Levels, trends and correlates of unmet need for family planning among postpartum women in Indonesia: 2007–2015

Wilopo, Siswanto Agus; Setyawan, Althaf; Pinandari, Anggriyani Wahyu; Prihyugiarto, Titut Yuli; Juliaan, Flourisa; Magnani, Robert J.

doi:10.1186/s12905-017-0476-x

Cited by 32 publications

(26 citation statements)

References 24 publications

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“…This study describes the prevalence of postpartum contraceptive use and skilled maternal healthcare among two representative samples (collected in 2011 and 2016) of married/in sexual union women in Ethiopia with a birth in the previous year. Our findings in both rounds are far lower than a finding from similar study in Indonesia (74%) [ 28 ]. In our 2011 sample, we found low contraceptive use; only 15% of women were protected from early pregnancy.…”

Section: Discussioncontrasting

confidence: 99%

Association between skilled maternal healthcare and postpartum contraceptive use in Ethiopia

Tessema

Mekonnen²,

Mengesha

et al. 2018

BMC Pregnancy Childbirth

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BackgroundThe postpartum period provides an important opportunity to address unmet need for contraception and reduce short birth intervals. This study aims to assess the association between skilled maternal healthcare and postpartum contraceptive use in Ethiopia.MethodsData for this analysis come from the 2011 to 2016 Ethiopian Demographic and Health Surveys (EDHS) and include nearly 5000 married women of reproductive age with a recent birth. Multivariate logistic regression was conducted to investigate the relationship between skilled maternal healthcare and postpartum contraceptive use.ResultsBetween rounds of the 2011 and 2016 EDHS, the postpartum contraceptive prevalence increased from 15 to 23% and delivery in public facilities, use of skilled birth assistance, and skilled antenatal care also grew. In both survey rounds, educated women had approximately twice the odds of postpartum contraceptive use, compared with non-educated women, while an initially significant relationship between wealth and postpartum contraceptive use diminished in significance by 2016. Women with a desire to limit future pregnancy had five to six times the odds of postpartum contraceptive use in both survey rounds, and women in 2016 – unlike those in 2011 – with a desire to delay pregnancy were significantly more likely to use contraception (adjusted odds ratio (AOR) = 4.38, 95% CI: 1.46-13.18) compared to women who wanted another child soon. In 2011, no statistically significant associations were found between any maternal healthcare and postpartum contraceptive use. In contrast, in 2016, postpartum contraceptive use was significantly associated with an institutional delivery (AOR = 1.71, 95% confidence interval (CI): 1.12-2.62) and skilled antenatal care (AOR = 2.41, 95% CI: 1.41-4.10). No significant relationship was observed in either survey round between postpartum contraceptive use and skilled delivery or postnatal care.ConclusionsA comparison of postpartum women in the 2011 and 2016 EDHS reveals increased use of both contraception and skilled maternal healthcare services and improved likelihood of contraceptive use among women with an institutional delivery or antenatal care, perhaps as a result of increased attention to postpartum family planning integration. Additionally, results suggest postpartum women are now using contraception to space future pregnancies, with the potential to help women achieve more optimal birth intervals.

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Section: Discussioncontrasting

confidence: 99%

Association between skilled maternal healthcare and postpartum contraceptive use in Ethiopia

Tessema

Mekonnen²,

Mengesha

et al. 2018

BMC Pregnancy Childbirth

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“…8 The analyses of data from the 2007 and 2012 Indonesia Demographic and Health Surveys (IDHS) and the 2015 PMA 2020 survey however reported total unmet need ranging from 23% to 28% which is lower compared to the findings from our study. 19 Lower rates of unmet need in comparison to our study were also reported by the studies conducted in Ethiopia 20 and Egypt. 21 The most popular modern contraceptive methods used by postpartum women were condoms (37.1%), Depo-Provera (29.3%) and pills (20.0%).…”

Section: Discussionsupporting

confidence: 86%

<p>Utilization of Family Planning Methods Among Postpartum Mothers in Kailali District, Nepal</p>

