Among women aged 15-44 years who had a live birth, the percentage that is provided a LARC method (implants or intrauterine devices or systems (IUD/IUS)) within 3 and 60 days of delivery.
The 60-day period reflects American College of Obstetricians and Gynecologists (ACOG) recommendations that women should receive contraceptive care at the 6-week postpartum visit. The 3-day period reflects recent Centers for Disease Control and Prevention (CDC) and ACOG recommendations that the immediate postpartum period (i.e. at delivery, while the woman is in the hospital) is a safe and particularly effective time to provide contraception, which may offer greater convenience to the client and avoid missed opportunities to provide contraceptive care, especially considering that many women do not attend a postpartum visit.
How the Measure Should be Used
The Contraceptive Care – Postpartum Access to LARC measure should be used as an access measure; very low rates (less than 1-2% use) may signal barriers to LARC provision that should be addressed through training and quality improvement processes. The barriers to obtaining LARC are well documented, and include client and physician lack of knowledge, financial constraints, and logistical issues. The Contraceptive Care – Postpartum Access to LARC measure should NOT be used to encourage high rates of use as this may lead to coercive practices. This is especially important given the historical context of coercive practices related to contraception. For this reason, it is not appropriate to use this measure in a pay-for-performance context.
Measure specifications and SAS code have been developed to calculate the measures using administrative claims data:
- Link to 2014 Measure Specifications
- Link to 2015 Measure Specifications
- Link to 2016 Measure Specifications
- Link to 2017 Measure Specifications
- Link to 2018 Measure Specifications (updated)
- Link to 2019 Measure Specifications
- Link to 2020 Measure Specifications
- Link to 2021 Measure Specifications
- Value Sets, Code Lookup Tables, and SAS Code Instructions for Calculating the Measures for All Years