Immediate postpartum intrauterine contraceptive device use among pregnant women attending antenatal clinics in Jimma town public healthcare facilities, Ethiopia: Intentions and barriers

Abstract

Objective: This study aimed to assess the intention and barriers to the use of immediate postpartum intrauterine contraceptive devices among pregnant women attending antenatal clinics in Jimma town public healthcare facilities, southwest Ethiopia. Methods: A facility-based cross-sectional study design was conducted from 1 September to 30 October 2020 by using a systematic sampling technique. Data were entered into Epi-data 3.1 version and exported to Statistical Package for Social Sciences 23 for analysis. A binary logistic regression analysis was done to sort candidate variables for multiple logistic regression, and multivariable logistic regressions were done to identify factors associated with the intention to postpartum intrauterine contraceptive devices. Factors associated with intention to use immediate postpartum intrauterine contraceptive device declared at 95% confidence interval. Results: This study finding showed that 37.6% (95% confidence interval (31.5, 43.7)) of pregnant women intended to use the immediate postpartum intrauterine contraceptive device after their delivery. The main reason women refused to use immediate postpartum intrauterine contraceptive devices was being satisfied with other methods to use after they gave birth (27.5 %), the concern of health harm (22.2%), and the fear of impaired future fertility (16.4%). The identified factors that were statically significant with the intention to use immediate postpartum intrauterine contraceptive devices among pregnant women were included: attended secondary education (adjusted odd ratio = 2.36; p = 0.03; 95% confidence interval (1.089, 5.128)), attended college and above (adjusted odd ratio = 2.99; p = 0.020; 95% confidence interval (1.189, 7.541)), have high knowledge on immediate postpartum intrauterine contraceptive devices ((adjusted odd ratio = 2.10; p = 0.006; 95% confidence interval (1.236, 3.564)), the previous history of LACM used (adjusted odd ratio = 6.85; p = 0.0001; 95% confidence interval (3.560, 10.021)), parity >4 (adjusted odd ratio = 1.86; p = 0.043; 95% confidence interval (3.99, 8.703)). Conclusion: The intention of pregnant women to use after they gave birth in the study area was low. Maternal educational level, high knowledge, history of previous long-acting contraceptive methods use, and parity were significantly associated with pregnant women’s intention to use immediate postpartum intrauterine contraceptive devices. Healthcare providers should focus on delivering crucial information about immediate postpartum intrauterine contraceptive device benefits for postpartum women, particularly concerning reducing barriers during antenatal care follow-up as they plan to use it after their delivery.

Knowledge and Practice regarding Post-Partum Intra-Uterine Contraceptive Device among Antenatal Women Attending AMDA Hospital, Jhapa

“…Postpartum family planning is a prevention of unintended and closely spaced pregnancies in the first 12 months after delivery. During the postpartum period, there is a high chance of having unplanned pregnancy which has an adverse outcome like abortion, premature labor, postpartum hemorrhage, low birth weight baby, fetal loss and maternal death (Terefe et al, 2023).…”

“…An intrauterine contraceptive device (IUCD) has several advantages for use in postpartum period, as it is an effective, long term reversible contraception, is coitus independent, and does not interfere with breast-feeding. Postpartum IUCD (PPIUCD) insertion can be done post placental that is within 10 min of placental expulsion, intra cesarean at the time of cesarean section or within 48 hr of delivery (Terefe, 2023). There is a gap in knowledge regarding PPIUCD.…”