Our Summary

This research paper looks at how women used long-lasting reversible contraception (known as PPLARC) after giving birth, during a time when the COVID-19 pandemic was at its peak and many surgeries, including postpartum sterilization (known as PPBTL), were cancelled. The researchers studied the medical records of patients who had wanted to have their tubes tied (PPBTL) after giving birth between March and June 2020 but were unable to do so because surgeries were cancelled. They then checked to see what forms of contraception these women were using at the time they were released from the hospital and again 18 months later. They also checked to see how many of these women became pregnant during that time.

The researchers found that 22% of the women chose to use PPLARC as a temporary form of birth control until they could have their tubes tied. However, after 18 months, only 14.3% of these women had ended up having the sterilization procedure, compared to 39.3% of the women who did not use PPLARC. None of the women who used PPLARC became pregnant, while 21.6% of the women who did not use PPLARC did become pregnant.

The study suggests that using PPLARC as a temporary form of birth control can be effective, but doctors need to be aware that women might delay getting their tubes tied if they are comfortable with the effectiveness of PPLARC. The researchers recommend that doctors improve the way they discuss birth control options with their patients and be more transparent about the challenges of getting a sterilization procedure.

FAQs

  1. What is the difference between PPLARC and PPBTL?
  2. What percentage of women chose to use PPLARC as a temporary form of birth control when they could not have their tubes tied due to the cancellation of surgeries during the COVID-19 pandemic?
  3. Based on the research, what are the recommendations for doctors regarding the discussion of birth control options with their patients?

Doctor’s Tip

One helpful tip a doctor might give a patient considering bilateral tubal ligation is to discuss all available options for long-lasting reversible contraception, such as PPLARC, and explain the pros and cons of each method. It’s important for patients to understand that PPLARC can be an effective temporary form of birth control but may lead to delays in getting a permanent sterilization procedure. Patients should be encouraged to communicate openly with their healthcare provider about their preferences and concerns regarding contraception and sterilization.

Suitable For

Patients who are typically recommended bilateral tubal ligation are those who have completed their desired family size or do not wish to have any more children in the future. This procedure is a permanent form of contraception and is typically recommended for women who are sure they do not want to have biological children in the future. It is also a popular choice for women who have a high risk of complications during pregnancy or childbirth and want to avoid the risks associated with pregnancy. Additionally, women who have certain medical conditions that make pregnancy dangerous or difficult may also be recommended bilateral tubal ligation as a form of contraception.

Timeline

Before bilateral tubal ligation:

  • Patient expresses desire to have tubes tied after giving birth
  • Surgery is scheduled for postpartum sterilization (PPBTL)
  • Surgery is cancelled due to COVID-19 pandemic
  • Patient is discharged from hospital with temporary forms of contraception, including long-lasting reversible contraception (PPLARC)

After bilateral tubal ligation:

  • Patient uses PPLARC as temporary form of birth control
  • Patient eventually undergoes bilateral tubal ligation procedure
  • Patient is monitored for pregnancy
  • Researchers track contraception use and pregnancy rates over 18 months
  • Results show that women who used PPLARC had lower pregnancy rates but delayed getting the sterilization procedure compared to those who did not use PPLARC

What to Ask Your Doctor

  1. What are the risks and benefits of bilateral tubal ligation as a permanent form of contraception?
  2. What is the success rate of bilateral tubal ligation in preventing pregnancy?
  3. Are there any alternative forms of contraception that may be more suitable for my individual needs and lifestyle?
  4. What is the recovery process like after undergoing bilateral tubal ligation?
  5. Are there any long-term side effects or complications associated with bilateral tubal ligation?
  6. How soon after giving birth can bilateral tubal ligation be performed safely?
  7. Will bilateral tubal ligation affect my hormone levels or menstrual cycle?
  8. Is bilateral tubal ligation reversible in case I change my mind in the future?
  9. What should I expect in terms of follow-up care after undergoing bilateral tubal ligation?
  10. How does the use of long-lasting reversible contraception (PPLARC) compare to bilateral tubal ligation in terms of effectiveness and safety?

Reference

Authors: Cosgriff L, Plummer M, Concepcion G, Danvers AA. Journal: Womens Health Rep (New Rochelle). 2024 Apr 23;5(1):352-357. doi: 10.1089/whr.2023.0142. eCollection 2024. PMID: 38666225