Utilization and associated factors of modern contraceptives during postpartum period among women who gave birth in the last 12 months in injibara town Awi Zone, North-West Ethiopia 2019

Abstract

Background: The postpartum period is an important entry point for family planning service providers to reduce unintended and too closely spaced pregnancy. A postpartum modern contraceptive service is one of the recommended public health interventions for reducing maternal and child morbidity and mortalities. However, In Ethiopia modern contraceptive use during the postpartum period is low; resulting in unintended pregnancies and unwanted childbearing . there for this study was done to assess utilization and associated factors of modern contraceptives during the postpartum period among women who gave birth in the last 12 months in Injibara Town Awi Zone, North-Western Ethiopia. Methods: A Community based cross-sectional study design was conducted from March 01 to 15/2019 on 400 women who gave birth in the last 12 months preceding the survey. A simple random sampling technique was used to recruit study subjects. Data was collected using interviewer-administered pretested and structured questionnaires. Data were entered using Epi data 3.5 and exported to SPSS version 23 for analysis. The association between variables was analyzed using Bivariate and multivariable logistic regression models and p-value < 0.05 at 95% Confidence interval was considered as statistically significant. Result: The prevalence of modern contraceptive utilization was 58.5% (95% CI: 53.5- 63%) among postpartum mothers. Secondary school and higher educational levels [AOR= 5.02; 95% CI (1.53-16.47)],[AOR= 4.25; 95% CI:(1.32-13.64) respectively)], previous history of abortion [AOR= 3.93; 95%, CI: (1.43-10.84)], having three and four antenatal care visit [AOR= 4.74; 95%, CI: (1.94-11.54)] [AOR= 5.9; 95%, CI: (2.42-14.39) respectively], family planning counselling during antenatal care [AOR=2.81; 95% ,CI: (1.63- 4.86)], having postnatal care [AOR =1.79, 95%, CI: (1.09-2.96)], menses returning after birth [AOR=2.84, 95% CI: (1.77- 4.57)] and resuming sexual activity [AOR= 2.86, 95% CI: (1.71-4.78)] were factors affecting contraceptive use in postpartum period. Conclusion : The prevalence of modern contraceptive use among postpartum women was found to be high in Injibara town. Therefore, strengthen family planning counseling during antenatal care and postnatal care to reduce the missed opportunity of postpartum women to get family planning methods, especially long-acting reversible contraceptives.

Postpartum modern contraception utilization and its determinants in Ethiopia: A systematic review and meta-analysis

“…Eighteen articles were cross-sectional in design while one article was a follow-up study with a sample size ranging from 248 in Debre Berhan town [ 25 ] to 1109 in the Tigray region [ 26 ]. With regard to the region in which the study conducted, nine Articles were from the Amhara region [ 16 , 18 , 19 , 25 , 27 – 31 ], two from Oromia [ 19 , 32 ], Three from Tigray [ 26 , 33 , 34 ] two from SNNP [ 16 , 35 ], two from Addis Ababa [ 14 , 36 ] and one from Somali [ 15 ] region with publication year ranging from 2015 to 2019 ( Table 1 ).…”

Modern Contraceptive Use and Associated Factors During Extended Postpartum Period Among Women Who Gave Birth in the Last 12 Months at Northwest Ethiopia

“…The findings of this study are consistent with those of previous studies conducted in Bangladesh, Axum, and Injibara. 7,23,31 Having discussion about modern FP methods with partner was significantly associated with postpartum modern contraceptive use. This is supported by reports from Urban Ghana, 32 Kebri Beyah Ethiopia.…”

“…6 Although the recommended time for initiation of contraceptives in the postpartum period is 6 weeks after delivery, most women do not receive contraceptives as recommended. 7 Most women start sexual activity without using contraceptive methods, although more than 90% of them want to postpone a future pregnancy in the first year of postpartum period. 1 As a result of low use of modern contraceptives, high rates of unintended pregnancies, unsafe abortions and unplanned births occur in the SSA.…”

“…13 Maternal mortality related to pregnancy and child birth complications in Ethiopia is the highest among SSA countries and it represents about 412 per 100,000 live births. 7 The unmet need for postpartum family planning in Ethiopia is still high, ranging from 86% in the first 5 months to 76% by the end of the first year after delivery and 81% of women do not use PPFP due to not realizing they could get pregnant one year after delivery. 14,15 Resumption of menses, limited knowledge of available choices, confusion when fertility comes back and unpredictability of the timing of the onset of intercourse, and not discussing family planning methods with partners, were the factors identified by previous studies.…”

“…6 Although the recommended time for initiation of contraceptives in the postpartum period is 6 weeks after delivery, most women do not receive contraceptives as recommended. 7 …”