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Florida Perinatal Quality Collaborative

LARC Initiative

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Access LARC: Increasing Access to Immediate Postpartum Long-Acting Reversible Contraception

Over half of pregnancies in the United States are unintended; in 2010, Florida’s unintended pregnancy rate was 59% (Kost 2015). Furthermore, in 2010, 71% of unplanned Florida births were publicly funded (Sonfield and Kost 2015). The consequences of unintended or closely spaced pregnancies include poor pregnancy outcomes (i.e., low birth weight, preterm birth, small for gestational age), delayed initiation of prenatal care, lower breastfeeding rates, and higher risk of maternal depression and potential future child maltreatment (Guttmacher Institute 2011). Long-acting reversible contraceptive methods (LARC), including intrauterine devices (IUD) and progesterone implants, are safe and highly effective in preventing unintended pregnancies. Moreover, these can be given to women immediately after delivery. 

Project Timeline

This project launched in Fall 2017. Hospitals will participate in collaborative activities, including online learning sessions, in-person training, and submission and review of quality improvement process and outcome data until Spring of 2019. Strategies will be adaptable to all hospital settings. Each facility can either adopt an existing set of protocols or guidelines and tools or develop/adapt protocols or guidelines and tools using the evidence-based elements.

Collaborative hospitals will learn improvement strategies that include establishing goals and methods to develop, and test and implement changes to their systems using a quality improvement change cycle. 

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Project Goal

To work with participating Florida hospitals to improve hospital policies, procedures, and collaboration to increase access to immediate postpartum long-acting reversible contraception, and to work with Medicaid, and other payers and state partners, to facilitate access and use.