Family Planning NSW, Ashfield, Australia; SPHERE Centre of Research Excellence, Monash University, Australia.
Canterbury Hospital, SLHD, Australia.
Women Birth. 2022 Sep;35(5):e439-e445. doi: 10.1016/j.wombi.2021.11.002. Epub 2021 Nov 23.
Repeat pregnancy in the first year after a birth is common. Many of these conceptions are unintended and may be prevented by providing access to contraception in the immediate postpartum period. Midwives in the hospital setting could potentially play a greater role in improving postnatal contraception information and provision.
We sought to implement and examine the success of a program training hospital-based midwives in immediate postpartum implant insertion.
This mixed methods study in two hospitals in New South Wales sought to explore the feasibility, acceptability and sustainability of a program that provided competency-based implant insertion training for midwives. The study documented training completion, implant insertion numbers and experience, and conducted end of study interviews with midwives and stakeholders.
Twenty-seven midwives undertook training and inserted 265 implants during the study period. Interviews with 13 midwives and 11 stakeholders concluded the program to be feasible and acceptable with midwives reporting high satisfaction from their involvement. All interviewees felt that midwives were well placed to insert implants, and reported that challenges around workload and opportunities for practice were generally manageable. It was recognised that sustainability of the program would require supportive policy and regular insertion opportunities.
Midwives successfully upskilled in implant insertions and there was widespread support for the program with expectations it would be sustained. Provision of contraceptive information and implant insertion by midwives in the immediate postpartum period is likely to increase contraceptive choice and access for women and contribute to reducing rapid repeat pregnancies.
产后一年内再次怀孕的情况很常见。其中许多怀孕是意外的，如果在产后立即提供避孕措施，就可以预防这些怀孕。医院里的助产士可能在改善产后避孕信息和服务方面发挥更大的作用。
我们旨在实施并检验培训医院助产士进行产后立即放置宫内节育器的计划的成功情况。
本研究在新南威尔士州的两家医院进行，采用混合方法，旨在探讨为助产士提供基于能力的宫内节育器插入培训的计划的可行性、可接受性和可持续性。该研究记录了培训完成情况、宫内节育器插入数量和经验，并对助产士和利益相关者进行了研究结束时的访谈。
27 名助产士接受了培训，并在研究期间插入了 265 个宫内节育器。对 13 名助产士和 11 名利益相关者的访谈得出结论，该计划是可行和可接受的，助产士对参与该计划表示非常满意。所有受访者都认为助产士很适合插入宫内节育器，并报告说工作量方面的挑战和实践机会有限，通常是可以管理的。人们认识到，该计划的可持续性需要有支持性的政策和定期的插入机会。
助产士成功地掌握了宫内节育器插入技术，并且该计划得到了广泛的支持，预计将得以持续。在产后立即由助产士提供避孕信息和宫内节育器插入服务，可能会增加妇女的避孕选择和获得机会，并有助于减少快速重复怀孕的情况。
