Contraception Choice and Compliance Among Mothers with Opioid Addiction: Identifying Barriers to Care

Abstract

West Virginia leads the nation in substance abuse deaths per capita. This epidemic has given rise to a novel population of high risk, obstetrics patients with opiate abuse. Appropriate education, counseling, and implementation of contraception is of extreme importance among this population due to risks of unintended pregnancy. This study was a retrospective chart review to determine compliance and uptake of contraceptive methods by patients in a maternal buprenorphine maintenance program prior to and following implementation of standardized contraception education and Medicaid coverage of immediate postpartum long acting reversible contraceptives (LARC). Rates of planned contraception and rates of actual method initiation were compared between two groups representing two distinct time periods before and after intervention. Rates of high efficacy contraception options, especially LARC options, were noted to statistically significantly increase following dedicated education and Medicaid coverage. Patients receiving no contraception at all significantly decreased following these interventions. Patients desiring surgical sterilization continued to encounter barriers to care as the rate of actual sterilization to desired sterilization was still very low.

Keywords

• substance abuse
• maternal
• compliance
• contraception