Abstract
Introduction Integrated use of postpartum intrauterine contraceptive devices with delivery service during the immediate postpartum period is ideal for both women and health-care providers. However, utilization of intrauterine contraceptive devices during the postpartum period was rare and in Ethiopia, with information regarding uptake of postpartum intrauterine contraceptive devices limited. Objective Identify determinants of postpartum intrauterine contraceptive devices uptake among women delivering in public hospitals of South Gondar zone, Northwest Ethiopia, 2019. Methods An unmatched case-control study was conducted in public hospitals of South Gondar, Ethiopia, from August 1, 2019, to November 10, 2019. A total of 140 cases and 280 controls have actively participated in the study. Five hospitals were selected by simple random sampling. Cases were selected consecutively, whereas two controls for each case were recruited by the lottery method. Pretested questionnaires were used to collect data and it was entered into Epidata version 4.4.2. Logistic regression analysis was used to identify variables associated with the use of outcome and adjusted odds ratio with a 95% confidence interval was used to determine the association between independent and outcome variables. Results Completing secondary education (AOR = 4.5, 95%CI 2.3–8.85), having a total number of children of 3–4 (AOR = 3.6, 95%CI 1.25–10.2), having ≥ 5 (AOR = 4.7, 95%CI 1.5–15.3), attending 3 antenatal care (AOR = 2.8, 95%CI 1.44–5.6), ever hearing about postpartum IUCD (AOR = 6.6, 95%CI 2.7–16.1), and having counseling from health-care provider about a postpartum intrauterine contraceptive device (AOR = 6.2, 95%CI 2.99–12.8) were significantly associated with uptake of the postpartum intrauterine contraceptive. Conclusion and Recommendation. Completing secondary education, having 3–4 and ≥5 children, attending three antenatal care, ever hearing about postpartum IUCD, and having counseling from health-care providers about the postpartum intrauterine contraceptive device among women were significantly associated with uptake of an intrauterine contraceptive device after birth. Therefore, it is better to advise women to strictly follow their antenatal care, access to information, and provide counseling.
Highlights
IntroductionPostpartum intrauterine contraceptive devices are a provision of IUCD vaginally within 10 minutes after removal of the placenta, called postplacental IUCD, or it can be inserted within 2 days (morning of the first postpartum day before discharge to home) after vaginal delivery, called early postpartum intrauterine contraceptive device
Integrated use of postpartum intrauterine contraceptive devices with delivery service during the immediate postpartum period is ideal for both women and health-care providers
Postpartum intrauterine contraceptive devices are a provision of IUCD vaginally within 10 minutes after removal of the placenta, called postplacental IUCD, or it can be inserted within 2 days after vaginal delivery, called early postpartum intrauterine contraceptive device
Summary
Postpartum intrauterine contraceptive devices are a provision of IUCD vaginally within 10 minutes after removal of the placenta, called postplacental IUCD, or it can be inserted within 2 days (morning of the first postpartum day before discharge to home) after vaginal delivery, called early postpartum intrauterine contraceptive device. E unmet needs of family planning can be reduced by providing it immediately after childbirth without a need for repeated visiting of the health-care system and are very convenient for women who will be unable to return for contraception purposes [4] Despite this advantage, uptake of a postpartum intrauterine contraceptive device during early and immediate postpartum periods is low [5,6,7,8]. Even if little researches were conducted in Ethiopia about the postpartum intrauterine contraceptive device, most of them focused on the proportion of IUCD acceptance and utilization [5,6,7] Those researches included factors such as sociodemographic and obstetric related characters; it was not sufficient to show full information about determinants of a postpartum intrauterine contraceptive device, because of sociodemographic characteristic variation throughout different regions of the country. Erefore, this study design was appropriate to dig out a full picture of determinants for postpartum intrauterine contraceptive device uptake within a short period. erefore, the purpose of this study is to fill these gaps by identifying major determinant factors of postpartum intrauterine contraceptive device uptake
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