centre, NHS Lothian, Edinburgh, UK.
BMJ Sex Reprod Health. 2022 Apr;48(2):85-92. doi: 10.1136/bmjsrh-2021-201170. Epub 2021 Jun 29.
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.
Qualitative health services research within two public maternity hospitals in Lothian (Edinburgh and surrounding region), UK. Interviews with 30 maternity staff (obstetricians n=8; midwives n=22) involved in PPIUD provision. Data were analysed thematically.
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.
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 the 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.
即时产后宫内节育器（PPIUD）的插入是安全有效的，但在欧洲却基本无法获得。关于产科工作人员对 PPIUD 服务的提供和实施的看法的数据有限。本定性评估的目的是探讨在英国产科环境中提供 PPIUD 的产科医生和助产士的观点和经验，以确定改进的领域，并为其他领域的服务提供信息。
在英国洛锡安的两家公立医院（爱丁堡及周边地区）进行定性卫生服务研究。对 30 名参与 PPIUD 提供的产科工作人员（妇产科医生 n=8；助产士 n=22）进行了访谈。数据进行了主题分析。
产科工作人员对 PPIUD 对妇女的益处持积极态度。助产士最初对 PPIUD 的安全性和对工作量的影响表示担忧；在接受培训后，随着 PPIUD 被纳入实践，这些观点发生了转变。拥有大量接受过 PPIUD 培训的工作人员被认为是成功实施服务的一个重要因素。有 PPIUD“拥护者”对解决员工的担忧、鼓励培训参与率以及倡导服务以确保持续提供资源非常重要。
在产科服务中使用 PPIUD 可以帮助解决产后立即使用有效避孕方法的未满足需求。我们强调了所有参与妇女护理的医疗保健专业人员广泛参与 PPIUD 的重要性，以确保员工得到充分的信息和支持。临床拥护者和领导者在放大 PPIUD 的益处和推进组织学习方面发挥着关键作用。