Joshi

Tiwari

Poudyal

et al. 2020

IJWH

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Background: Postpartum contraceptives use offers a distinctive opportunity to maintain appropriate birth spacing for health benefits to both mother and child. However, the concept of postpartum family planning (PPFP) is poorly understood and contraceptives use during the postpartum period remains low in Nepal. Therefore, this study aimed to assess the factors affecting the utilization of family planning (FP) methods among postpartum mothers in the Kailali district, Nepal. Methods: A community-based cross-sectional study was conducted between September and October 2013 among postpartum mothers in Kailali district. Simple random sampling was applied to select a total of 427 study participants. A pre-tested standard semi-structured questionnaire was used for gathering data. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 20.0. Results: Overall, 32.8% of the postpartum women used different types of contraceptives. Condoms (37.1%) followed by Depo-Provera 29.3% were the most used postpartum contraceptives. Half (50%) of the postpartum women had an unmet need for family planning. Multiple logistic regression model revealed that the occupation of husband [AOR=3.2 (95% CI: 2.0-6.00], past use of family planning methods [AOR=4.0 (95% CI:2.4-6.5)] and resumption of menstruation [AOR=2.5 (95% CI:1.6-4.1)] were significantly associated with the use of modern contraceptives during the first year of the postpartum period. Conclusion: Contraceptive uptake within the first year of postpartum was found to be low among women in the Kailali district, Nepal. Previous experience with the use of family planning methods, occupation of the husbands, and resumption of menstruation are important factors in the PPFP decisions of women in this population. Therefore, the family planning program should work on improving couples' knowledge of the risk of pregnancy, fertility returning time and modern contraceptives use during the postpartum period targeting women whose husbands are in migrant occupations, who are not menstruating and who have not used FP before.

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“…The proportion of women who use contraception declines with age; contraceptive use was highest among women < 24 and lowest among women > 35 [10, 35, 38, 42, 48, 49]. Postpartum contraceptive use was also higher among women who were more educated [11, 35, 40, 43, 44, 48, 50–56], lived in urban residence [17, 40, 43, 51, 52], and had higher socio-economic status [40, 49, 51, 52]. However, in Sri Lanka contraceptive use was higher among women with low socio-economic status, which may be attributed to postnatal home visits by midwives who referred women for FP in this study [56].…”

Section: Resultsmentioning

confidence: 99%

A systematic review and meta-analysis of postpartum contraceptive use among women in low- and middle-income countries

et al. 2019

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BackgroundShort birth intervals increase risk for adverse maternal and infant outcomes including preterm birth, low birth weight (LBW), and infant mortality. Although postpartum family planning (PPFP) is an increasingly high priority for many countries, uptake and need for PPFP varies in low- and middle-income countries (LMIC). We performed a systematic review and meta-analysis to characterize postpartum contraceptive use, and predictors and barriers to use, among postpartum women in LMIC.MethodsPubMed, EMBASE, CINAHL, PsycINFO, Scopus, Web of Science, and Global Health databases were searched for articles and abstracts published between January 1997 and May 2018. Studies with data on contraceptive uptake through 12 months postpartum in low- and middle-income countries were included. We used random-effects models to compute pooled estimates and confidence intervals of modern contraceptive prevalence rates (mCPR), fertility intentions (birth spacing and birth limiting), and unmet need for contraception in the postpartum period.ResultsAmong 669 studies identified, 90 were selected for full-text review, and 35 met inclusion criteria. The majority of studies were from East Africa, West Africa, and South Asia/South East Asia. The overall pooled mCPR during the postpartum period across all regions was 41.2% (95% CI: 15.7–69.1%), with lower pooled mCPR in West Africa (36.3%; 95% CI: 27.0–45.5%). The pooled prevalence of unmet need was 48.5% (95% CI: 19.1–78.0%) across all regions, and highest in South Asia/South East Asia (59.4, 95% CI: 53.4–65.4%). Perceptions of low pregnancy risk due to breastfeeding and postpartum amenorrhea were commonly associated with lack of contraceptive use and use of male condoms, withdrawal, and abstinence. Women who were not using contraception were also less likely to utilize maternal and child health (MCH) services and reside in urban settings, and be more likely to have a fear of method side effects and receive inadequate FP counseling. In contrast, women who received FP counseling in antenatal and/or postnatal care were more likely to use PPFP.ConclusionsPPFP use is low and unmet need for contraception following pregnancy in LMIC is high. Tailored counseling approaches may help overcome misconceptions and meet heterogeneous needs for PPFP.

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Levels, trends and correlates of unmet need for family planning among postpartum women in Indonesia: 2007–2015

Cited by 32 publications

References 24 publications

Association between skilled maternal healthcare and postpartum contraceptive use in Ethiopia

Association between skilled maternal healthcare and postpartum contraceptive use in Ethiopia

<p>Utilization of Family Planning Methods Among Postpartum Mothers in Kailali District, Nepal</p>

A systematic review and meta-analysis of postpartum contraceptive use among women in low- and middle-income countries

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