Clinical Study of Acceptability And Safety of Postpartum Intrauterine Contraceptive Devices

Abstract

Objective: India is first to introduce family planning services, Government of India revised its policy in 2013 to permit trained nurses and midwives to insert postpartum intrauterine contraceptive devices (PPIUCDs). To assess the acceptability and safety of Postpartum Intrauterine Contraceptive Device insertion among women on bases of two key outcomes of PPIUCD insertions — expulsion and infection,who delivered at Rajkiya Mahila Chikitsalya J.L.N. Medical College and Hospital. Method: this is a prospective interventional analytical study. The postpartum family planning services offered are in the form of health education in group counseling session at the postnatal ward. Results: Total women counseled 1000, accepted 312, declined 688, lost to follow up 56, followed up 256, complications 82 (Expulsion 8, Bleeding 21, String problem 32, Removal 8, continuation 231) Interpretation and conclusions: Immediate post-partum IUCD insertion provides highly effective contraception immediately after delivery. Although the expulsion rate for immediate post-partum is higher than for interval insertion particularly in country where women have limited access to medical care. The government needs to develop strategies to increase public awareness of the PPIUCD through different media sources. It is also important to arrange training on PPIUCD in order to increase knowledge and skills among health care providers. This will also further promote PPIUCD use and aid in reduction of expulsion rates. Case incentives to the acceptor, motivator and provider will bring about substantial progress in the PPIUCD use in developing countries like India.