Immediate postpartum long-acting reversible contraception (LARCs, or implants and IUDs) can reduce unintended pregnancy and short intervals between pregnancy. Georgia was one of the first states in the nation to reimburse for LARCs placed immediately after childbirth. The Jane Fonda Center, P3, Georgia Ob/Gyn Society, and the CDC met with the Department of Community Health, the CMOs and Department of Public Health to work on this issue, and the Medicaid Bulletin was released April 2014.
The Jane Fonda Center and Dr. Kottke have led the training and implementation efforts for the state of Georgia:
- Chair of the Georgia Perinatal Quality Committee (GAP-QC), a workgroup seeking to have postpartum LARC services as a quality project for State hospitals. The Jane Fonda Center hosts the workgroup meetings and is considered the content expert.
- Trainings at approximately 15 sites in Georgia (including each academic institution and regional perinatal system)
- Training at the Georgia Ob/Gyn Society meeting annually for several years
- Presentations at the Georgia Hospital Pharmacists Annual Meeting
- Presentations at the Georgia Perinatal Association’s Annual Meeting
- Presentation at combined Georgia Ob/Gyn and Pediatrician Meeting
- Presentation at Healthy Moms, Healthy Babies Conference
- Georgia Ob/Gyn Society newsletter mailing on the topic
- Chair the Maternal Project for the Georgia Perinatal Quality Collaborative, which focused on implementation of PPLARC at the hospital level
This work also takes place at the national level:
- Along with the Department of Public Health and Medicaid, represented Georgia at the Association of State and Territorial Health Officials (ASTHO) for their PPLARC learning collaborative.
- Presented training experiences at the Association of Maternal Child Health Programs (AMCHIP)
- Presentations in Missouri, Minneosta, Oklahoma, Tennessee
Lisa Hofler, MD, MPH, MBA, was a Family Planning fellow at Emory from 2014 to 2016. Under the direction of Dr. Kottke, she conducted a qualitative study on postpartum LARC implementation:
Hofler LG, Cordes S, Cwiak CA, Goedken P, Jamieson DJ, Kottke M. Implementing Immediate Postpartum Long-Acting Reversible Contraception Programs. Obstet Gynecol. 2016 Dec 2. [Epub ahead of print] PMID: 27926643
- ACOG plans to develop a platform for national training and has reached out to partner on this given our State experiences.
- Georgia Ob/Gyn Society and Doctor’s Company and the Center are working on a webinar with CME that will always be available
- Revising our tool kit to include implementation considerations
- Working on protocol for a study looking at issues of consent for PPLARC