Awareness, acceptability and clinical outcome of post-placental insertion of intrauterine contraceptive device in Marathwada region, India (original) (raw)
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International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
Background: The current outburst of Indian population (1.21 billion as per census 2011) is because of the lack of awareness and acceptance of contraception in the immediate postpartum period. Postpartum intrauterine contraceptive device (PPIUCD) insertion can do wonders and curb this unmet need of family planning if good counselling and proper insertion techniques are followed. Methods: The present study was carried among 526 women in the department of obstetrics and gynaecology of Nehru Hospital in BRD medical college Gorakhpur, India. Intrauterine contraceptive device (IUCD) was inserted in 424 women in PPIUCD group and in 102 women in interval IUCD group after taking proper consent and following the WHO medical eligibility criteria for contraceptive use (MEC). Follow-up was done at 6 weeks and 6 months. Results: The acceptance rate of PPIUCD was 30.34% as compared to 18% in interval IUCD group (p-value <0.05). The chief reason for declining the use of IUCD was fear of excessive pain and bleeding (26.3%). Long term reversible method (32%) was the main reason given for accepting IUCD. There was no perforation or any other major complication at the time of insertion in both the groups. Rate of expulsion was 5.7% in PPIUCD and 2.22% in interval IUCD group p-value (>0.05). Conclusions: PPIUCD is a safe, effective, feasible and reversible method of contraception. It should be made a part of family health care programmes in India.
Changing Scenario in Indian Contraceptive Methods: A Glimpse Through a Tertiary Hospital Statistics
The Journal of Obstetrics and Gynecology of India, 2019
Background The patient scenario of a tertiary hospital changes with the implementation of various national programmes in any country. These programmes are conceived after understanding the felt need of the society. Though IUCD was available as an interval method of contraception in the past also and was meant to be effective for 10 years, the prerequisite to come again to the medical facility after 6 weeks of childbirth for insertion resulted in almost all patients to dropout and only the highly motivated would come on their own. Post-partum insertion of IUCD at the time of childbirth or within 48 h has addressed the need of contraception in the post-partum period as well as omitted the need for second visit to a health setup. Earlier, after achieving the desired family goal of children, tubectomy was the preferred choice, irrespective of age of children but PPIUCD seems to have come up as a long-term reversible method of contraception. Objective The present study was conceived to study the shift of method of long-term contraception from tubal sterilization and vasectomy to PPIUCD over a period of 8 years from 2010 to 2017. Method This study was a retrospective analytical study conducted at the Department of Obstetrics and Gynaecology in Safdarjung Hospital between the years 2010 and 2017. The number of IUCDs inserted post-placental (i.e. within 10 min of delivery of placenta) and within 48 h (of vaginal childbirth) and intra-caesarean (intrauterine insertion while performing caesarean) were recorded and analysed. Also, sterilizations (tubectomy) and interval IUCD insertions done during this time period were compared. Results With the introduction of PPIUCD in national family programme, more women are inclining towards long-term spacing method and not resorting to sterilizations. PPIUCD is preferred over interval IUCD. Conclusions PPIUCD is there to stay as a method of long-term contraception.
