Background of the Study In India, although a number of contraceptive choices are available, the usage of contraceptive methods among postpartum women is rather low. The current study intended to determine the impact of ''structured contraception counseling'' on women's decision making on selection of contraceptive methods and the reasons behind the selection of a contraceptive method. Methods One-hundred-and-seventeen postpartum women in the age group of 18-35 years, requesting contraception, were enrolled in the study. ''Structured contraception counseling'' was provided using a standardized protocol with balanced and comprehensive education material on the available hormonal and nonhormonal contraceptive methods. Questionnaires with information on the women's pre-and post-counseling contraceptive choice, her perceptions, and the reasons behind her postcounseling decision were filled by the participating women. Results Maximum women enrolled for the study were in the age group of 21-25 years. In pre-counseling, 36 % postpartum women selected a contraceptive method, 23.1 % a nonhormonal method, and 12.8 % a hormonal method. After ''structured contraception counseling, '' 92. Conclusion ''Structured contraception counseling'' using standardized protocol resulted in significant improvements in the selection of contraceptive methods by postpartum women.

Background In India, a large proportion of women with an unmet need for contraception are within their first year after childbirth. Therefore, concentrating efforts to educate postpartum women on the importance of attending contraceptive clinics could have a proportionally bigger impact on increasing postpartum contraception usage. Methods Hundred and seventy-eight (178) women were followed up to determine the proportion of postpartum women who attended the family planning clinics for contraceptive counseling. The reason for non-attendance, choice and effectiveness of contraceptive method selected was determined. Results Out of 178 postpartum women who were followed up, only 12 (6.8 %) attended the contraceptive clinic. IUD, POPs and Inj-DMPA are the preferred contraceptive methods selected by postpartum women. Hundred percent of the postpartum women who attended contraceptive selected a contraceptive method as compared to only 44 % of the postpartum women who did not attend a contraceptive clinic. Only 29.2 % of these postpartum women selected highly effective contraceptive methods as compared to 83.3 % by the postpartum women who attended family planning clinics. The common reasons cited for not 123 attending contraceptive clinic was found to be time constraint (43.9 %) followed by 'stay far away' (39 %), followed by 'already have information' (9.7 %). Conclusions Family planning service that is scheduled to be delivered at the 6-week postpartum is rarely attended. The common reason cited by postpartum women for poor attendance in these family planning clinics was time constraint.

No abstract

Objective: To assess a case of infertility and amenorrhea following bilateral internal iliac ligation for post-partum hemorrhage. Review of literature shows only few series evaluating fertility and obstetric performance after bilateral internal iliac ligation. The data reviewed does not appear to have any adverse effect on menstrual / ovarian function or fertility. We have presented an unusual case of amenorrhea and infertility following bilateral internal iliac ligation done for ruptured uterus and PPH. All parameters of pituitary functions were within normal limits ruling out the possibility of Sheehan's syndrome. New investigational modality using color Doppler has clearly shown absent or diminished uterine artery flow velocimetry.

No abstract