Impact of COVID-19 pandemic on postpartum contraception services in women delivering at a tertiary care centre in South India
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20214444Keywords:
COVID-19, Contraception services, Postpartum, ChallengesAbstract
Background: Contraception and sexual health are a fundamental human right and an integral part of women’s health services. Postpartum period is the unique opportunity for counselling and availing contraception. COVID-19 pandemic hindered routine and special services like postpartum clinics has negative impact on family planning services. Objectives were to assess the effect of the COVID-19 pandemic on postpartum contraceptive care services received and to describe the challenges faced in availing these services among pregnant women delivering at a tertiary care centre in South India.
Methods: A descriptive study carried out in 422 women who had delivered at our hospital from July 2020 to October 2020. Data was collected in Epicollect version 5 and analysed using Stata version 14.2.
Results: A total of 422 women were interviewed. Only one-third of the participants received contraceptive counselling in the antenatal period compared to 90% postpartum. 39% (primiparous-34%/multiparous-5%) had adopted barrier methods followed by post-partum intrauterine uterine contraceptive devices in 33% (primiparous-19.6%/multiparous-13.4%) and 5% had sterilisation concurrent with caesarean section. Around 30-40% of women faced challenges in accessing the family planning methods due to closure of elective services like postpartum clinics, operation theatres, nationwide lockdown, and non-availability of field health workers.
Conclusions: Contraceptive choices for postpartum women appear to be largely restricted to temporary methods with additional challenges of availing these services during the pandemic. With the ongoing COVID-19 crisis and continuous need for contraception, there is a need to refocus and motivate eligible couples for long-acting reversible contraceptive methods (LARC) with significantly lower failure rates.
Metrics
References
World Health Organisation. Director-General’s opening remarks at the media briefing on COVID-19. Available at: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020. Accessed on 11 March 2020.
Bietsch K, Williamson J, Reeves M. Family Planning During and After the West African Ebola Crisis. Stud Fam Plann. 2020;51(1):71-86.
UNFPA. Sexual and Reproductive Health and Rights: Modern Contraceptives and Other Medical Supply Needs, Including for COVID-19 Prevention, Protection and Response. Available at: https://www.unfpa.org/sites/default/files/resource-pdf/COVID-19_Preparedness_and_Response_ UNFPA_Interim_Technical_Briefs_Contraceptives_and_Medical_Supplies_23_March.pdf. Accessed on 10 July 2021.
Debnath DJ. Kakkar R. Modified BG Prasad Socio-economic Classification, Updated – 2020. Indian J Comm Health. 2020;32(1):124-5.
FIGO. FIGO Committee on Contraception and Family Planning statement on COVID‐19 and pregnancy. Available at: https://www.figo.org/covid-19-contraception-family-planning. Accessed on 12 July 2021.
RMNCH+A. A Strategic approach to reproductive, maternal, new born, child and adolescent health (RMNCH+A) in India. Available at: https://nhm.gov.in/images/pdf/RMNCH+A/RMNCH+A_Strategy.pdf. Accessed on 12 July 2021.
FSRH, RCOG, and RCM. Guidance on the provision of contraception by maternity services after childbirth during the COVID-19 pandemic. Available at: https://www.rcog.org.uk/globalassets/documents/guidelines/2021-02-guidance-on-the-provision-of-contraception-by-maternity-services-after-childbirth-during-the-covid-19-pandemic.pdf. Accessed on 15 July 2021.
World Health Organization. Maintaining essential health services: operational guidance for the COVID-19 context: interim guidance. Available at: https://apps.who.int/iris/handle/10665/332240. Accessed on 17 July 2021.
Centers for Disease Control and Prevention. Ensuring access to family planning services during COVID-19: A summary of CDC’s family planning recommendations for healthcare providers. Available at: https://www.cdc.gov/reproductivehealth/contrace ption/pdf/FP-and-Covid-19-Fact-Sheet_Final.pdf. Accessed on 17 July 2021.
Foundation for Reproductive Health Services India. Impact of COVID 19 on India’s Family Planning Program. Available at http://www.frhsi.org.in/pdf/ impact-of-covid-19-on-indias-family-planning-program-policy-brief.pdf. Accessed on 17 July 2021.
International Institute for Population Sciences (IIPS) and ICF. 2017. National Family Health Survey (NFHS-4), 2015-16: India. Mumbai: IIPS. Available at http://rchiips.org/nfhs/NFHS4Reports/India.pdf. Accessed on 17 July 2021.
Dev R, Kohler P, Feder M, Unger JA, Woods NF, Drake AL. A systematic review and meta-analysis of postpartum contraceptive use among women in low- and middle-income countries. Reprod Health. 2019;16(1):154.
Downloads
Published
How to Cite
Issue
Section
