Effect of postpartum counseling on postpartum contraceptive use

Abstract

Introduction The postpartum period is one of the important transitional phases in women's life (1). Following serious changes of delivery and transition to parenthood, primigravidas undergo significant physical, social and psychological changes (2). With important physiological and psychological changes such as adapting to changes in the body, woman face maternal role and support of certain people (3). Therefore, mother needs to adapt to new life and newborn care (4). Most of them aren't ready to take care of themselves and their baby with plentiful needs (5). During this stage of adjustment, mother experiences psy-chosocial social imbalances that lead to severe stress (6). The true prevalence of postpartum stress among women is unknown, but studies show that 10% to 15% of women are affected by mental issues including depression, anxiety and stress after delivery (7). Webb et al showed that 69% of women have at least one physical complaint after childbirth (8). Based on the results, 25.71% to 32.38% of women have mild mental disorders during the first 6 weeks after delivery (9) and, in some studies; this figure has even reached up to 44.4% (10). In Iran, 47.5% of nul-liparous women and 67.1% of multiparous are not in a good mental health status (11) and 32% of women experience postpartum stress disorder after delivery (12). Overall , postpartum stress in Iranian women is higher than other countries and is inversely related to social protection (13). Many diseases and problems of women in this period are related to stress or their inability to cope with changes (14). Stress can be a component of any disease. Therefore, understanding the stressors and improving the capacity of the person to be compatible with them is very important (3). Episiotomy and perineal pain, back pain, breast swelling and pain, incontinence, constipation, fatigue, sleep problems and breast problems are the most important physical stressors and the pressure to return to pre-pregnancy weight, sexual changes, concerns about the maternal role, problems regarding the infant (e.g., feeding, crying, care, bathing, unpredictable behaviors of the baby, sucking , neonatal jaundice, sleep disorders, flatulence, inadequate weight gain, eye infection and umbilical infection), relationships with partners and lack of social support are psychological stressors (15-17). Baby care, sexual relationships , self-care, family planning and mental health are women's concerns and educational needs in the postpar-tum period (18). Based on the analysis of various factors, Hung et al found that three factors of maternal role attainment , lack of social support and physical changes are important in the occurrence of postpartum stress (5). Postpartum stresses are determinants of women's health and even threaten child-parent relationship and child Abstract Objectives: Planned interventions can facilitate the maternal role for primiparous women by reducing postpartum stress. The present study aims to determine the effect of home-based supportive-educational counseling on...

Review of Postpartum Contraceptive Practices at Chiang Mai University Hospital: Implications for Improving Quality of Service

“…The variation in postpartum contraceptive practices seen in this study confirmed previous studies [6,7,8,9]. The variety of contraceptive methods used is related to various differences in baseline characteristics, details of intended fertility spacing, completeness of the family, and attitude and beliefs of either the women or care providers in individual institution.…”

The Influence of Prenatal Counselling on Postpartum Contraceptive Choice

“…6 Postpartum education and counselling has been reported to increase contraception usage, 7 but also to have no impact on the use of effective and modern postpartum contraception. 5 A meta-analysis regarding the effectiveness of postpartum education on contraceptive use concluded that postpartum education led to more contraceptive use and fewer unplanned pregnancies. 8 In Mexico, where family planning counselling is integrated into routine prenatal care, women are twice as likely to use postpartum contraception, 9 with condom use, IUD and sterilization increasing significantly with prenatal family planning counselling.…”

“…Postpartum contraceptive counselling has been studied by several groups, but the prenatal period is usually neglected. 4,5 Contraceptive counselling, given according to the needs of couples during routine prenatal care visits, especially in the third trimester, might increase the use of postpartum contraception.…”

A select issue in the postpartum period: contraception

“…38,40 The effectiveness of counseling interventions in reducing unintended pregnancy and increasing postpartum contraceptive use, however, has been seldom examined. 39,43 Of those studies investigating the topic, several have concluded that focused contraceptive counseling in the postpartum or antepartum period is effective, [45][46][47] yet others report no impact on contraceptive use following contraception counseling 48 alone, versus educational leaflets, 49 or a short-term increase in contraceptive use only. 40 A systematic review (2010) of contraceptive counseling interventions taking place in the postpartum period, including both short-term and multiplecontact interventions, concluded that postpartum contraceptive education led to more contraception use and fewer unplanned pregnancies, though, was based on a limited number of studies.…”

“…41 Several small studies have investigated the way in which postpartum contraception is approached in an attempt to determine which method may be most effective. 38,[46][47][48]50 For example, women who watched a video were less satisfied than those who had received counseling from a physician, though the video watchers were as likely to be satisfied as those who received a pamphlet. 43 In a paper investigating patient satisfaction and the impact of written material about postpartum contraceptive decisions in 109 women, women in the intervention group were more likely to state that written material contributed to their ultimate choice in birth control.…”