Impact of the contraceptive implant on maternal and neonatal morbidity and mortality in rural Papua New Guinea: a retrospective observational cohort study

Using routinely collected birth data, this study sought to measure changes in maternal and neonatal morbidity and mortality after introduction of the levonorgestrel contraceptive implant into a large, rural island population in Papua New Guinea (PNG). We conducted a retrospective observational study of birth records from 4251 births that occurred between January 2010 and December 2016 on Karkar Island, PNG. The primary outcome was the change in crude birth rate (CBR) before (2010–2012) and after (2014–2016) introduction of the implant. Secondary outcomes were the change in rates (per year/1000 births) of severe postpartum hemorrhage, postpartum infection, hospital readmission, prematurity (