A prospective study of postpartum insertions of intrauterine contraceptive device in a tertiary care hospital

Priya Kumar; Chaitanya Indrani; Karunya Nagaraju; Dharmavijaya Mathigatta Narayanappa

doi:10.18203/2320-1770.ijrcog20242290

Authors

Priya Kumar Department of Obstetrics and Gynecology, MVJ Medical College and Research Hospital, Bangalore, Karnataka, India
Chaitanya Indrani Department of Obstetrics and Gynecology, MVJ Medical College and Research Hospital, Bangalore, Karnataka, India
Karunya Nagaraju Department of Obstetrics and Gynecology, MVJ Medical College and Research Hospital, Bangalore, Karnataka, India
Dharmavijaya Mathigatta Narayanappa Department of Obstetrics and Gynecology, MVJ Medical College and Research Hospital, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20242290

Keywords:

Contraception, PPIUCD, Post partum insertion, Postplacental insertion, Long term contraception

Abstract

Background: We are facing a major challenge due to unmet need for contraception in the postpartum period. Inspite of many available contraceptives numerous unplanned pregnancies occur. Though the couples desire contraception, they are not able to accept it due to their ignorance and misconception. Postpartum IUCD insertion is an effective way to counter this. This study was planned to build up data for acceptance, safety and to identify the reasons for non-acceptance and follow up of postpartum IUCD insertions and the challenges faced.

Methods: The present study is a prospective study which was conducted in MVJMC&RH over a period of 1 year which included 397 participants and they were followed up for a period of 6 months at two intervals. Reasons for acceptance and refusal of PPIUCD was recorded, and all issues were addressed along with routine postnatal care.

Results: In the study period of one year there were total of 397 deliveries and 235 insertions. Out of them acceptance rate was 59.19%. Follow up was done at 6 weeks and 6 months. A follow up of 66.8% at 6 weeks and 51.9% at 6 months was noted. Expulsion rates were 2.9% at 6 weeks and 1.7% at 6 months follow up.

Conclusions: This study shows that a steadfast commitment to postpartum contraception by health care providers and the government will unquestionably lessen incidence of unintended pregnancies and the accompanying burden which is a need of the hour to our booming nation.

Metrics

Metrics Loading ...

References

Family Planning Division, Ministry of Health and Family Welfare, Govt. of India. Postpartum IUCD Reference Manual for Medical Officers and Nursing Personnel, 2013. Available at: https://nhm.gov.in/images/pdf/programmes/family-planing/guidelines/IUCD_Reference_Manual_for_MOs_and_Nursing_Personne_-Final-Sept_2013.pdf. Accessed 6th December 2022.

World Health Organization. Report of a WHO Technical Consultation on Birth Spacing, 2007. Available at: https://apps.who.int/iris/handle/10665/69855. Accessed 6th December 2022.

World Health Organization. Programming Strategies for Postpartum Family Planning, 2013. Available at: https://www.who.int/publications/i/item/9789241506496. Accessed 6th December 2022.

Hounton S, Winfrey W, Barros AJ, Askew I. Patterns and trends of postpartum family planning in Ethiopia, Malawi, and Nigeria: Evidence of missed opportunities for integration. Glob Heal Action. 2015;8:29738.

International Institute for Population Sciences (IIPS) and ICF. National Family Health Survey (NFHS-5), 2019-21, India: Volume I, 2021. Available at: http://www.rchiips.org/nfhs or http://www.iipsindia.ac.in. Accessed 6th December 2022.

Iftikhar PM, Shaheen N, Arora E. Efficacy and satisfaction rate in postpartum intrauterine contraceptive device insertion: A prospective study. Cureus. 2019;11(9):e5646.

Cleland J, Bernstein S, Ezeh A, Faundes A, Glasier A, Innis J. Family planning: the unfinished agenda. The Lancet. 2006;368(9549):1810-27.

Gudi SN, Sachdeva J, Manchanda R, Mani M, Sinha SR, Sinha S, Shivkumar P, et al. A prospective multi-centric study of acceptance, insertion and follow-up of postpartum insertions of IUCD. J Obstetr Gynecol India. 2023;73(3):254-61.

Sharma A, Gupta V. A study of awareness and factors affecting acceptance of PPIUCD in South-East Rajasthan. Int J Community Med Public Heal. 2017;4(8):2706-10.

Deshpande S, Gadappa S, Yelikar K, Wanjare N, Andurkar S. Awareness, acceptability and clinical outcome of post-placental insertion of intrauterine contraceptive device in Marathwada region, India. Indian J Obstetr Gynecol Res. 2017;4(1):77-82.

Gujju RL, Prasad U, Prasad U. Study on the acceptance, complications and continuation rate of post-partum family planning using the post placental intrauterine contraceptive device among women delivering at a tertiary care hospital. Int J Reprod Contracept Obstetr Gynecol. 2015;4(2):388-92.

Mishra S. Evaluation of safety, efficacy, and expulsion of post-placental and intra-cesarean insertion of intrauterine contraceptive devices (PPIUCD). J Obstetr Gynecol India. 2014;64:337-43.

Nelson A. Intrauterine contraceptive. J Obstet Gynecol. 2008;6:219-24.