Effect of a mobile phone-assisted postpartum family planning service on the use of long-acting reversible contraception: a randomised controlled trial

Abstract

Objective: The aim of the study was to evaluate the effect of adding mobile phone call reminders to a postpartum family planning service on the initiation of long-acting reversible contraception (LARC).

Methods: A randomised, open-label controlled trial (ClinicalTrials.gov NCT03135288) was carried out at a university hospital between July 2017 and March 2019. The study comprised women who delivered a live birth at >28 weeks' gestation and who requested birth spacing for ≥1 year. Eligible women were recruited and randomised to two groups. The study group received contraceptive counselling and two reminders of their first postpartum appointment, one week and again 48 h before the appointment. The control group received contraceptive counselling but no mobile phone reminders of their first postpartum appointment. The primary outcome was the rate of initiation of a LARC method in the first 6 months postpartum.

Results: The study comprised 500 participants in each group. The rate of initiation and continuation of a LARC method was significantly higher in the study group compared with the control group (30.2% vs 8.4% and 95.4% vs 83.3%, respectively; p < .001). In the study group, 382 (76.4%) women had started using a contraceptive method during the first 6 months, compared with 218 (43.6%) women in the control group (p < .001).

Conclusion: Using mobile phone reminders as part of the postpartum service increases the frequency of women who attends family planning clinics and initiates contraception, including a LARC methods, as well as the proportion who continue LARC use through the first 6 months postpartum.

Keywords: Contraception; LARC; family planning; mobile phone.