Acceptability and factors associated with post-partum IUCD use among women who gave birth at bale zone health facilities, Southeast-Ethiopia

Abstract

BackgroundThe postpartum intrauterine contraceptive devices (PPIUCD) is the only family planning method for couples requesting highly effective, reliable, inexpensive, non-hormonal, immediately reversible, and long-acting contraceptive that can be initiated during the immediate postpartum period and it has no a negative effect on lactation. Despite these benefit, the acceptance and utilization of immediate PPIUCD were very low and the reasons for rejecting immediate PPIUCD usage have not been characterized in Southeast Ethiopia. Therefore, this study determined the level of acceptability and factors associated with immediate PPIUCD use among women who gave birth at Bale zone health facilities, Southeast Ethiopia.MethodsA facility based cross-sectional study was conducted from March to July 2017 in Bale zone health facilities. Four hundred twenty-nine women were successfully interviewed using structured and pre-tested questionnaire. Health facilities were selected by lottery method. Study participants were selected systematically. Data were entered into Epi data version 3.1 and exported into SPSS version 21 for analysis. Logistic regression analyses were done. A significant association was declared at a p-value less than 0.05.ResultsThe acceptance of immediate PPIUCD usage was 12.4%. Non-acceptors reported their reasons for rejecting PPIUCD use; concern and fears of complications (24.8%), religious beliefs (19.8%), and husband refusal (17.7%). Respondents who had completed secondary education were more likely to accept PPIUCD usage than those who had no formal education (AOR = 3, CI = 11.81, 53.91). In addition, the odds of accepting PPIUCD insertion was higher among women who attended 3 antenatal care visits than those who did not attend antenatal care visits for the current birth (AOR = 1.81, CI = 0.34, 0.85).ConclusionsThe acceptance of immediate PPIUCD usage was still low. This might be attributed to the low achievement of education, perceived concern and fears of complications towards IUCD insertion. The male partner’s refusal and religious beliefs also have a role in the usage of postpartum IUCD. Due attention should be given to enhancing educational level of women and effective IUCDs counseling should be given during antenatal care visits to correct misconceptions and fears of complication about PPIUCD insertion.Electronic supplementary materialThe online version of this article (10.1186/s40834-018-0071-z) contains supplementary material, which is available to authorized users.

Factors associated with the Uptake of Immediate Postpartum Intrauterine Contraceptive Devices(PPIUCD) in Rwanda: A Mixed Methods Study

“…Women who are educated are empowered to decide fertility control and can better understand the health information offered to them regarding the use of PPIUCD, Additional women who are educated were more likely to visit a health facility and receive counselling for different methods available in the health facility. This is in line also with a study done in Ethiopia where women with formal education were more likely to use PPIUCD compared with counterparts (12) .…”

“…The medical eligibility criteria WHO recommended it can be initiated during the immediate postpartum period and it cannot interfere with breastfeeding (10,11). The PPIUCD has shown that when it is initiated after delivery it can improve maternal and newborn health by preventing obstetrics complications such as maternal and newborn mortality and other health related complications associated with closed spaced pregnancy (12). Immediate post-partum period is an ideal time for PPIUCD when women are highly motivated to accept family planning methods (13) (14).…”

“…The immediate postpartum period is a great opportunity for PPIUCD services providers to introduce the method especially in setting where women meet with health care providers is di cult due to geographical barrier (15). Lack of provision for PPIUCD can contribute to the occurrence of unintended pregnancies because most of the women do not return for postnatal services (12). The early initiation and provision of postpartum family planning method (PPIUCD) during immediate postpartum period protect women from unintended pregnancy as majority of women either resume early sexual activity or have early return to fertility(1)(10).…”

Prevalence and pattern of long acting reversible contraception (LARC) methods use in immediate postpartum period at Jimma University Medical Center, Ethiopia

“…agreed that insertion of IUD causes loss of privacy and 41.6% agreed that IUDs may impair future fertility (29). In another community based study cross-sectional study, nearly one-third (31%) of study participants disagreed with the statement "insertion of intrauterine contraceptive devices does not lead to loss of privacy".…”

Determinants of postpartum IUCD utilization among mothers who gave birth in Gamo zone public health facilities, southern Ethiopia; case-control study

“…Similar finding also obtained in Egypt, which is 23.7% of mother who gave birth in public health facilities used PPIUCD (7). Among mothers who gave birth at public health facilities in Ethiopia, only few proportion of them utilize PPIUCD (12.4%) (8).…”