Determinants of Postpartum Intrauterine Contraceptive Device Uptake among Women Delivering in Public Hospitals of South Gondar Zone, Northwest Ethiopia, 2019: An Unmatched Case-Control Study

Abstract

Introduction. Integrated use of postpartum intrauterine contraceptive devices with delivery service during the immediate postpartum period is ideal for both women and health-care providers. However, utilization of intrauterine contraceptive devices during the postpartum period was rare and in Ethiopia, with information regarding uptake of postpartum intrauterine contraceptive devices limited. Objective. Identify determinants of postpartum intrauterine contraceptive devices uptake among women delivering in public hospitals of South Gondar zone, Northwest Ethiopia, 2019. Methods. An unmatched case-control study was conducted in public hospitals of South Gondar, Ethiopia, from August 1, 2019, to November 10, 2019. A total of 140 cases and 280 controls have actively participated in the study. Five hospitals were selected by simple random sampling. Cases were selected consecutively, whereas two controls for each case were recruited by the lottery method. Pretested questionnaires were used to collect data and it was entered into Epidata version 4.4.2. Logistic regression analysis was used to identify variables associated with the use of outcome and adjusted odds ratio with a 95% confidence interval was used to determine the association between independent and outcome variables. Results. Completing secondary education (AOR = 4.5, 95%CI 2.3–8.85), having a total number of children of 3–4 (AOR = 3.6, 95%CI 1.25–10.2), having ≥ 5 (AOR = 4.7, 95%CI 1.5–15.3), attending 3 antenatal care (AOR = 2.8, 95%CI 1.44–5.6), ever hearing about postpartum IUCD (AOR = 6.6, 95%CI 2.7–16.1), and having counseling from health-care provider about a postpartum intrauterine contraceptive device (AOR = 6.2, 95%CI 2.99–12.8) were significantly associated with uptake of the postpartum intrauterine contraceptive. Conclusion and Recommendation. Completing secondary education, having 3–4 and ≥5 children, attending three antenatal care, ever hearing about postpartum IUCD, and having counseling from health-care providers about the postpartum intrauterine contraceptive device among women were significantly associated with uptake of an intrauterine contraceptive device after birth. Therefore, it is better to advise women to strictly follow their antenatal care, access to information, and provide counseling.

Acceptance, Utilization and Factors Associated With Immediate Postpartum Intrauterine Contraceptive Devise Among Mothers Delivered in Public Health Facilities of Hawassa City, Sidama Regional State, Ethiopia.

“…Mothers having greater than 3 children were 4.5 times more likely to utilize immediate PPIUCD than their counterparts. This association was consistent with a studie conducted in China (35), Nigeria(39), Ruwanda-(4, 21) and other part of Ethiopia (34,40,41). The possible justi cation might be that mothers who have a large number of children may be inspired to prevent additional pregnancy to limit their family size.…”

Postpartum intrauterine contraceptive device use and its associated factors in Ethiopia: systematic review and meta-analysis

“…In the present review and meta-analysis, subgroup analysis was done by regions, study population, and study design indicated that there were variations in the utilisation of PPIUCD among different included regions, population and study design in Ethiopia. Accordingly, the highest in utilization of PPIUCD was observed in Addis Ababa 25.68% (95% CI: 11.07, 40.29) [ 27 , 32 – 34 ], 34.09% (95% CI: 32.52, 35.66) [ 32 , 35 ], and 21.63% (95% CI: 14.45, 28.81) [ 26 , 32 , 36 ] by region, study population and study design respectively. The observed differences could be due to culture, residence, educational status and religious differences across the region.…”

Postpartum contraceptive practices among urban and peri-urban women in North India: a mixed-methods cohort study protocol

“…Counselling of couples, focusing on male involvement have also been suggested, although all men do not willingly accompany women to antenatal clinic [ 45 – 47 ]. Studies in LMICs show that a substantial proportion of women did not use modern contraceptive methods in the first year after birth and maternal services were found to be the sole predictors in postpartum contraceptive use.…”

“…Counselling of couples, focusing on male involvement have also been suggested, although all men do not willingly accompany women to antenatal clinic [45][46][47].…”