International Journal of Research in Medical Sciences, 2020
Background: The safety and efficacy of the Post-Partum Intra Uterine Contraceptive Device (PPIUCD) has been documented worldwide. With increasing institutional deliveries and greater sensitization, the aim is to increase PPIUCD insertions. Many areas still report poor acceptance. Objectives of this study to determine the proportion of antenatal women willing to accept PPIUCD insertion and the reasons behind refusal to accept this method.Methods: A prospective questionnaire study was done between January 2019 to June 2019 of 200 women. Inclusion criteria were antenatal women in the 2nd/3rd trimester. Exclusion criteria were those opting for a permanent method of contraception and those with a contra-indication.Results: Eighty-four women (42%) had never used any method of contraception. Earlier Intrauterine device (IUD) use (including both interval and PPIUCD) was in only 18.9% of all contraceptive users. Only 2 women in the group had ever used PPIUCD. 79% of women were aware of IUDs...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2019
Apart from this, it does not interfere with breastfeeding. 5 In addition, complaints associated by IUCD insertion are masked by postnatal lochia and afterpains. 6 The objective of the present study was to assess the Knowledge, attitude and practice of postpartum Intrauterine contraceptive ABSTRACT Background: PPIUCD has been introduced in the national family welfare program since March 2010 in several states. AN IUCD can be inserted in 48 hours postpartum, referred to here as postpartum intrauterine contraceptive device. This study was done to assess the Knowledge, attitude and practice of postpartum Intrauterine contraceptive device in antenatal patients at a tertiary care centre in Northern India. Methods: This is a questionnaire based cross sectional observational study including 350 antenatal women attending antenatal OPD over a period of 6 months. Results: Out of these 350 women, 126 women (36%) had knowledge of PPIUCD. only 30 % of women had previous knowledge about PPIUCD however only 10 % of women practiced it in the past. After appropriate counselling 18% of women agreed for insertion of PPIUCD after this delivery. Conclusions: The study concludes that the antenatal women had poor knowledge regarding PPIUCD. Practices were even worse. This might be attributed to low education , refusal by family especially male partner, and religious beliefs. But once appropriate knowledge and information is provided, attitude gradually changes.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: IUCD (intrauterine contraceptive device) to prevent pregnancy are among the oldest method of contraception. The modern IUCD are highly effective, safe private, long acting and rapidly reversible contraceptive method. Aims and objective of this study was to study the acceptability and safety of postpartum intrauterine contraceptive device (PPIUCD) in postpartum period and to assess the feasibility, safety, efficacy and expulsion rate of IUCD.Methods: A prospective observational study was conducted at tertiary care teaching hospital in Maharashtra from January 2018 to October 2018 and patients were followed up to a period of one-year post IUCD insertion.Results: Majority of patients in this study were in age group 21 to 26 years of age (58.7%) and the least number were in the age group more than 30 years (3.3%). This study showed that majority of patients were primigravida (44%) and the lowest number belonged to gravida 6 (0.3%). Regarding timing of IUCD insertion 73% were...
Journal of Medical and Scientific Research, 2022
introduction: Immediate postpartum period is when women are receptive to family planning counselling. Pregnancy within a year of the last delivery increases maternal and perinatal morbidity and mortality. Postpartum intrauterine contraceptive device (PPIUCD) is one method which is safe and effective method for spacing and also for limiting pregnancy. This study was done to evaluate PPIUCD insertion for its awareness, acceptance, and expulsion. Materials and methods: All pregnant women were counselled regarding PPIUCD, and those willing were included in the study. Intrauterine contraceptive device used in this study was CuT 380A. It was inserted after delivery of the placenta after vaginal delivery and after caesarean section using sponge-holding forceps. They were asked to follow up after 6 weeks and 6 months of insertion. Data collected was subjected to statistical analysis using SPSS V22 software, and results were drawn. Results: From 1602 deliveries, 456 (28.46%) women accepted PPIUCD, and 36.32% (n=582) were aware of this method. 60.08% (n=274) had PPIUCD insertion after vaginal delivery and 39.91% (n=182) after caesarean section. The main reason for refusal was fear of bleeding (n=280) (26.81%). The most common complication seen was lower abdominal pain (11.62%). No case was reported with uterine perforation. conclusion: This method has shown to be a very safe, effective and economical method for contraception. In India, where there is very little access to contraception during interval period and women do not return to the hospital for a postnatal checkup and contraceptive advice, this PPIUCD method is most beneficial.
