Evaluation of factors associated with acceptance of post-partum intrauterine contraceptive device in a tertiary care hospital

  • Humera Naeem Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, Pakistan.
  • Kiran Jabeen Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, Pakistan.
  • Kholood Janjua Shifa Clinical Research Center, Shifa International Hospitals Limited., Islamabad, Pakistan
Keywords: Long acting reversible, contraception, intrauterine devices, postpartum period, patient acceptance

Abstract

Objective: The post-partum intrauterine contraceptive device (PPIUCD) is a highly effective, long acting, reversible, economical and easily accessible family planning method. The aim of the study was to estimate the proportion of pregnant women aware of immediate post-partum intrauterine contraceptive device and to analyze the factors associated with acceptance.

Methodology: This is a cross sectional study in which 300 pregnant were selected who were visiting the antenatal clinics and admitted in early labor in labor ward. Their awareness and acceptance for PPIUCD was assessed through a structured questionnaire. Factors associated with acceptance were analyzed and the reasons for acceptance or refusal were determined.

Results: In this study the awareness of PPIUCD was found to be 46% and the acceptance rate of PPIUCD was 18%. The major reason for refusal was that women don’t think they need contraception immediately after delivery and secondly, they need to talk to their partners for the decision. Most common reasons for acceptance of PPIUCD was that it is long acting and reversible.

Gravidity (p= 0.006), parity (p< 0.001), unplanned pregnancy (p= 0.002) and inter pregnancy interval (p= 0.004) were the factors significantly influencing the acceptance of PPIUCD.

Conclusion: This study revealed that awareness regarding PPIUCD is increasing in women but acceptance is still poor. It was due to misconception that no contraception is needed in postpartum period. Provision of adequate knowledge regarding convenience and effectiveness of post-partum contraception in preventing unintended pregnancies can play vital role to increase its acceptance.

Downloads

Download data is not yet available.

Author Biographies

Humera Naeem, Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, Pakistan.

Assistant Professor

Kiran Jabeen, Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, Pakistan.

Senior Registrar

Kholood Janjua, Shifa Clinical Research Center, Shifa International Hospitals Limited., Islamabad, Pakistan

Clinical Research Associate

References

DESA U. United nations department of economic and social affairs, population division. world population prospects: The 2015 revision, key findings and advance tables. InTechnical Report 2015. Working Paper No. ESA/P/WP. 241.

National Institute of Population Studies (NIPS) [Pakistan] and ICF. 2019. Pakistan Demographic and Health Survey 2017-18. Islamabad, Pakistan, and Rockville, Maryland, USA: NIPS and ICF.

Patel S, Patel D, Pandit, N, Patel M.A Cross Sectional Study of Contraceptive Uses and Unmet Need for Family Planning Among Rural Population of Vadodara. Int J Biomed Advance Res. 2015; 6(11):765-7.

DOI: https://doi.org/10.7439/ijbar.v6i11.2663

Bajracharya A. Knowledge, Attitude and Practice of Contraception among Postpartum Women Attending Kathmandu Medical College Teaching Hospital. Kathmandu Univ Med J 2015; 13(4):292-7.

DOI: https://doi.org/10.3126/kumj.v13i4.16826

Gazdar H, Khan A, Qureshi S. Measuring the economic costs of unsafe abortion mortality and morbidity in Pakistan: Preliminary findings and survey design. Karachi: Collective for Social Science Research. 2010.

Gazdar H, Khan A, Qureshi S. Causes and implications of induced abortion in Pakistan, A social and economic analysis. Karachi, Pakistan: Collective Social Sci Res. 2012:37-46.

Sathar Z., Singh S, Rashida G, Shah Z, Niazi R. Induced abortions and unintended pregnancies in Pakistan. Stud FamPlann. 2014; 45(4): 471-91.

DOI: https://doi.org/10.1111/j.1728-4465.2014.00004.x

Waqas H, Azmat SK, Mohsina B, Muhammad I. Determining the factors associated with unmet need for family planning: a cross-sectional survey in 49 districts of Pakistan. Pak J Public Heal. 2011; 1(1):21-7.

Hooda R, Mann S, Nanda S, Gupta A, More H, Bhutani J. Immediate Postpartum Intrauterine Contraceptive Device Insertions in Caesarean and Vaginal Deliveries: A Comparative Study of Follow-Up Outcomes. Int J Reprod Med. 2016; 2016:1–5.

