Acceptance, utilization, and factors associated with immediate postpartum intrauterine contraceptive device among mothers delivered at public health facilities in Hawassa city, Ethiopia: Institution-based study

Shiferaw, Yemisrach; Jisso, Meskerem; Fantahun, Selam; Eshetu, Betelhem; Assefa, Abiyu Ayalew; Gebretsadik, Achamyelesh

doi:10.1186/s12978-023-01586-z

Cited by 4 publications

(2 citation statements)

References 43 publications

(58 reference statements)

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“…This finding also found to be lower compared with studies conducted in Rural Kenya 86.3% [ 50 ], Mexico 47% [ 51 ], Kenya 46% [ 52 ], Tanzania 46% [ 53 ], Ntchisi district hospital Malawi 75% [ 22 ], and Rwanda 51% [ 54 ]. The possible reason for this discrepancy might be attributed to the differences in policy, variation in service accessibility, and maternal health care service utilization [ 55 ].…”

Section: Discussionmentioning

confidence: 99%

Modern contraceptive utilization and associated factors among postpartum women in Kena Woreda, Konso Zone, South Ethiopian Regional State, Ethiopia, 2023: mixed type community based cross-sectional study design

Moloro,

Beza,

Kumsa

2024

Contracept Reprod Med

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Background Even though family planning 2020 has made remarkable progress about solving the issue of unmet need for family planning, 70% of women in a developing countries who do not want to conceive are not using it. There are limited research that provided detail information regarding barriers of modern contraceptive utilization during postpartum period in the study area. In addition, previous study also recommended that to conduct using mixed quantitative and qualitative design for further investigations to answer these “why” questions and narrow these gaps. Objective This study aimed to assess postpartum modern contraceptive utilization and associated factors among postpartum women in Kena woreda, Konso zone, South Ethiopian Regional State, Ethiopia, 2023. Methods A mixed type community based cross-sectional study design was conducted among 605 women in Kena woreda, from September 1–30/2023 out of 628 sampled mothers. Multistage sampling technique was used to select study participant and data was collected using semi-structured pretested questionnaire and entered in to Epi data version 3.1 and then exported to STATA version 14 for analysis for quantitative. The association between variables was analyzed using bivariate and multivariable binary logistic regression and level of significant determined with adjusted odd ratio at 95% CI and P-value less than < 0.05. After translation and transcription, manual thematic analysis was applied to the qualitative data. Results The prevalence of modern contraceptive use among women during postpartum period in Kena woreda was found to be 39.01% [95% CI: 35.18–42.96%]. Menses resumed (AOR = 1.63; 95% CI: 1.02, 2.59), linked to the family planning unit during their child`s immunization (AOR = 2.17; 95% CI: 1.45, 3.25), family planning counselling during antenatal care visit (AOR = 1.63; 95% CI: 1.10, 2.42) and good knowledge towards modern contraceptive (AOR = 1.53; 95% CI: 1.03, 2.26) were factors associated with postpartum contraceptive utilization. Partner oppose, myths and misconception, need for excess family size, religious prohibition, fear of side effect,menses not resumed, lack of counselling and privacy room, and lack of transportation to health facility were barriers to modern postpartum contraceptive utilization. Conclusions and recommendations The utilization of postpartum contraceptives was found to be lower than the target set by the 2020/21 national reproductive health strategy plan, which aimed to increase contraceptive method usage to 50%. Menses resumed, family planning counselling during antenatal care visit, linked to the family planning unit during child immunization and good knowledge were factors associated to modern postpartum contraceptive utilization. Strengthening service integration and family planning counseling during antenatal care visits and encourage mothers to start using modern family planning methods before menses resume are important. Overcoming barriers including partner opposition, myths, religious beliefs, fear of side effects, lack of counseling at health facilities, and transportation challenges is essential.

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Section: Discussionmentioning

confidence: 99%

Modern contraceptive utilization and associated factors among postpartum women in Kena Woreda, Konso Zone, South Ethiopian Regional State, Ethiopia, 2023: mixed type community based cross-sectional study design

Moloro,

Beza,

Kumsa

2024

Contracept Reprod Med

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“…In order to boost the adoption of postpartum contraception, it is therefore necessary to update and improve health education, contraceptive knowledge, and legislation based on research data. 17,18 According to earlier research, women who received postpartum contraceptive counselling were more likely to use LARC. 19 This emphasises how crucial it is to provide integrated reproductive health services, such as family planning counselling, throughout prenatal, antenatal, and postnatal visits.…”

Section: Discussionmentioning

confidence: 99%

Barriers to Uptake of Postpartum Long Acting Reversible Contraception; A Cross Sectional Study

