Postpartum intrauterine device (PPIUD) insertion: A single centre follow-up telephone survey assessing clinical outcomes and client perception

Abstract

Introduction: Closely spaced pregnancies result in adverse maternal perinatal and infant outcomes. Postpartum Family Planning (PPFP) enables women to achieve healthy intervals between births, potentially averting maternal deaths and reducing child mortality. The PPIUD enables women to leave the birth facility with a safe, effective, long-acting, reversible method already in place.The aim of the study was to study clinical outcomes and client perceptions on follow-up after insertion of PPIUD from 2014 to 2019 at the Teaching Hospital, Mahamodara (THM), Galle, Sri Lanka.Results: A total of 46,815 deliveries were reported in the facility during the study period, and 470 (3.4%) PPIUD insertions were carried out. Only 67/470 (14.3%) women who had PPIUD responded to the survey. The median (IQR) duration of PPIUD in situ was 63 (39 - 76) months, and it was positively correlated with the satisfaction score (Spearman’s rho 0.29, p=0.02). Out of all, 58 (86.6%) women recommended PPIUD to a friend as a PPFP method. Median (IQR) satisfaction score for the PPIUD was 9.5 (5.5 - 9.5), and most women (65.7%) were satisfied with PPIUD. However, 19.4% of women responded as ‘Neutral’ to the questionnaire. There were no uterine perforations or ectopic pregnancies.Conclusions: The study shows that PPIUD is a good option as an effective contraceptive method before leaving the birth facility.