Choice of postpartum contraception and its socio-demographic and cultural determinants

Authors

  • Vidyadhar B. Bangal Centre for Social Medicine, Pravara Institute of Medical Sciences (Deemed to be University) Loni, Ahmednagar, Maharashtra, India
  • Sunil Thitame Centre for Social Medicine, Pravara Institute of Medical Sciences (Deemed to be University) Loni, Ahmednagar, Maharashtra, India
  • K. V. Somasundaram Centre for Social Medicine, Pravara Institute of Medical Sciences (Deemed to be University) Loni, Ahmednagar, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20202723

Keywords:

Family planning, Injectable progesterone, Postpartum contraception, Postpartum intra uterine contraceptive device, Tubectomy

Abstract

Background: Postpartum contraception is essential for avoidance of unwanted pregnancy and for adequate spacing between two pregnancies. There are many socio demographic and cultural factors that influence the choice of contraception in rural community in India. Third trimester of pregnancy is ideal time for counselling the women regarding breast feeding and contraception. The objective of the present study was to find out the choice of postpartum contraception among antenatal women and the socio demographic and cultural determinants that influence this choice.

Methods: Six hundred pregnant women were interviewed regarding their choice of postpartum contraception during their antenatal visit in third trimester of pregnancy, using a pre-validated and pre-tested brief questionnaire. The choices were compiled and analysed to draw conclusions.

Results: Postpartum sterilization was choice of 30% of multiparous women. Primi-parous women either opted for barrier contraception like condom (10%), intrauterine contraception (9%) or oral steroidal pills (8%). The progesterone injectable contraceptives and centchroman each were chosen by 2% respondents. There was strong influence of education, parity, sex of the living children on the choice of contraception. It was observed that 40% of women did not want to use hormonal pills and intrauterine contraceptives due to strong age old misbelieves associated with them.

Conclusions: Women in rural area prefer permanent method of contraception in the form of tubectomy operation after having desired number of children. There is insufficient spacing between pregnancies due to either non-use of contraception or inconsistent use of temporary method of contraception. More than 50% women are dependent on the husband regarding the choice and practice of contraception. The level of education of woman, age at marriage, socio economic class, desired sex combination of children are strong determinants of choice of contraception.

References

Family planning: A global handbook for providers. World Health Organization; 2007. Available at: https://www.who.int/reproductivehealth/publications/fp-global-handbook/en/. Accessed on 12th March 2020.

WHealth benefits of family planning. World Health Organization; 1995. Available at: http://whqlibdoc.who.int/hq/1995/WHO_FHE_FPP_95.11.pdf. Accessed on 12th March 2020.

2002 PRAMS Surveillance Report: Multistate exhibits - Postpartum contraceptive use. Centers for disease control and prevention; 2006.

Germano E, Jenning V. New approaches to fertility awareness-based methods: incorporating the standard days and two days methods into practice. J Midwifery Women’s Health. 2006;51:471-7.

King J. Contraception and lactation. J Midwifery Women’s Health. 2007;52(6):614-20.

Progesterone-only contraceptive use during lactation and its effects on the neonate. World Health Organization; 2009. Available at: https://www.who.int/reproductivehealth/publications/family_planning/WHO_RHR_09_13/en/. Accessed on 12th March 2020.

Contraception: A guide to help you choose. Marie Stopes International Australia; 2007.

Cleland J, Bernstein S, Ezeh A, Faundes A, Glasier A, Innis J. Family planning: the unfinished agenda. Lancet. 2006;368:1810-27.

Rutstein S. Further evidence of the effects of preceding birth intervals on neonatal, infant, and under-five-years mortality and nutritional status in developing countries: evidence from the demographic and health surveys. DHS Working. Macro International; 2008.

Postpartum IUCD reference manual, Family Planning Division, Ministry of Health and Family Welfare, Government of India; 2010.

Contraception after childbirth and during breastfeeding. Available at: https://healthengine.com.au/info/contraception-after-childbirth-and-during-breastfeeding. Accessed on 18th March 2020.

Karla M. Knowledge and choices of postpartum contraception among pregnant teens. P R Health Sci J. 2014;33(3):117-21.

Igwegbe AO, Ugboaja JO, Monago EN. Knowledge and practice of family planning among antenatal care attendees at Nnewi, south east Nigeria. Niger Postgraduate Med J. 2010 Dec;17(4):287-90.

Olamijulo J. Knowledge and practice of contraception among pregnant women attending the antenatal clinic in Lagos University Teaching Hospital. Niger J Med. 2012;21(4):387-93.

Obisesan K. Awareness and use of family planning methods among married women in Ibadan, Nigeria East. Afr Med J. 1998;75(3):135-8.

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Published

2020-06-25

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Original Research Articles