Cross sectional study on analysis of reasons for refusal of PPIUCD at GIMS, Gadag
Keywords:Contraception, Family planning, Postpartum, Counselling
Background: Women are highly motivated and receptive to accept Family Planning (FP) methods during the postpartum period. Intrauterine Contraceptive Device (IUCD) is one of the commonly used reversible methods of contraception and provide very effective, safe and long-term protection against pregnancy and the health risks associated with the method are negligible. Taking advantage of the immediate postpartum period for counselling on family planning and IUCD insertion, overcomes multiple barriers to service provision. The increased institutional deliveries are opportunity to provide women easy access to immediate PPIUCD services. Objective-The aim of the study was to determine proportion of women accepting postplacental intrauterine contraceptive device insertion, and to describe the factors associated with acceptability and non-acceptance.
Methods: Cross-sectional study conducted from September 2021 to October 2021 in 250 women admitted for delivery at Gadag institute of medical sciences, Gadag. The respondents were interviewed using structured interviewer administered questionnaire.
Results: In the study, it is found that overall awareness regarding PPIUCD in the study population is only 32% which is comparable with the study findings of Rajasthan where the 8 awareness was 20.2%. The readiness rate for PPIUCD insertion after the counselling in present study was 8% which is similar the study report from Government Medical College, Trissur, Kerala where the acceptance rate 1 was 10.5%. The major factors associated with nonacceptance were refusal by patient (50%) and relatives.
Conclusions: The emerging factors for less acceptance of PPIUCD are low literacy rate among women and infrequent counselling and education during antenatal period. Integration of a PPIUCD counselling service at every delivery point with provision of couple counselling can improve the success of this programme.
World Health Organization. Technical Report Series No. 483; 1971. Available at: apps.who.int>iris>bitstream>handle. Accessed on 28th May 2019.
International Institute for Population Sciences (IIPS) and Macro International: National Family Health Survey (NFHS-3), 2005–2006, India.
Speroff L, Mishell DR. The postpartum visit: its time for a change in order to optimally initiate contraception. Contracept. 2008;78:90-8.
Family Planning Division, Ministry of Health and Family Welfare, Government of India : Postpartum IUCD reference manual, 2010. Available at: www.nrhmtn.gov.in>modules> PPIUCD. Accessed on 28th May 2019.
Ashutosh S, Vinita G. A study of awareness and factors affecting acceptance of PPIUCD in South-East Rajasthan. International Journal Of Community Medicine And Public Health. 2017;4(8):2706-10.
Tresa AA, Resmy RC, Lissiamma G. PPIUCD: awareness and reasons for non-acceptance. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2018;7(2):582-6.
Doley RPB. A retrospective study on acceptability and complications of PPIUCD insertion. J Evol Med Dent Sci. 2016;5(31):1631-4.
Saroj K, Neha G. Acceptability for the use of postpartum intrauterine contraceptive devices, Zenana Hospital, Jaipur. Int J Sci Res. 2016;5(5):401-9.
Kant S. Acceptance rate, probability of follow-up, and expulsion of postpartum intrauterine contraceptive device offered at two primary health centers , North India. J Fam Med Prim Care. 2016;5(4):770-6.
Yadav S. Knowledge attitude practice and acceptance of postpartum intrauterine devices among postpartum women in a tertiary care center. Int J Reprod Contracept Obs Gynecol. 2017;6(4):1507-10.
Nayak, Jain. Experience on Awareness, Acceptability, Safety, Efficacy. Complications and expulsion of postpartum intrauterine contraceptive device insertion. Int J Sci Study. 2017;5(1):207-12
Malchuru S, Arun V, Prabhavathi N. Postpartum intrauterine device insertion- 2 years’ experience at tertiary care centre in Gunture Medical College/Govt general hospital, Guntur. J Dent Med Sci. 2015;14:56-61.
Gautam R, Arya KN, Kharakwal S, Singh S, Trivedi M. Overview of immediate PPIUCD application in Bundelk hand region. J Evol Med Dent Sci. 2014;3:9518-26.
Vidyarama R, Nagamani T, Prasad U. PPIUCD as a long acting reversible contraceptive (Larc)-an experience at a tertiary care centre. IJSR. 2012;4:5-7.
Jairaj S, Dayyala S. A cross-sectional study on acceptability and safety of IUCD among postpartum mothers at tertiary care hospital, Telangana. J Clin Diagnostic Res. 2016;10(1):4-7.
Sangeetha J, Sridhar. A cross-sectional study on acceptability and safety of IUCD among postpartum mothers at tertiary care hospital, Telangana. J Clin Diagnostic Res. 2016;10(1):4-7.