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Bring Back the Tubal: An Intervention to Provide Postpartum Bilateral Tubal Ligation in the Underserved Population
Purpose: Improve educational
awareness and receptiveness to the PPBTL procedure.
Background: 50% of
women requesting a PPBTL undergo the procedure. Barriers exist to obtain the
PPBTL, including lack of available operating rooms and concern for patient
regret. Half of pregnancies in the U.S. are unintended, occurring
disproportionately higher in low-income and minority populations. Children
resulting from unintended pregnancies are at risk for poor health outcomes
including low birth weight and developmental delay. Additionally, the U.S.
financial burden of unintended pregnancy accounted for approximately 21 billion
dollars in 2010.
retrospective chart review was conducted from 2015-2016 to document the
baseline prevalence of PPBTLs performed at IFMC. Educational sessions with pre-
and post-session questionnaires were conducted for departments of OB/GYN, Anesthesia,
and Nursing. Data was collected from April 2017 - April 2018 regarding patients
desiring the procedure, those completing the procedure, and reasons for
unsuccessful procedure completion. A pre-post comparison was performed to
assess the impact of the educational sessions and the overall prevalence of
multidisciplinary staff members at IFMC participated in the educational
sessions. All departments showed significant improvement in knowledge of the
PPBTL (OB/GYN p=0.0117, Anesthesia p=0.0002, Nursing p=0.0001). A baseline
prevalence of three PPBTLs were performed from 2015-2016, which increased to
fifty-six from 2017-2018. Comparing pre-post intervention, the percentage of
PPBTLs requested and ultimately performed increased from 39% to 60%.
multidisciplinary educational sessions were effective in identifying barriers
and increasing educational awareness. Overall, this resulted in increased
access to and performance of sterilization in the underserved population.
CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Residency Director, Patient Care, Professionalism, Interpersonal & Communication Skills, GME, Quality & Safety, Team-Based Learning, Advocacy, Contraception or Family Planning,