DOI: https://doi.org/10.1155/2016/7695847

Okonofua F. Abortion and maternal mortality in developing world. J Obstet Gynecol Can. 2006; 28(11):974-9.

DOI: https://doi.org/10.1016/S1701-2163(16)32307-6

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.

DOI: https:doi.org/10.5455/2320-1770.ijrcog20130619

Byrd JE, Hyde JS, DeLamater JD, Plant EA. Sexuality during pregnancy and the year postpartum. J Fam Pract. 1998; 47(4):305-8.

DOI: https://doi.org/10.1080/00224499609551826

Grimes DA, Lopez LM, Schulz KF, Van Vliet HA, Stanwood NL. Immediate post‐partum insertion of intrauterine devices. Cochr Database Sys Review. 2010; (5).

DOI: https://doi.org/10.1002/14651858.CD003036.pub2

Lemeshow S, Hosmer DW, Klar J, Lwanga SK, World Health Organization. Adequacy of sample size in health studies. Chichester: Wiley; 1990.

Asghar S, Homayun A, Awan F. The Future of Postplacental Intrauterine Contraceptive Device (PPIUCD) in Pakistan. Pak J Med Health Sci. 2016; 10(1):320-2.

Sultana R, Hafeez M, Badar N. Reasons of Refusal to Postpartum Intrauterine Contraceptive Device. J Society Obst & Gynae Pak. 2017; 7(4):177-81.

Sharma A,Gupta V. A study of awareness and factors affecting acceptance of PPIUCD in South-East Rajasthan. Int J Community Med Public Health. 2017; 4(8):2706-10.

DOI: https://doi.org/10.18203/2394-6040.ijcmph20173313

Alukal AT, Raveendran RC, George L. PPIUCD: awareness and reasons for non-acceptance. Int J Reprod Contracept Obstet Gynecol. 2018; 7(2):582-6.

DOI: https://doi.org/10.18203/2320-1770.ijrcog20180176

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 Gynecol. 2013; 2(4):539-43.

DOI: https://doi.org/10.5455/2320-1770.ijrcog20131210

Kanmani K ,Gokulakrishnan G, Rani PR. Acceptance of postplacental intrauterine contraceptive device: recent increase in trend. Int J Reprod Contracept Obstet Gynecol 2016; 5:1341-4.

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 Obstetr Gynecol Res. 2017; 4(1):77-82. DOI: https://doi.org/10.18231/2394-2754.2017.0016

Maluchuru S, Aruna V, Prabhavathi N. Post partum—intrauterine device insertion 2 yr experience at a Tertiary Care Center in Guntur Medical College/Govt. General Hospital, Guntur. IOSR J Dent. Med Sci. 2015; 14(3):56-61.

DOI: https://doi.org/10.9790/0853-14345661

Gujju RLB, 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 Reproduction Contraception Obstet Gynaecol. 2015; 4(2):388-91.

DOI: https://doi.org/10.5455/2320-1770.ijrcog20150420

Ranjana, Verma A, Chawla I. A follow up study of postpartum intrauterine device insertion in a tertiary health care centre. Int J Reprod Contracept Obstet Gynecol. 2017; 6(7):2800-5.

DOI: https://doi.org/10.18203/2320-1770.ijrcog20172529

Valliappan A, Dorairajan G, Chinnakali P. Postpartum intrauterine contraceptive device: Knowledge and factors affecting acceptance among pregnant/parturient women attending a large tertiary health center in Puducherry, India. Int J Adv Med Health Res.2017; 4(2):69-74.

DOI: https://doi.org/10.4103/IJAMR.IJAMR_28_17

Vidyarama R, Nagamani T, Prasad K. PPIUCD as a long acting reversible contraceptive (Larc)–an experience at a tertiary care centre. Int J Sci Res. 2015; 4(5):5-7.

Published
2019-12-19
How to Cite
1.
Naeem H, Jabeen K, Janjua K. Evaluation of factors associated with acceptance of post-partum intrauterine contraceptive device in a tertiary care hospital. JSTMU [Internet]. 19Dec.2019 [cited 25Apr.2024];2(2):52-7. Available from: https://j.stmu.edu.pk/ojs/index.php/jstmu/article/view/59