Population Research Center, The University of Texas at Austin, Austin, Texas.
Population Research Center, The University of Texas at Austin, Austin, Texas; Department of Sociology, The University of Texas at Austin, Austin, Texas.
Womens Health Issues. 2022 Jul-Aug;32(4):334-342. doi: 10.1016/j.whi.2022.02.006. Epub 2022 Apr 19.
Prior longitudinal studies of long-acting reversible contraception (LARC) satisfaction and continuation guaranteed their participants access to LARC removal. Under real-world conditions, LARC users who wish to discontinue may experience barriers to LARC removal.
A prospective cohort study recruited 1,700 postpartum Texans without private insurance from 8 hospitals in 6 cities. Our analysis included the 418 respondents who initiated LARC in the 24 months after childbirth. A content analysis of open-ended survey responses identified three categories of LARC users: satisfied, resigned, and dissatisfied. Satisfied LARC users were using their method of choice. Resigned users were using LARC as an alternative method when their preferred method was inaccessible. Dissatisfied users were unhappy with LARC. Multinomial logistic regression models identified risk factors for resignation and dissatisfaction. Cox proportional hazards models assessed differences in LARC discontinuation by satisfaction and sociodemographic characteristics.
Participants completed 1,505 surveys while using LARC. LARC users were satisfied in 83.46% of survey responses, resigned in 5.25%, and dissatisfied in 11.30%. Resignation was more likely if respondents were uninsured or wanted sterilization at the time of childbirth. The risk of dissatisfaction increased with time using LARC and was higher among uninsured respondents. U.S.-born Hispanic LARC users were more likely than foreign-born Hispanic LARC users to be dissatisfied and less likely to discontinue when dissatisfied. Dissatisfaction-but not resignation-predicted discontinuation. Cost, lack of insurance, and difficulty obtaining an appointment were frequent barriers to LARC removal.
Most postpartum LARC users were satisfied, but users who wished to discontinue frequently encountered barriers.
先前关于长效可逆避孕（LARC）满意度和持续使用的纵向研究保证了参与者可以获得 LARC 取出服务。在现实情况下，希望停止使用 LARC 的使用者可能会面临 LARC 取出的障碍。
一项前瞻性队列研究从德克萨斯州的 8 家医院招募了 1700 名没有私人保险的产后妇女。我们的分析包括在产后 24 个月内开始使用 LARC 的 418 名受访者。对开放式调查回复的内容分析确定了三种 LARC 用户类别：满意、顺从和不满意。满意的 LARC 用户正在使用他们选择的方法。顺从的用户在无法使用首选方法时，将 LARC 作为替代方法使用。不满意的用户对 LARC 感到不满。多项逻辑回归模型确定了顺从和不满的风险因素。Cox 比例风险模型评估了满意度和社会人口特征对 LARC 停用的差异。
参与者在使用 LARC 期间完成了 1505 份调查。在调查回复中，LARC 用户满意的比例为 83.46%，顺从的比例为 5.25%，不满的比例为 11.30%。如果受访者在分娩时没有保险或想要绝育，那么他们更有可能顺从。随着使用 LARC 的时间增加，不满的风险增加，并且没有保险的受访者的风险更高。与出生于美国的西班牙裔 LARC 用户相比，出生于外国的西班牙裔 LARC 用户更有可能不满，而在不满时更不可能停止使用。不满但不顺从预测了停用。成本、缺乏保险和难以预约是 LARC 取出的常见障碍。
大多数产后 LARC 用户满意，但希望停止使用的用户经常遇到障碍。
