WHAT’S NEW: Early insertion is safe and fosters compliance
Lactogenesis and lactation failure rates were comparable, whether the etonogestrel implant was inserted between 1 and 3 days postpartum or 4 to 8 weeks postpartum. An advantage of early insertion was increased contraceptive compliance. At 3 months postpartum, 13% of the women in the standard group were not using any birth control. Among those in the early insertion group, compliance was 100%.
CAVEATS: Study sample may not be representative
This was a small study, but it was powered to detect ≥8 hour difference in onset of stage II lactogenesis. Participants were not representative of all populations (91% were white, 73% of whom were Hispanic). Both the mothers and babies were healthy, so we can’t extrapolate to situations where either mom or baby is sick.
CHALLENGES TO IMPLEMENTATION: Finding clinicians trained in insertion technique
Health care providers trained in insertion of the etonogestrel implant would need to be available to promote insertion in the early postpartum period. Ensuring availability of the device in hospitals may require extra logistical planning; incorporating etonogestrel implant insertion into already-hectic morning rounds may be challenging, as well.
Acknowledgement
The PURLs Surveillance System is supported in part by Grant Number UL1RR024999 from the National Center for Research Resources, a Clinical Translational Science Award to the University of Chicago. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources or the National Institutes of Health.