Immediate Postpartum Etonogestrel Implant Insertion

Document Type

Conference Proceeding

Publication Date

6-30-2025

Publication Title

Michigan Medical Education and Health Bulletin

Abstract

Introduction: The immediate postpartum period is an opportunity to initiate effective contraception to help lengthen pregnancy intervals and improve maternal outcomes. There has been much data to support the safety and efficacy of immediate postpartum Etonogestrel implant insertion. We initiated postpartum Etonogestrel implant protocol at Corewell Heath Dearborn over the past year. Methods: This is a quality improvement project to evaluate uptake of inpatient postpartum etonogestrel implant insertions from August 01, 2024 to Jan 31, 2025. The number of etonogestrel implant inserted in the immediate postpartum periods both after vaginal delivery and cesarean delivery were analyzed. Results: During the six months between Aug 2024 to Jan 2025, a total of six etonogestrel implants were inserted in postpartum patients. There were no insertions from August through November 2024. However, two etonogestrel implants were inserted in December and four etonogestrel implants were inserted in January. Conclusions: This project demonstrated that the immediate postpartum period is an accessible and appropriate time to discuss and place log-acting reversible contraception such as the 68 mg etonogestrel implant. Factors that led to successful placement include adequate time to educate the patient and address their concerns, having the implant readily available on the postpartum floor, and patient willingness to accept contraception during the postpartum period. Barriers to postpartum implant insertion include patient concern with contraception affecting breastfeeding, language barriers, patient concern for side effects, belief that contraception not required due to breastfeeding or abstinence, lack of time afforded to patient to express questions or concerns, personal religious or cultural beliefs, and anecdotal evidence of negative effects from patient’s social network. Overall, immediate postpartum etonogestrel implant insertion provides the patient with vital contraception to reduce the risk of short-interval and unintended pregnancies provided thorough education and counselling is provided to the patient and the implant is readily available for insertion.

Volume

3

Issue

2 Suppl

First Page

A129

Comments

10th Annual Michigan Summit on Quality Improvement, Patient Safety & High Value Care, May 22, 2025, Troy, MI

Last Page

A129

DOI

10.69735/​001c.141328

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