The Journal of Obstetrics and Gynecology of India
Objective To determine critical factors and barriers to postpartum intrauterine contraceptive device (PPIUCD) use in India in order to guide programs aimed at reducing maternal and child mortality. Methods All pregnant women were enrolled for contraception counseling during their visit to the antenatal outpatient clinic. Women who opted for PPIUCDs were enrolled in the study and offered PPIUCD insertion, irrespective of mode of delivery. Those who withdrew consent when in labor or soon after delivery, experienced severe bleeding, or exhibited unstable vital signs were excluded, as were febrile women and those diagnosed with chorioamnionitis. Results A total of 66,508 women were enrolled in the study. 86.1% indicated they discussed family planning options with their partners/husbands before making a decision. 178 respondents (0.3%) could not mention one advantage of PPIUCDs, while 23.1% could not mention one disadvantage. 13.9% of the women withdrew consent. Family member objections (43.44%), husband/partner objection (27.94%), and deciding on another method (15.59%) were the main reasons for consent withdrawal. Conclusions Awareness of PPIUCDs is not a limiting factor in women's consent to PPIUCD insertion. As a woman's decision to use a PPIUCD is significantly influenced by family members and her partner/husband, awareness initiatives that target these populations should be considered.
Women's experience with postpartum intrauterine contraceptive device use in India
Reproductive Health, 2014
Background: Postpartum intrauterine contraceptive devices (PPIUCD) are increasingly included in many national postpartum family planning (PPFP) programs, but satisfaction of women who have adopted PPIUCD and complication rates need further characterization. Our specific aims were to describe women who accepted PPIUCD, their experience and satisfaction with their choice, and complication of expulsion or infection. Methods: We studied 2,733 married women, aged 15-49 years, who received PPIUCD in sixteen health facilities, located in eight states and the national capital territory of India, at the time of IUCD insertion and six weeks later. The satisfaction of women who received IUCD during the postpartum period and problems and complications following insertion were assessed using standardized questionnaires. Results: Mean (SD) age of women accepting PPIUCD was 24 (4) years. Over half of women had parity of one, and nearly one-quarter had no formal schooling. Nearly all women (99.6%) reported that they were satisfied with IUCD at the time of insertion and 92% reported satisfaction at the six-week follow-up visit. The rate of expulsion of IUCD was 3.6% by six weeks of follow-up. There were large variations in rates of problems and complications that were largely attributable to the individual hospitals implementing the study. Conclusions: Women who receive PPIUCD show a high level of satisfaction with this choice of contraception, and the rates of expulsion were low enough such that the benefits of contraceptive protection outweigh the potential inconvenience of needing to return for care for that subset of women.
Reproductive Health, 2013
Background: Pakistan was among the leading countries in south Asia which started the family planning program in late 50s, forecasting the need to control the population. Despite this early intervention, fertility rate has declined but slower in Pakistan as compared to most other Asian countries. Pakistan has almost a stagnant contraceptive prevalence rate for more than a decade now, perhaps owing to the inadequate performance of the family planning programs. The provision and use of long term contraceptives such as IUCD has always been low (around 2%) and associated with numerous issues. Married women who want to wait before having another child, or end childbearing altogether, are not using any long term method of contraception. Methodology: A descriptive qualitative study was conducted from May to July 2012, to explore and understand the perceptions of women regarding the use of IUCDs and to understand the challenges/issues at the service provider's end. Six FGDs with community women and 12 in-depth interviews were conducted with family planning providers. The data was analyzed using the Qualitative Content Analysis approach. Results: The study revealed that the family planning clients are reluctant to use IUCDs because of a number of myths and misconceptions associated with the method. They have reservations about the provider's capability and quality of care at the facility. Private health providers are not motivated and are reluctant to provide the IUCDs because of inadequate counseling skills, lack of competence and improper supporting infrastructure. Government programs either do not have enough supplies or trained staff to promote the IUCD utilization. Conclusion: Besides a well-designed community awareness campaign, providers' communication and counseling skills have to be enhanced, as these are major contributing factors in IUCD acceptance. Ongoing training of all family planning service providers in IUCD insertion is very important, along with strengthening of their services.