PPIUCD: awareness and reasons for non-acceptance

Anila Tresa Alukal, Resmy C. Raveendran, Lissiamma George


Background: The recommended interval between pregnancies is at least 24 months in order to reduce the risk of adverse maternal, perinatal and infant outcomes. Ministry of Health & Family Welfare, Government of India has taken initiative for provision of IUCD in immediate postpartum period. Several training programs and awareness camps are conducted by NHM for health service providers and also for the public.  The aim of the study was to determine proportion of women accepting post placental intrauterine Contraceptive Device insertion, and to describe the factors associated with acceptability and non-acceptance.

Methods: The study was conducted at the Government Medical College Thrissur, Kerala, India and study period was 1 year (2014-2015). The study population included women who planned to deliver at Government Medical College, Thrissur during the study period including vaginal and caesarean section.

Results: The awareness regarding PPIUCD was only 11.1% whereas for interval IUCD it was 94.9%. The acceptance rate of PPIUCD was very low (10.5%). The most common reason to accept was its long action (68.5%) The most common reason for rejection was that they wanted permanent sterilisation. The other reasons for non-acceptance include unwillingness of husband, fear of complications etc.

Conclusions: The acceptance rate was very low even though majority of the study population were well educated. The most common reason for acceptance was long action followed by reversibility.The reasons for refusal like unwillingness of husband, fear of complications etc. can be overcome by proper counselling and public awareness programs.


Acceptance, Copper-T, Family planning, Post placental

Full Text:



Lucksom PG, Kanungo BK, Sebastian N, Mehrotra R, Pradhan D, Upadhya R. Comparative study of interval versus postpartum Cu-T insertion in a central referral hospital of North East India. Int J Reprod Contracept Obstet Gynecol. 2015 Feb;4(1):47-51.

Shukla M, Qureshi S, Chandrawati. Post placental intrauterine device insertion a five year experience at a tertiary care centre in north India. Indian J Med Res. 2012;136(3):432-5.

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 Obstet Gynecol Res. 2017;4(1):77-82.

Nisha S, Sathi MS, Vijayan CP. Post-placental insertion of IUCD in a tertiary care centre - Acceptance and safety. J Evol Med Dent Sci. 2016;5(80):5933-8.

Kathpalia SK, Mustafa MS. Awareness about Postpartum insertion of intrauterine device among antenatal cases. Med J Armed Forces India. 2015;71:221-4.

Bai Gujju RL, Prasad U, Prasad U. Study on the acceptance, complications, and continuation rate of postpartum family planning using the post placental intrauterine contraceptive device among women delivering at a tertiary care hospital. Int J Reprod Contracept Obstet Gynecol. 2015;4:388-91.

Bedi PK, Guliani MS, Bala S. A prospective study to assess the safety and expulsion rate of copper T380A in immediate post-partum period during caesarean section. Int J Reprod Contracept Obstet Gynecol. 2016 Sept;5(9):3195-9.

Yadav S, Joshi R, Solanki M. Knowledge attitude practice and acceptance of postpartum intrauterine devices among postpartal women in a tertiary care center. Int J Reprod Contracept Obstet Gynecol. 2017 Apr;6(4):1507-10.

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.

Gautam R, Arya KN, Kharakwal S, Singh S, Trivedi M. Overview of immediate PPIUCD application in Bundelkhand Region. J Evol Med Dental Sci. 2014;3:9518-26.

Mishra S. Evaluation of safety, efficacy, and expulsion of post-placental and intracesarean insertion of intrauterine contraceptive device (PPIUCD). J Obstet Gynaecol India. 2014;64:337.

Postpartum IUCD Facilitators’ Guide November, 2010 Family Planning Division Ministry of Health and Family Welfare, Government of India. Available at

Gadre SS, Ahirwar R. Level of acceptance of IUCD insertion in Indian women - a cross-sectional mixed research from central India. Int J Reprod Contracept Obstet Gynecol. 2015;4(4):1079-85.

Kanhere AV, Pateriya P, Jain M. Acceptability and feasibility of immediate postpartum IUCD insertion in a tertiary care centre in Central India. Int J Reprod Contracept Obstet Gynecol. 2015;4(1):179-84.

Singal S, Bharti R, Dewan R. Clinical outcome of postplacental Copper T 380A insertion in women delivering by caesarean section. JCDR. 2014 Sep;8(9):OC01.

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 Gynaecol. 2013;2:539-43.