Evaluation of safety, efficacy and continuation rates of post-partum intrauterine contraceptive device

Jayotika Verma; Suman Thakur; Rama Thakur; Kushla Pathania; Nitesh Thakur

doi:10.18203/2320-1770.ijrcog20253889

Authors

Jayotika Verma Department of Obstetrics and Gynaecology, Indra Gandhi Medical College (I.G.M.C.), Shimla, Himachal Pradesh, India
Suman Thakur Department of Obstetrics and Gynaecology, Indra Gandhi Medical College (I.G.M.C.), Shimla, Himachal Pradesh, India
Rama Thakur Department of Obstetrics and Gynaecology, Indra Gandhi Medical College (I.G.M.C.), Shimla, Himachal Pradesh, India
Kushla Pathania Department of Obstetrics and Gynaecology, Indra Gandhi Medical College (I.G.M.C.), Shimla, Himachal Pradesh, India
Nitesh Thakur Department of Obstetrics and Gynaecology, Indra Gandhi Medical College (I.G.M.C.), Shimla, Himachal Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20253889

Keywords:

PPIUCD, Counselling, Acceptance, Safety, Continuation

Abstract

Background: Postpartum intrauterine contraceptive device (PPIUCD) is a proven, safe, reversible, and long-acting method of contraception. Despite availability, its acceptance remains low. This study aimed to evaluate the safety, efficacy, and continuation rates of PPIUCD in a tertiary care hospital in Himachal Pradesh.

Methods: A prospective study was conducted from June 2023 to May 2024 among women >34 weeks gestation attending antenatal outpatient department (OPD), admitted in the labor room, and postpartum ward. PPIUCD insertion was performed either post-placental or intra-caesarean after counselling. Women were followed up at 6 weeks, 12 weeks, and 6 months to assess safety, efficacy and continuation rates.

Results: Of 500 women, the acceptance rate was 40%, significantly influenced by antenatal counselling. The main reasons for acceptance were long-term contraception (91.5%), safety (88%), and reduced clinic visits (62.5%). Refusals were attributed to poor knowledge (55.67%), partner/family disapproval (41.33%), preference for another method (35.33%), and fear of complications (33.67%). Most participants were 26–30 years (36.5%), multiparous (66%), graduates (48.5%), from rural areas (62%), and upper middle class (32.7%). Vaginal delivery accounted for 67.5% of insertions. The expulsion rate was 6.84%, with no significant association with type of insertion (p=0.24). At follow-up, 76.31% reported no complaints. Removal rate was 1.58%. Continuation was 91.58% and efficacy 100%, with no failures recorded.

Conclusion: PPIUCD is a safe, effective, and highly acceptable contraceptive option with excellent continuation and satisfaction rates. It is particularly advantageous in rural settings where access to follow-up and contraceptive services is limited.

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