Imran Sohail Sheikh,

Ghulam Mujtaba Nasir,

Hameed Mumtaz Durrani

et al. 2023

Ann Pak Inst Med Sci

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Objective: To investigate factors limiting postpartum long-acting reversible contraception from being used in our system. Methodology: This cross sectional study was carried out in the department of Obstetrics and Gynecology, Nishtar Medical University, Multan, from September 2022 to April 2023, consisted of all women who gave birth at this hospital during the study period. Data were gathered using a structured questionnaire that had been pretested. The survey asks questions about sociodemographics, reproductive health, healthcare, knowledge and attitudes about LARC, and family planning use. At discharge, a skilled nurse conducted a face-to-face interview with the patient in a quiet private room to gather the data. Results: In our study most (56.04%) of the women were between age of 26-35 years and (69.97%) belonged to urban area. Main bulk (47.68%) of the women had parity of 3-4 and majority (44.58%) of the women in sample had 0-2 alive children and (21.05%) women presented with history of previous abortion. Most (74.61%) of the women had spontaneous vaginal delivery. The rate of use of LARCs was 69 (21.36%) in our study sample. The comparison of rate of use of LARC’s was found to be significantly (P-value < 0.05) associated with increasing age, increasing women education, occupation and job status. Family income, number of alive children and duration for plan to have next pregnancy were also significant (P-value < 0.05) contributors for uptake of LARCs. Conclusion: The rate of used of postpartum LARC was low (21.36%) in the studied population. Postpartum women from of higher age, having higher education, with formal employment, having higher level of family income, and with higher duration for plan to have next pregnancy were more likely to use LARC.

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Challenging PPIUCD Removal: A Case of Hysteroscopic Extraction from the Uterine Fundus

Hema Divakar,

Rita Singh,

Poorni Narayanan

et al. 2024

jemds

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Intrauterine contraceptive devices offer reliable and reversible contraception. However, there are still challenges that persist in their management, particularly regarding deeply embedded PPIUCDs (Post-Partum Intrauterine Contraceptive Devices). We present a case study of a 30-year-old woman who had two caesarean deliveries and sought PPIUCD removal to plan a future pregnancy. On speculum evaluation, the threads of the device were undetectable with no abnormal health symptoms. Subsequent ultrasound analysis confirmed the presence of PPIUCD, positioned obliquely within the uterine cavity. The first removal attempt under aseptic precautions with an IUCD hook was unsuccessful. The second attempt was guided by ultrasound and hysteroscopy, which successfully eliminated the IUCD. The case highlights the intricate challenges in managing PPIUCDs and emphasizes the importance of proactive management strategies. By integrating advanced techniques like hysteroscopy, healthcare providers can navigate these challenges effectively, enhancing patient care and satisfaction. Intrauterine contraceptive devices have become a reliable and convenient method of birth control due to their high effectiveness and reversibility. Long-acting contraceptives provide reliable and lasting protection against unintended pregnancy, making them a popular choice for individuals looking for a hassle-free contraception method. The PPIUCD technique involves implanting an IUCD within 48 hours following either vaginal delivery or caesarean surgery to block sperm survival and prevent endometrial foreign body reactions.[1] The acceptability rate for PPIUCD implantation is 36.25%.[2] The placement of the PPIUCD is preferable since it does not interfere with breastfeeding.[3] The prevalence of modern contraceptives among married women who have reached reproductive age has gradually increased globally, rising from 55.0% in 2000 to 57.1% in 2019.[4] According to the recent India National Family Health Survey, the contraception prevalence rate among currently married women under 15 to 49 increased from 54% in 2015-16 to 67% in 2019-21. Intrauterine devices comprise only 2.1% of all contraceptive techniques used in family planning. However, all government facilities offer free IUCD services.[5] Complications like bleeding, pain, infection, perforation, and expulsion contribute to 20–40% discontinuation rates.[6] Younger women using IUDs are more likely to experience adverse effects than older women.[7] The limited progress was attributed to factors such as the low quality of services offered, restricted access, and misconceptions about techniques held by providers and users. Despite their effectiveness, IUDs can lead to potential complications. One such issue is the occurrence of lost or embedded IUDs, which are rarely observed, with approximately 1-2 cases per 1000 insertions.[8] This case report illustrates the difficulties encountered in removing embedded IUDs and underscores the significance of exploring alternative techniques to manage challenging cases safely and effectively.

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Acceptance, utilization, and factors associated with immediate postpartum intrauterine contraceptive device among mothers delivered at public health facilities in Hawassa city, Ethiopia: Institution-based study

Cited by 4 publications

References 43 publications

Modern contraceptive utilization and associated factors among postpartum women in Kena Woreda, Konso Zone, South Ethiopian Regional State, Ethiopia, 2023: mixed type community based cross-sectional study design

Modern contraceptive utilization and associated factors among postpartum women in Kena Woreda, Konso Zone, South Ethiopian Regional State, Ethiopia, 2023: mixed type community based cross-sectional study design

Barriers to Uptake of Postpartum Long Acting Reversible Contraception; A Cross Sectional Study

Challenging PPIUCD Removal: A Case of Hysteroscopic Extraction from the Uterine Fundus

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