Abstract
BackgroundLess than 1% of married women in Tanzania use an Intrauterine Contraceptive Device (IUD) for contraception. An initiative by the International Federation of Gynecology and Obstetrics (FIGO) has been in progress since 2015 resulting in escalated method uptake in implementing hospitals. This study investigates failure rate, complications, and risk factors for one-year continuation of TCu380A IUD when used for immediate postpartum contraception under the initiative in Tanzania.MethodologyA prospective cohort study of women who had TCu380A insertion within 48 h of delivery in 6 hospitals in Tanzania between 1st December 2017 and 18th April 2018 was conducted. Face to face post insertion interviews were made with 1114 clients before discharge and later through phone calls up to the beginning of 13th month postpartum. Postpartum Intrauterine Device (PPIUD) continuation status, complications, duration of time they stayed with the IUD and the currently used method if PPIUD was discontinued were enquired. The outcome variable was PPIUD continuation at one year of IUD insertion. Data were analyzed using Statistical Product and Service Solutions software (SPSS) for Windows version 20 (IBM SPSS Statistics, Chicago, IL, USA).ResultsIn total 511(45.8%)clients had consented and availed to complete the one-year follow-up. Out of these, 440 still had IUD, giving a one-year continuation rate of 86.1%. Most (63%) IUD discontinuations occurred in the period between 7th week and 6 months of insertion. One-year method expulsion rate was 2.1%. There was one reported pregnancy that gives a method failure rate of about 2 per 1000. The independent risk factors in favor of method continuation at one year were absence of medical or social problem, being a youth (16–24 years), and delivery by Cesarean section.ConclusionsThe continuation rate when CuT380A is used for immediate postpartum contraception is high, with low complication and failure rates. Some medical and social factors are important for method continuation, hence the need to consider in training, counselling and advocacy.
Highlights
Less than 1% of married women in Tanzania use an Intrauterine Contraceptive Device (IUD) for contraception
The continuation rate when CuT380A is used for immediate postpartum contraception is high, with low complication and failure rates
Some medical and social factors are important for method continuation, the need to consider in training, counselling and advocacy
Summary
Less than 1% of married women in Tanzania use an Intrauterine Contraceptive Device (IUD) for contraception. This study investigates failure rate, complications, and risk factors for one-year continuation of TCu380A IUD when used for immediate postpartum contraception under the initiative in Tanzania. Intrauterine contraceptive device (IUD) is one of the most effective methods for family planning [1]. Available evidence suggest that the timing of IUD insertion immediately postpartum has important implications on acceptance, complications and continuation of the method [1,2,3]. Studies have shown that the immediate postpartum period provides an ample chance for a convenient and cost-effective contraceptive option in settings where women do not usually return for follow-up visits because of distance or socioeconomic reasons [1, 2]. The knowledge created by these and published studies is limited by shorter periods of follow-up than the standard one year for most of them, the lack of standardized insertion technique, and the mix-up of IUD types
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
