Postpartum contraception utilization among low-income women seeking immunization for infants in Mumbai, India

Abstract

Objective To examine postpartum contraception utilization among Indian women seeking immunization for their infants in three low-income communities in Mumbai, India. Study Design We conducted a cross-sectional questionnaire of low-income postpartum women seeking immunization for their infants at three large urban health centers in Mumbai. Contraceptive utilization data was collected as part of a larger study focused on the impact of postpartum domestic violence on maternal and infant health. Descriptive, bivariate and multivariate analyses were conducted to describe and identify predictors of postpartum contraceptive utilization. Results Postpartum women aged 17–45 years (N=1049) completed the survey; 44.5% (n= 467) reported resuming sexual relations with their husbands. Among these women, the majority (65.3%; n=305) reported not currently using contraception. In multivariate analyses, women who did not discuss postpartum family planning with their husbands, had not used contraception previous to the recent birth, and who had experienced physical violence or forced sex were more likely to not use postpartum contraception (AORs = 1.47–1.77). Among the 162 women using contraception, the most common time to initiation of contraception was 5 weeks postpartum and the most common method used was condoms 77.8% (n=126). Conclusion Contraception non-use was common among urban, low-income postpartum women in India. This study highlights the importance of developing interventions to increase use of highly effective contraceptive methods postpartum, and that spousal violence and lack of marital communication may present barriers to postpartum contraception utilization. Infant immunization may represent an opportunity for provision of contraceptives and contraceptive counseling. Implications This original research study is a unique contribution to the literature because it presents data regarding the non-use of postpartum contraception among women seeking immunizations for their infants in urban centers in a developing country. It also reveals barriers to not using postpartum contraception and provides data for future interventions.

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“…This study revealed that the magnitude of timely initiation of postpartum contraceptive among extended postpartum women was 37.2% [95% CI(34,40.5)]. This finding is consistent with the study conducted in Nigeria (38%) (8) and India (34.7%) (9) However, this finding was higher than studies conducted in Aroressa District, Southern Ethiopia (31.7%) (7) and Togo (17.3%) (10). This difference might be due to improvement in maternal health service and health seeking behavior, the difference in the study area as well as the socio-economic status and demographic characteristics of the study participants.…”

Timely initiation of postpartum contraceptive utilization and associated factors among women of child bearing age in Aroressa District, Southern Ethiopia: a community based cross-sectional study

“…This difference might be due to improvement in health service delivery, difference in study period as well as socio-economic status of the study participants. However, this finding was found to be lower when compared with study done in Northern Ethiopia and India [ 21 , 27 ]. The possible explanation for this variation might be difference in study period, socio-economic and socio-cultural status as well as availability and accessibility of the health services.…”

Reproductive healthcare utilization in urban poor settlements of Delhi: Baseline survey of ANCHUL (Ante Natal and Child Health care in Urban Slums) project

“…In our study population, only one fourth of couples were using contraception (mostly condoms) and living in nuclear families was the single most important predictor. A study in urban slums of Mumbai of family planning in recently delivered mothers [ 35 ] also found only 35 % used contraception and non-use was associated with domestic violence. This emphasises the need for counselling of couples on post-partum contraception during postnatal hospital visits or home visits by community health workers.…”