A prospective observational study of post-partum intrauterine contraceptive device acceptance in a tertiary care centre
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20231560Keywords:
Postplacental intrauterine contraceptive device, Long-acting reversible contraceptive, Tubal ligationAbstract
Background: Provision of PPIUCD is being rapidly scaled up in India with facilities in at least 19 states offering the method in 2013. According to National Family Health Survey (NFHS)-3, the prevalence of modern method of contraceptive use is 48.5% and all methods 56% in India. PPIUCD placement remains a viable option for patients who wish to use a long-acting reversible contraceptive (LARC) method and to have it placed at the time of their delivery. Hence, we planned this study with an aim to evaluate acceptability PPIUCD at tertiary care centre.
Methods: It was an observational and prospective study of acceptance of PPIUCD as a method of contraception in patients who delivered within the study period in our institute Grant Medical Hospital and College, Mumbai. Data analysis was done with statistical software SPSS V 25.0.
Results: A total of 2014 patients were enrolled in the study. The mean age was noted to be 25.87 years. Frequency of ANC visits among the patients was 4 to 6 (39.87%). Commonest obstetric history finding was previous live birth history in 59.38% cases. Pregnancy outcome was vaginal delivery noted in 63.01% of the females. 879 (43.65%) cases accepted PPIUCD. For those who did not accept PPIUCD, commonest cause was tubal ligation in 34.19%, followed by fear of pain in 18.94%, partner’s refusal in 10.31%.
Conclusions: The acceptance rate in study for PPIUCD was 43.65% which was higher than most of the published evidence. The common reasons for not accepting PPIUCD were tubal ligation.
References
Bagul R, Sable P. Janani Suraksha Yojana-cash assistance scheme for maternal and child health: Retrospective analysis of acceptance of postpartum intrauterine contraceptive device insertion among its beneficiaries. Int J Med Sci Public Health. 2019;(0):1.
Taklikar CS, More S, Kshirsagar V, Gode V. Prevalence of contraceptive practices in an urban slum of Pune city, India. Int J Med Sci Pub Heal. 2015;4(12):1772-8.
Moniz MH, Chang T, Heisler M, et al. Inpa- tient postpartum long-acting reversible contraception and sterilization in the United States, 2008-2013. Obstet Gynecol. 2017;129(6):1078-85.
Katheit G, Agarwal J. Evaluation of post-placental intrauterine device (PPIUCD) in terms of awareness, acceptance, and expulsion in a tertiary care centre. Int J Reprod Contracept Obstet Gynecol. 2013;2(4):539.
Mishra S. Evaluation of safety, efficacy, and expulsion of post-placental and intra-cesarean insertion of intrauterine contraceptive devices (PPIUCD). J Obstet Gynaecol India. 2014;64(5):337-43.
Maluchuru S, Aruna V. Post partum-intrauterine device insertion – 2yr experience at a tertiary care center in Guntur Medical College/Govt. General Hospital, Guntur. IOSR. 2015;14(7):2279-861.
Jairaj S, Dayyala S. A cross sectional study on acceptability and safety of IUCD among postpartum mothers at tertiary care hospital, Telangana. J Clin Diagn Res. 2016;10(1):LC01-4.
Vishwakarma S, Verma V, Singh M. Experience on safety, expulsion, and complication of intracesarean post-partum intrauterine copper device. Cureus 2020;12(9):e10647.
IUCD reference manual for medical officers and nursing personnel. Available at: https://nhm.gov.in/images/pdf/programmes/family- planing/guidelines/IUCD_Reference_Manual_for_MOs_and_Nursing_Person ne_-Final-Sept_2013.pdf. Accessed on 7 January 2023.
WHO. Unmet need for family planning. Available at: http://www.who.int/reproductivehealth/topics/family_planning/unmet_need_fp/en/. Accessed 01 February 2023.
Azmat SK, Shaikh BT, Hameed W, Bilgrami M, Mustafa G, Ali M, et al. Rates of IUCD discontinuation and its associated factors among the clients of a social franchising network in Pakistan. BMC Womens Health. 2012;12(1):8.
IUD Guidelines for family planning service programs. Available at: http://www.jhpiego.org/files/IUD_Manual_0.pdf. Accessed on 15 January 2023.
India Fact Sheet. National Family Health Survey (NFHS-4). (2015-2016). Available at: http://rchiips.org/NFHS/pdf/NFHS4/India.pdf. Accessed on 30 January 2023.
Mignini LE, Carroli G, Betran AP. Interpregnancy interval and perinatal outcomes across Latin America from 1990 to 2009: a large multi‐country study. BJOG. 2016;123:730-37.
Medical eligibility criteria for contraceptive use: fourth edition, 2010. Available at: https://www.who.int/reproductivehealth/publications/family_planning/9789241563888/en/. Accessed 30 January 2023.
Kumar S, Sethi R, Balasubramaniam S, Charurat E, Lalchandani K, Semba R, et al. Women’s experience with postpartum intrauterine contraceptive device use in India. Reprod Health. 2014;11:32.
