Published: 2017-02-08

Knowledge and attitude towards contraceptive methods for spacing and decision making factors regarding its use in postpartum women

Jyotsna Sharma, Gowri Dorairajan, Palanivel Chinnakali


Background: Though the permanent methods have been successful in our country the spacing methods lag behind and unwanted unplanned pregnancies continue to be high. This study was undertaken to explore the knowledge level, attitude and the factors influencing the potential use of spacing contraception among recently delivered women.

Methods: This cross sectional study was carried out in a teaching institution using a structured questionnaire among recently delivered women willing to participate in the study.

Results: Among the 404 women studied 74% were primipara. The level of awareness about spacing contraception was 70% though only 30% knew the correct use. The most frequent source of information was social circle and friends. Two thirds of women felt the need for spacing but 65.8% were not willing to adopt any modern method for fear of side effects and want of husband approval. Bivariate analysis showed that prenatal counselling (X2=41.33 P<0.001) and higher education (X2=16.6 P<0.001) were significant predictors of knowledge about spacing contraception. On bivariate analysis prenatal counselling (X2=3.83p<0.05) and prior discussion with husbands (X2=17.4 P=0.001) emerged to be the most significant predictors of positive attitude towards contraception. On multivariate analysis prior discussion with husband emerged as the most significant factor to predict the likely use of contraception for spacing (Adjusted OR-2.8; 95%CI 1.6-5.1).

Conclusions: Prenatal counselling detailing about the contraceptive methods and doing away with the myths and involving husbands in these sessions would be important strategies to improve the effective use of spacing contraception among recently delivered women.


Spacing, Contraception, Knowledge, Attitude, Counselling, Postpartum

Full Text:



Mahmood SE, Srivastava A, Shrotriya VP, Shaifali I, Mishra P. Postpartum contraceptive use in rural Bareilly. Indian J Comm Health. 2011;23(2):56-7.

Chandhick N, Dhillon BS, Kambo I, Saxena NC. Contraceptive knowledge, practices and utilization of services in the rural areas of India (an ICMR task force study). Indian JMed Sci. 2003;57(7):303-10.

Kanojia JK, Nirbhavane NC, Toddywala VS, Betrabet SS, Patel SB, Datte S, et al. Dynamics of contraceptive practice amongst urban Indian women. Natl Med J India. 1996;9(3):109-12.

Kunwar S, Faridi MMA, Singh S, Zahra F, Alizaidi Z. Pattern and determinants of breastfeeding and contraceptive practices among mothers within six months postpartum. Biosci Trends. 2010;4(4):186-9.

Salway S, Nurani S. Uptake of contraception during postpartum amenorrhoea: understandings and preferences of poor, urban women in Bangladesh. Soc Sci Med. 1998;47(7):899-909.

Mathe JK, Kasonia KK, Maliro AK. Barriers to adoption of family planning amongwomen in Eastern Democratic Republic of Congo. Afr J Reprod Health. 2011;15(1):69-77.

International Institute for Population Sciences (IIPS) and Macro International. National family health survey (NFHS-3), 2005-06: India. In: IIPS, eds. IIPS Survey. Volume I. Chap 5. Mumbai: IIPS; 2007: 111-113.

Speizer IS, Calhoun LM, Hoke T, Sengupta R. Measurement of unmet need for family planning: longitudinal analysis of the impact of fertility desires on subsequent childbearing behaviours among urban women from Uttar Pradesh, India. Contraception. 2013;88(4):553-60.

Bastianelli C, Farris M, Benagiano G, D’Andrea G. Unmet needs and knowledge of postpartum contraception in Italian women. Clin Exp Obstet Gynecol. 2013;40(4):514-8.

Hernandez LE, Sappenfield WM, Goodman D, Pooler J. Is effective contraceptive useconceived prenatally in Florida? The association between prenatal contraceptive counseling and postpartum contraceptive use. Matern Child Health J. 2012;16(2):423-9.

Hayat H, Khan PS, Imtiyaz B, Hayat G, Hayat R. Knowledge, attitude and practice of contraception in rural Kashmir. J Obstet Gynaecol India. 2013;63(6):410-4.

Romero-Gutiérrez G, Garcia-Vazquez MG, Huerta-Vargas LF, Ponce-Ponce de Leon AL. Postpartum contraception in LeÓn, Mexico: a multivariate analysis. Eur J Contracept Reprod Health Care. 2003;8(4):210-6.

Di Giacomo P, Sbarlati A, Bagnasco A, Sasso L. Woman's contraceptive needs and preferences in the postpartum period: an Italian study. J Clin Nurs. 2013;22(23-24):3406-17.

Sebastian MP, Khan ME, Kumari K, Idnani R. Increasing postpartum contraception in rural India: evaluation of a community-based behavior change communication intervention. Int Perspect Sex Reprod Health. 2012;38(2):68-77.

Barber SL. Family planning advice and postpartum contraceptive use among low-income women in Mexico. Int Fam Plan Perspect. 2007;33(1):6-12.

Lopez LM, Grey TW, Chen M, Hiller JE. Strategies for improving postpartum contraceptive use: evidence from non-randomized studies. Cochrane Database Syst Rev. 2014;11:CD011298.

Mustafa R, Afreen U, Hashmi HA. Contraceptive knowledge, attitude and practice among rural women. J Coll Physicians Surg Pak. 2008;18(9):542-5.

Gebremariam A. Intention to use long acting and permanent contraceptive methods and factors affecting it among married women in Adigrat town, Tigray, Northern Ethiopia. Reprod Health. 2014;11:24.

Saroha E, Altarac M, Sibley LM. Low use of contraceptives among rural women in Maitha, Uttar Pradesh, India. J Indian Med Assoc. 2013;111(5):302-6, 308.

Bhattathiry MM, Ethirajan N. Unmet need for family planning among married women of reproductive age group in urban Tamil Nadu. J Fam Community Med. 2014;21(1):53-7.

Brunie A1, Tolley EE, Ngabo F, Wesson J, Chen M. Getting to 70%: barriers to modern contraceptive use for women in Rwanda. Int J Gynaecol Obstet. 2013;123(Suppl 1):e11-5.

Kapil Yadav, Bir Singh, Kiran Goswami. Agreement and concordance regarding reproductive intentions and contraception between husbands and wives in Rural Ballabgarh, India. Indian J Community Med. 2010;35(1):19-23.

Bhattarai D, Panta OB. Knowledge attitude and practice on contraception in village women in Khotang. J Nepal Health Res Counc. 2013;11(23):40-3.

Eliason S, Baiden F, Quansah-Asare G, Graham-Hayfron Y, Bonsu D, Phillips J, et al. Factors influencing the intention of women in rural Ghana to adopt postpartum family planning. Reprod Health. 2013;10:34.