Evaluation of postpartum intrauterine contraceptive device in terms of awareness, acceptance and expulsion

Abstract

Introduction: Immediate postpartum period is when women are receptive to family planning counselling. Pregnancy within a year of the last delivery increases maternal and perinatal morbidity and mortality. Postpartum intrauterine contraceptive device (PPIUCD) is one method which is safe and effective method for spacing and also for limiting pregnancy. This study was done to evaluate PPIUCD insertion for its awareness, acceptance, and expulsion. Materials and methods: All pregnant women were counselled regarding PPIUCD, and those willing were included in the study. Intrauterine contraceptive device used in this study was Cu-T 380A. It was inserted after delivery of the placenta after vaginal delivery and after caesarean section using sponge-holding forceps. They were asked to follow up after 6 weeks and 6 months of insertion. Data collected was subjected to statistical analysis using SPSS V22 software, and results were drawn. Results: From 1602 deliveries, 456 (28.46%) women accepted PPIUCD, and 36.32% (n=582) were aware of this method. 60.08% (n=274) had PPIUCD insertion after vaginal delivery and 39.91% (n=182) after caesarean section. The main reason for refusal was fear of bleeding (n=280) (26.81%). The most common complication seen was lower abdominal pain (11.62%). No case was reported with uterine perforation. Conclusion: This method has shown to be a very safe, effective and economical method for contraception. In India, where there is very little access to contraception during interval period and women do not return to the hospital for a postnatal check-up and contraceptive advice, this PPIUCD method is most beneficial.