Critical Factors Influencing the Acceptability of Post-placental Insertion of Intrauterine Contraceptive Device: A Study in Six Public/Private Institutes in India

Abstract

Objective To determine critical factors and barriers to postpartum intrauterine contraceptive device (PPIUCD) use in India in order to guide programs aimed at reducing maternal and child mortality. Methods All pregnant women were enrolled for contraception counseling during their visit to the antenatal outpatient clinic. Women who opted for PPIUCDs were enrolled in the study and offered PPIUCD insertion, irrespective of mode of delivery. Those who withdrew consent when in labor or soon after delivery, experienced severe bleeding, or exhibited unstable vital signs were excluded, as were febrile women and those diagnosed with chorioamnionitis. Results A total of 66,508 women were enrolled in the study. 86.1% indicated they discussed family planning options with their partners/husbands before making a decision. 178 respondents (0.3%) could not mention one advantage of PPIUCDs, while 23.1% could not mention one disadvantage. 13.9% of the women withdrew consent. Family member objections (43.44%), husband/partner objection (27.94%), and deciding on another method (15.59%) were the main reasons for consent withdrawal. Conclusions Awareness of PPIUCDs is not a limiting factor in women's consent to PPIUCD insertion. As a woman's decision to use a PPIUCD is significantly influenced by family members and her partner/husband, awareness initiatives that target these populations should be considered.

A Prospective Study of Effectivity, Expulsion, and Acceptability of Post-placental IUD Cu T380A Insertion Using Clamp in a Tertiary Hospital

“…25 Divakar et al reported 16% of vaginal discharge with 1% in need of antibiotic therapy. 27 The IUD acceptance was 96.8, 93.3, and 90.8% at 6 weeks, 3 months, and 6 months of follow-up, respectively. This result was higher than the result of Gupta's study of 86.9% at 6 months of follow-up of IUD acceptance .…”

“…5,28 Heavy menstrual bleeding was the most common reason for removal. 27 In this study, the reasons for IUD discontinuation were dyspareunia, vaginal bleeding, abdominal pain, and vaginal discharge (one patient in each complaint). Two patients had other reasons.…”

Barriers and Enablers Influencing Women's Adoption and Continuation of Vaginally Inserted Contraceptive Methods: A Literature Review

“…2016; Divakar et al. 2019; Goswami, Yadav, and Patel 2015; Takele, Degu, and Yitayal 2012; Masvawure et al. 2014; Puri et al.…”

“…2016; Divakar et al. 2019), were the most common barriers to the adoption and continuation of the copper IUD. The copper IUD was the only nonhormonal method where side effects played a key role in women's decision not to adopt or continue to use it.…”

Measuring potential interest in a postpartum contraceptive vaginal ring among breastfeeding women in India

“…Most Indian women consult numerous family members including their partner, mother, mother-in-law, or sister while deciding on the use of contraception [35]. In the clinical trial for the PVR, some of the most commonly cited reasons among the 40% of women who did not express interest in any family planning method was a need to discuss with family members.…”