Knowledge attitude practice and acceptance of postpartum intrauterine devices among postpartal women in a tertiary care center

Abstract

INTRODUCTIONIn 2012 the London Summit on Family Planning was held to bring back the focus on family planning globally. With 60% unmet need for FP in the postpartum period and JSY (conditional cash transfer scheme) bringing women to facilities, PPIUCD is a safe and effective reversible long term birth spacing method that should be available to women. IUCDs are used by only 2% of current users of contraception in India. According to the World Health Organization Medical Eligibility Criteria, an IUCD can be inserted in the 48 hours postpartum, referred to here as a postpartum IUCD (PPIUCD), or after four weeks following a birth. ABSTRACTBackground: PPIUCDs are the only method for couples requesting a highly effective and reversible, yet long acting, family planning method that can be initiated during the immediate postpartum phase. World Health Organization (WHO) medical eligibility criteria state that it is generally safe for postpartum lactating women to use a PPIUCD, with the advantages outweighing the disadvantages. PPIUCDs are cost-effective and they are low-cost intervention that reduces maternal, infant, and under-five Child mortality. Methods: After approval from the ethical committee and consent from the patients, the study was performed on 1000 postpartum women within 10 min. of delivery and up to 6 weeks of delivery at Labour Room of, M.Y. Hospital, Indore. Results: Majority of acceptor (72.5%) belong to age group of 18-25 years and 53% belonged to urban area. Acceptance was more in those who completed their secondary school level education (33%). Working women (55.5%) accepted PPIUCD more than the non-working. Out of 1000 women counselled only 10% agreed for PPIUVD insertion. During the study of 1 year duration (3.5%) of non-acceptors become pregnant and none of the acceptors conceived. Most common reason stated for accepting PPIUCD among acceptors, was that it is a reversible method (66%). Most common reason for not accepting PPIUCD among non-acceptors, because they are interested in Other Method of Family Planning (60%). Conclusions: Verbal acceptance is more than actual insertion of PPIUCD because of adoption of other method of family planning, family pressure, nonacceptance by partner, lack of awareness, fear of complication. Proper counselling can help to generate awareness and compliance for PPIUCD use in postpartum mother who have institutional delivery. Inserting CuT 380A within 10 min after placental delivery is safe and effective, has high retention rate. The expulsion rate was not high, and further can be reduced with practice could not be predicted.

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

“…The present review and meta-analysis also demonstrated that good knowledge about PPIUCD has significantly associated with the utilisation of PPIUCD 4.16 (95% CI: 1.65, 10.49) compared to their counterparts. This is similar with the study conducted in India [ 37 ]. It also revealed that counselled about PPIUCD were strongly influence the use of PPIUCD.…”

Study of knowledge, attitude, practices regarding PPIUCD among antenatal women at a tertiary care centre in Northern India

“…Acceptance rate in present study was found to be 18% which was higher than findings in central India (11.9%), tertiary care centre Indore (10%), but lower than other studies conducted in Zenana hospital Jaipur (21.8%), Johrat tertiary care hospital, Assam (36.6%), Faridabad district, (39%), Cuttack medical college, Odisha (25.32%). [11][12][13][14][15] Present study findings are also supported by Kathpalia SK, Mustafa MS who reported that knowledge and acceptance of postpartum insertion is low among antenatal women. 16 Present study was also supported by Nigem et al who showed overall contraceptive knowledge of 94%, although 48.4% women were aware of IUCD and only 21.9% were aware of PPIUCD.…”

Immediate postpartum intrauterine contraceptive device utilization and influencing factors in Addis Ababa public hospitals: a cross-sectional study

“…Consistently a study conducted in India states that clients who have good knowledge have better experience of PPIUCD [38]. In the other hand this study describes that 63.6% of participants scored mean and above the mean of attitude assessment questions, and considered as having a favorable attitude towards PPIUCD; attitude was not statistically a significant factor to utilize PPIUCD.…”