Evaluation of factors associated with acceptance of post-partum intrauterine contraceptive device in a tertiary care hospital

Abstract

Objective: The post-partum intrauterine contraceptive device (PPIUCD) is a highly effective, long acting, reversible, economical and easily accessible family planning method. The aim of the study was to estimate the proportion of pregnant women aware of immediate post-partum intrauterine contraceptive device and to analyze the factors associated with acceptance.
 Methodology: This is a cross sectional study in which 300 pregnant were selected who were visiting the antenatal clinics and admitted in early labor in labor ward. Their awareness and acceptance for PPIUCD was assessed through a structured questionnaire. Factors associated with acceptance were analyzed and the reasons for acceptance or refusal were determined.
 Results: In this study the awareness of PPIUCD was found to be 46% and the acceptance rate of PPIUCD was 18%. The major reason for refusal was that women don’t think they need contraception immediately after delivery and secondly, they need to talk to their partners for the decision. Most common reasons for acceptance of PPIUCD was that it is long acting and reversible.
 Gravidity (p= 0.006), parity (p< 0.001), unplanned pregnancy (p= 0.002) and inter pregnancy interval (p= 0.004) were the factors significantly influencing the acceptance of PPIUCD.
 Conclusion: This study revealed that awareness regarding PPIUCD is increasing in women but acceptance is still poor. It was due to misconception that no contraception is needed in postpartum period. Provision of adequate knowledge regarding convenience and effectiveness of post-partum contraception in preventing unintended pregnancies can play vital role to increase its acceptance.

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

“…This study also showed that mothers having a birth interval of below 24 months increase the odds of accepting immediate PPIUCD by 2.7 when compared with mothers having a birth interval of above 36 months. This association agreed with previous studies conducted in Pakistan [29] and Tanzania [32] that found a greater likelihood of post-partum IUCD acceptance if there had been less than two years since the last birth. Additionally, this finding is supported by a study conducted in Rwanda [4,24] that reports that fear of having an early or unwanted pregnancy was a reason for acceptance of immediate PPFP in 79% of respondents.…”

“…The possible reason might be that counseling may increase knowledge about PPIUCD and improve the decision-making power of mothers. Supporting evidence is also shown by a study conducted in Pakistan [29] and Rwanda [4], where counseling for mothers during prenatal visits increased the awareness of mothers regarding the PPIUCD. It could also be explained during counseling, when health care providers may clarify misconceptions about PPIUCD and motivate the women to accept PPIUCD immediately after delivery.…”

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.

“…This study also showed that mothers having birth interval of below 24 months increase the odds of accepting immediate PPIUCD by 2.7 when compared with mothers having birth interval of above 36 months. This association was agreed with previous studies conducted in Pakistan (29) and Tanzania (32) which indicated that, having less than 2 years of duration since last delivery increases the odds of acceptance of post-partum IUCD. Additionally, this nding is supported by a study conducted in Ruwanda (4,24)that reports, fear of having an early or unwanted pregnancy was a reason for acceptance of immediate PPFP in 79% of respondents.…”