This study investigates family planning activity in 308 Nigerian women attending an antenatal clinic. Family planning awareness was present in 234 women (76%) and practice occurred in 168 (54.5%). Proposal to practice family planning occurred in 66 of 137 women who had never used contraception while 69 (22.4%) had no intention to practice family planning. The best-known type of contraception was the condom, 182 (59.1%); the most common used, the safe period (rhythm), 73 women (23.7%); while Billings' contraception was the most commonly proposed type, 72 women (23.4%). Knowledge of the beneficial effects of the chosen method of contraception was claimed by 102 women (43.6%) while 33 (14.2%) conceded ignorance of this. Similarly, 81 women (34.6%) claimed to know the adverse effects of their chosen method of contraception, while 119 (50.9%) admitted ignorance of it. The most common source of information on contraception was the printed media, 112 (47.9%), while the least common was lecture/sex instruction, 27 (11.5%). Lack of adequate information and ignorance are key factors militating against family planning practice in Nigeria. Family planning activity in Nigeria would be improved by wider dissemination of information on family planning through public lectures and the electronic media; training of family planning counselors to facilitate grass-roots coverage; universal entrenchment of family planning counseling into routine antenatal clinic activities; and integration of private medical centers into the national family planning service.

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The factors determining the choice of contraception were studied among 230 pregnant women attending the antenatal clinic at Nnewi, Nigeria. There were 174 (52.1%) choices for the natural methods of contraception, 86 (25.7%) for the traditional methods, and 74 (22.2%) for the artificial methods. The most commonly chosen contraceptive methods were rhythm, 95 (28.4%) and Billings, 79 (23.5%), while the least was surgical contraception, 4 (1.2%). The barrier method was not chosen at all. The most common reason given for choice of contraception was safety, 28.7%, followed by dislike of artificial methods, 25.2%; the no-response rate was 29.1%. Other reasons given were ease of use, 10%; husband's decision, 1.3%; fear of the complications of the artificial methods, 13%; dislike of foreign body, 2.6%; the method most understood, 24.8%; need for further counselling, 7%; and long-lasting, 2.6%. The most common reason given against the use of the artificial methods of contraception was fear of its complications, 31.9%, followed by preference for the natural methods, 22.3%. Condom use decreased with increasing age, being highest at 16-20 years, 37.5%, and lowest at 31-35 years, 5.9%. When compared with other parity groups, the grandmultipara group (> or = 5) used the IUD, 14.3%; injectable contraception, 4.8%; and other traditional methods (breastfeeding and abstinence), 28.5%, and did not use the rhythm method. Women of the lowest social class most commonly chose other traditional methods, 57.1%, and never chose the Billings method. Women who desired 1 to 3 children most commonly chose the pill, 23.5%, or withdrawal method, 23.5%, while women who desired 4 to 10 children most commonly chose the rhythm and Billings methods. There was no difference in choice of method of contraception for the various religious denominations, although the artificial methods were less commonly chosen by Catholics, 14.1%, compared with Anglicans, 33%, and other Christian denominations, 33.3%. The physician was the most common source of information for the choosers of the condom, 18.9%; surgical contraception, 2.7%; and the pill, 8.1%; the nurse for injectable contraception, 4.9%, while the commonest source of information among choosers of the rhythm method was the electronic media, 40.5%; print media, 34.9%; and peer group, 34.4%. Lecture/sex instruction was the commonest source of information among choosers of the Billings, 35.5%, and withdrawal, 22.6%, methods, while the no-response rate on source of information on contraception was highest among choosers of the Billings method. There is a need to bridge the gap in contraceptive information by redirecting counselling strategies and restructuring family planning programs to dispel negative perceptions and encourage informed choice of effective family planning methods.

The rate of hospital deaths was generally found not to vary significantly over the weekends and weekdays in the hospital except for the labor ward which had significantly higher weekend to weekday death rates of 1.72:1. There is therefore need for confidential enquiry into the causes of hospital deaths, especially in the labor ward, in order to identify and prevent avoidable deaths.

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