Published: 2018-12-26

A novel approach to meet the unmet need for family planning

Subrata Samanta, Sujoy Dutta, Sudipta Samanta, Agrima Mullick


Background: Post-partum intra-uterine contraceptive device is one of the important methods of spacing to meet up the unmet need of family planning. The low complication rate, ease and certainty of insertion and one-time adoption advantages made it an option of family planning by Government of India. In the background of recent trends in family planning, the study aims to establish the efficacy and draw-backs of PP-IUCD among the clients in a tertiary care hospital of West Bengal.

Methods: Prospective observational study on 1680 women during January 2016 to December 2016, where the PP-IUCD was given to the patients after vaginal delivery or Cesarean section and were followed up to 3 months.

Results: During the study 1.37% patients did not turnup in either follow-up. The most common complication encountered was missing thread (4.64% at 6th week follow-up and 6.67% at 3rd month follow-up). Expulsion rate was much lower (2.02% at 6th week and 2.5% at 3rd month). Heavy bleeding per-vagina was in 1.55% at 6th week and 2.08% at 3rd month. Pain abdomen was .83% at 6th week and 1.67% at 3rd month. Incidence of perforation and failure was both nil at either follow-up. Dysmenorrhea was complained 2.44% at 6th week and 3.33% at 3rd month. Overall satisfaction rate at 6th week (86.05%) was higher than non-satisfaction (13.95%). This was also true for 3rd month where satisfaction rate (77.85%) was higher than non-satisfaction rate (22.15%).

Conclusions: PP-IUCD appears to be a safe, efficacious, acceptable and accessible method of contraception.


Cesarean section, Dysmenorrhea, Intrauterine contraceptive device, Perforation, PID, Vaginal delivery

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Dutta DC. Contraception. In: Konar H, ed. DC Dutta’s Textbook of Gynecology.7th ed. New Delhi. Jaypee Brothers Medical Publishers (P) Ltd; 2016:392-397.

Taneja DK. Demographic and Health Information of India. In: Banerjee B, ed. DK Taneja’s Health Policies and Programmes in India. 15th ed. New Delhi. Jaypee Brothers Medical Publishers (P) Ltd; 2017:55-57.

Department of family welfare Ministry of Health & family Welfare Government of India National Population Policy. 2000. Available at: f

Taneja DK. National Population Policy 2000. In: Banerjee B, ed. DK Taneja’s Health Policies and Programmes in India. 15th ed. New Delhi. Jaypee Brothers Medical Publishers (P) Ltd; 2017:13-20.

Majhi AK. Family Planning and Contraception. New Delhi. Jaypee Brothers Medical Publishers (P) Ltd; 2018:687-690.

Gupta A, Verma A, Chauhan J. Evaluation of PPIUCD versus interval IUCD (380A) insertion in a teaching hospital of Western U.P. Int J Reprod Contracept Obstet Gynecol. 2013;2(2):204-8.

National Health Mission, Ministry of Health & Family Welfare, Government of India. Available at:

Mishra S. Evaluation of safety, efficacy, and expulsion of post-placental and intra-cesarean insertion of intrauterine contraceptive devices (PPIUCD). J Obstet Gynecol India. 2014;64(5):337-43.

Kant S, Archana S, Singh AK, Ahamed F, Haldar P. Acceptance rate, probability of follow-up, and expulsion of postpartum intrauterine contraceptive device offered at two primary health centers, North India. J Fam Med Prim Care. 2016;5(4):770.

Garg N, Grover S, Kaur B. Postpartum IUCD: its acceptance and complications. Int J Reprod Contracept Obstet Gynecol. 2017;6(7):2973-7.

Mishra S. Tale of the tails, the missing postpartum IUCD strings. Obstet Gynecol India. 2017;67(3):202-7.

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

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(1):32.

Araujo VB, Ortiz L, Smith J. Postpartum IUD in Paraguay: a case series of 3000 cases. Contracept. 2012;86:173-86.

Nayak AK, Hota T. Hospital based-study regarding acceptance of PPIUCD as postpartum family planning method and its complications in a tertiary care hospital. Indian J Perinatol Reprod Biol. 2015;5(1):22-5.

Verma A, Sinha AR. Study of Postpartum IUCD Insertions in Tertiary Health care Centre in Bihar: Indian J Perinatol Reproduct Biol. 2014;4:8-10.

Kittur S, Kabadi YM. Enhancing contraceptive usage by post-placental intrauterine contraceptive devices (PPIUCD) insertion with evaluation of safety, efficacy, and expulsion. Int J Reprod Contracept Obstet Gynecol. 2016;1(1):26-32.