Impact of Structured Counseling on Choice of Contraceptive Method Among Postpartum Women.

Abstract

In India, although a number of contraceptive choices are available, the usage of contraceptive methods among postpartum women is rather low. The current study intended to determine the impact of "structured contraception counseling" on women's decision making on selection of contraceptive methods and the reasons behind the selection of a contraceptive method. One-hundred-and-seventeen postpartum women in the age group of 18-35years, requesting contraception, were enrolled in the study. "Structured contraception counseling" was provided using a standardized protocol with balanced and comprehensive education material on the available hormonal and nonhormonal contraceptive methods. Questionnaires with information on the women's pre- and post-counseling contraceptive choice, her perceptions, and the reasons behind her postcounseling decision were filled by the participating women. Maximum women enrolled for the study were in the age group of 21-25years. In pre-counseling, 36% postpartum women selected a contraceptive method, 23.1% a nonhormonal method, and 12.8% a hormonal method. After "structured contraception counseling," 92.25% of women chose a contraceptive method. There were significant differences between the women's choices of contraceptive methods in the pre- and post-counseling sessions, respectively [progesterone-only pills (POP): 5.1 vs. 38.46%, (p<0.001); injectable-depot medroxy progesterone acetate (DMPA): 2.56 vs. 21.356%, (p<0.01); and intra uterine device (IUD): 10.28 vs. 23.92%, (p<0.001). 38.46% chose a POP, 21.36% injectable-DMPA, and 23.9% the IUD]. "Structured contraception counseling" using standardized protocol resulted in significant improvements in the selection of contraceptive methods by postpartum women.