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Published in: Trials 1/2019

Open Access 01-12-2019 | Contraception | Study protocol

Delivery of home-based postpartum contraception in rural Guatemalan women: a cluster-randomized trial protocol

Authors: Margo S. Harrison, Saskia Bunge-Montes, Claudia Rivera, Andrea Jimenez-Zambrano, Gretchen Heinrichs, Sharon Scarbro, Elizabeth Juarez-Colunga, Antonio Bolanos, Edwin Asturias, Stephen Berman, Jeanelle Sheeder

Published in: Trials | Issue 1/2019

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Abstract

Background

Postpartum contraception is important to prevent unintended and closely spaced pregnancies following childbirth.

Methods

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.

Discussion

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.

Trial registration

Clinicaltrials.gov, NCT04005391. Retrospectively registered on 1 July 2019.
Appendix
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Literature
2.
go back to reference Pasha O, Goudar SS, Patel A, et al. Postpartum contraceptive use and unmet need for family planning in five low-income countries. Reprod Health. 2015;12(Suppl 2):S11.CrossRef Pasha O, Goudar SS, Patel A, et al. Postpartum contraceptive use and unmet need for family planning in five low-income countries. Reprod Health. 2015;12(Suppl 2):S11.CrossRef
3.
go back to reference Schultz C, Larrea N, Celada M, Heinrichs G. A qualitative assessment of community attitudes and barriers to family planning use in the Trifinio region of southwest Guatemala. Matern Child Health J. 2018;22(4):461–6.CrossRef Schultz C, Larrea N, Celada M, Heinrichs G. A qualitative assessment of community attitudes and barriers to family planning use in the Trifinio region of southwest Guatemala. Matern Child Health J. 2018;22(4):461–6.CrossRef
4.
go back to reference Secura GM, Allsworth JE, Madden T, Mullersman JL, Peipert JF. The Contraceptive CHOICE Project: reducing barriers to long-acting reversible contraception. Am J Obstet Gynecol. 2010;203(2):115 e111–115.e117.CrossRef Secura GM, Allsworth JE, Madden T, Mullersman JL, Peipert JF. The Contraceptive CHOICE Project: reducing barriers to long-acting reversible contraception. Am J Obstet Gynecol. 2010;203(2):115 e111–115.e117.CrossRef
5.
go back to reference Asturias EJ, Heinrichs G, Domek G, et al. The Center for Human Development in Guatemala. Adv Pedistrics. 2016;63(1):357–87.CrossRef Asturias EJ, Heinrichs G, Domek G, et al. The Center for Human Development in Guatemala. Adv Pedistrics. 2016;63(1):357–87.CrossRef
Metadata
Title
Delivery of home-based postpartum contraception in rural Guatemalan women: a cluster-randomized trial protocol
Authors
Margo S. Harrison
Saskia Bunge-Montes
Claudia Rivera
Andrea Jimenez-Zambrano
Gretchen Heinrichs
Sharon Scarbro
Elizabeth Juarez-Colunga
Antonio Bolanos
Edwin Asturias
Stephen Berman
Jeanelle Sheeder
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Trials / Issue 1/2019
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-019-3735-3

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