Antenatal counselling as a tool to increase acceptability of postpartum intrauterine contraceptive device insertion in a tertiary care hospital
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20150442Keywords:
PPIUCD insertion, Acceptability, Antenatal counsellingAbstract
Background: Acceptance of postpartum intrauterine device (IUD) insertions in women in Uttar Pradesh is low. In response to the concept that a good postpartum programme should begin prenatally, this study was designed to determine whether the provision of expert contraceptive counselling during the antenatal period would have an impact on its uptake as compared to women who were counselled in post partum period.
Methods: Expert contraceptive counselling was given to 264 and154 women during their antenatal visits and postpartum hospitalization, respectively. Acceptors received IUCDs within 48 h of delivery in the case of vaginal delivery or transcesarean insertion in case of abdominal delivery. The acceptance rate of PPIUCD and the percentage of actual insertions were recorded. The causes of refusal were also recorded.
Results: Among the 264 couples counselled in antenatal period 116 (43.9%) had PPIUCD insertion. Among the 154 unbooked women who were counselled postpartum only PPIUCD was inserted in 36 (23.4%) women. PPIUCD insertion was significantly high in women receiving expert counselling during antenatal period as compared to the women who were counselled in postnatal period (p< 0.001). Family refusal, No knowledge of PPIUCD and preference for another contraceptive methods were the most common reasons for refusing the use of PPIUCD.
Conclusion: Acceptability of PPIUCD insertion was high in women counselled in antenatal period. Hence, it is suggested that counselling for PPIUCD should start in antenatal period.
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References
Vernon R. Meeting the Family Planning Needs of Postpartum Women. Stud Fam Plann. 2009;40(3):235-45.
World Health Organization: Medical Eligibility Criteria for Contraceptive Use. 4th edition. Geneva: World Health Organization; 2010.
International Institute for Population Sciences (IIPS), The Third National Family Health Survey (NFHS-3), India: 2005–06 (Mumbai: International Institute for Population Sciences, 2007).
Sebastian MP et al. Increasing postpartum contraception in rural India: evaluation of a community-based behaviour change communication intervention. International Perspectives on Sexual and Reproductive Health. 2012;38(2):68–77.
Stephenson R and Tsui AO. Contextual influences on reproductive health service use in Uttar Pradesh, India. Stud Fam Plann.2002;33(4):309–20.
Varkey LC et al. Involving men in maternity care in India. New Delhi, India, Population Council, 2004.Available at http://www. popcouncil.org/pdfs/ frontiers/ FR Final Reports/ India-MIM.pdf. Accessed on 2nd June2015.
Priya et al. Exploring reasons behind Low acceptance for PPIUCD in postnatal women. New Indian Journal of Surgery. 2011;2(4):246.
Speizer IS, Nanda P, Achyut P, Pillai G, Guilkey DK. Family planning use among urban poor women from six cities of Uttar Pradesh, India. J Urban Health. 2012;89:639-58.
Mishra S: Evaluation of Safety, Efficacy, and Expulsion of Post-Placental and Intra-Caesarean Insertion of Intrauterine Contraceptive Devices (PPIUCD). JOGI. 2014;64(5):337–43.
Grimes D, Lopez LM, Schulz KF, Stanwood NL. Immediate post-partum insertion of intrauterine devices. Cochrane Database Syst Rev. 2010;12: CD003036.
Kumar et al: Women’s experience with postpartum intrauterine contraceptive device use in India. Reproductive Health. 2014;11:32.
pdf.usaid.gov/ pdf_docs: Postpartum Insertion of IUCD: A Safe and Effective Contraceptive Option. Available at http://pdf.usaid.gov/pdf_docs/pa00jvv4. pdf accessed on 4th June 2015.
