Abstract
BackgroundVery few postpartum women want to become pregnant within the next 2 years, but approximately 60% of postpartum women in low- and middle-income countries are not using contraceptive methods. The World Health Organization recommends that women receive postpartum family planning (PPFP) counseling during antenatal, immediate postpartum, and postnatal services. Our objective was to establish whether PPFP counseling is being provided in antenatal and postnatal care services in SNNPR, Ethiopia and whether receipt of PPFP counseling improved uptake of postpartum family planning use by 6 months postpartum.MethodsLongitudinal data from the Performance Monitoring for Accountability 2020 – Maternal and Newborn Health study were used. At screening, 329 women were identified as six or more months pregnant; 307 completed the survey at 6 months postpartum. We used weighted parametric survival analysis with Weibull distribution to assess the effect of receipt of postpartum counseling in antenatal and/or postnatal care by 6 weeks postpartum on contraceptive uptake, after adjusting for intention to use family planning, wantedness of the index pregnancy, delivery location, amenorrhea, exclusive breastfeeding, residence, parity, and education.ResultsCoverage of PPFP counseling is low; by six-weeks postpartum only 20% of women had received counseling. Women who received counseling in postnatal care only and postnatal care and antenatal care took up contraception at significantly higher rates than women who did not receive any counseling (HR: 3.4, p < .01 and HR: 2.5, p = .01, respectively). There was no difference between women who received PPFP counseling only in ANC and women who did not receive counseling at all. Women who did not want the child at all took up contraception at significantly lower rates than women who wanted the child at that time (HR: 0.3, p = .04). Women who had four or more children took up contraception at significantly lower rates than woman with 1–3 children (HR: 0.3, p = .01). There were no significant differences by delivery location, exclusive breastfeeding, residence, or education.ConclusionIntegration of postpartum family planning counseling into postnatal care services is an effective means to increase postpartum contraceptive uptake, but significant gaps in coverage, particularly in the delivery and postnatal period, remain.
Highlights
Very few postpartum women want to become pregnant within the 2 years, but approximately 60% of postpartum women in low- and middle-income countries are not using contraceptive methods
We found that receipt of postpartum family planning counseling in postnatal care services is an effective means to increase postpartum contraceptive uptake, but that significant gaps in coverage, in the delivery and postnatal period, remain a challenge
We found no association between receiving postpartum family planning (PPFP) counseling in antenatal care (ANC) services alone and PPFP uptake; this differs from studies that rely on DHS data [12, 13, 32], but is largely consistent with findings from smaller studies in Ethiopia and East Africa [14, 22, 23]
Summary
Very few postpartum women want to become pregnant within the 2 years, but approximately 60% of postpartum women in low- and middle-income countries are not using contraceptive methods. The World Health Organization recommends that women receive postpartum family planning (PPFP) counseling during antenatal, immediate postpartum, and postnatal services. Demographic and Health Survey data (DHS) suggest that very few postpartum women want to become pregnant within the 2 years (3–8%), but approximately 60% of postpartum women in low and middle income countries who want to delay childbearing are not using contraceptive methods [8, 10, 11]. To improve uptake of postpartum family planning (PPFP), the World Health Organization (WHO) recommends that women receive counseling during the antenatal, immediate postpartum, and the postnatal period, preferably integrated into a comprehensive maternal and newborn health (MNH) package [2]
Sign-in/Register to view highlights & summary 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 callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
