<qa>  What is the ideal contraceptive for the immediate postpartum period?Background: Opioid dependence in pregnancy has increased dramatically in the last decade. Over 86 of pregnancies conceived by OD women are unintended, compared to 31-43 of pregnancies in the general population. In evaluations of contraceptive use among sexually active women in opioid treatment programs, 40-75 of sexually active OD women report no contraceptive use. Even among women using contraception, 45-55 report using only condoms without more effective, hormonal contraception. Pregnancy and the postpartum period are unique opportunities to provide contraceptive education and services. Long-acting reversible contraception LARC has been shown to more effectively prevent rapid repeat, unintended pregnancies compared to other postpartum contraceptive options and does not incur the risk of venous thromboembolism associated with estrogen-containing methods i.e. pills, ring, patch. No studies have evaluated the impact of immediate postpartum etonogestrel implant Nexplanon placement on reproductive health outcomes in OD women, a population at significant risk for rapid repeat, unintended pregnancy. In contrast to an intrauterine device IUD, Nexplanon is safe to insert regardless of labor and delivery circumstances, does not incur an increased risk of postpartum expulsion and is long-acting, which makes it the ideal contraceptive for the immediate postpartum period. 