Abstract
Background: In Mali, contraceptive prevalence is low, while the unmet need for family planning is very high. Postpartum contraception can help to significantly reduce these unsatisfied needs. The introduction of the intrauterine device (IUD) in the postpartum quickly encountered problems with the type of forceps used to make the insertions (Kelly or Heart forceps), and also their availability at the various health centers. Thus, in 2016, the Population Services International Mali (PSI-Mali) introduced the insertion of the IUD in the postpartum with the new inserter in order to counter this forceps problem and to contribute to guaranteeing the quality of postpartum IUD insertions. Objectives: They were to determine the frequency, the socio-demographic and clinical characteristics and to report the side effects and the complications. Methods: This was a descriptive and analytical cross-sectional study from September 1st 2016 to August 31st, 2018. All deliveries that met the eligibility criteria, having chosen and benefited the postpartum intra-uterine device with the new inserter were included. Results: During the 2 years, we recorded 73 cases of insertion of the postpartum intra-uterine device with the new inserter over 7797 clients meeting of the world health organization’s criteria of medical admissibility for the use of an intra-uterine device with a frequency of 0.93%. They were married in 97% of cases, large multiparous in 48% of cases, aged between 30 and 39 years in 62% of cases. We didn’t notice any complications in 96% of cases. Expulsion with 4% was the only complication. The clients didn’t have any side effects in 98% of cases. Conclusion: The insertion of a postpartum intra-uterine device with the new inserter has supplanted the insertion techniques using forceps in our center because of its ease and speed. Its use is worth being popularized to help reduce the unmet need for family planning.
Highlights
Contraception is all the means and techniques medical or not, available to individuals and couples permitting them to perform their sexuality with enough responsibility, so as to avoid unintended pregnancies, to space births and to have the desired number of childbirths at the desired time [1]
The majority of postpartum IUD program (PPIUD) were inserted during a trans-caesarean section with 41% of cases, followed by postplacental insertion with 32% of cases and immediate postpartum insertion in 27% of cases (Table 3)
Concerning the education levels, these are contrary to those of the Demographic and Health Survey (DHS)-VI [7] according to which the clients who had opted for the intra-uterine device (IUD) were all educated
Summary
Contraception is all the means and techniques medical or not, available to individuals and couples permitting them to perform their sexuality with enough responsibility, so as to avoid unintended pregnancies, to space births and to have the desired number of childbirths at the desired time [1]. It plays a vital role in reducing maternal, neonatal and infant mortality Despite these benefits, the Demographic and Health Survey (DHS) data from 27 countries indicate that the needs in contraception of 65% of women in postpartum were not met [3]. Results: During the 2 years, we recorded 73 cases of insertion of the postpartum intra-uterine device with the new inserter over 7797 clients meeting of the world health organization’s criteria of medical admissibility for the use of an intra-uterine device with a frequency of 0.93%. They were married in 97% of cases, large multiparous in 48% of cases, aged between 30 and 39 years in 62% of cases.
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