Unmet need for family planning in Nepal during the first two years postpartum.

Suresh Mehata,Yuba Raj Paudel,Pradeep Poudel,Sarah Barnett,Ranju Mehta,Maureen Dariang

doi:10.1155/2014/649567

Abstract

Contraceptive use during the postpartum period is critical for maternal and child health. However, little is known about the use of family planning and the determinants in Nepal during this period. This study explored pregnancy spacing, unmet need, family planning use, and fertility behaviour among postpartum women in Nepal using child level data from the Nepal Demographic and Health Surveys 2011. More than one-quarter of women who gave birth in the last five years became pregnant within 24 months of giving birth and 52% had an unmet need for family planning within 24 months postpartum. Significantly higher rates of unmet need were found among rural and hill residents, the poorest quintile, and Muslims. Despite wanting to space or limit pregnancies, nonuse of modern family planning methods by women and returned fertility increased the risk of unintended pregnancy. High unmet need for family planning in Nepal, especially in high risk groups, indicates the need for more equitable and higher quality postpartum family planning services, including availability of range of methods and counselling which will help to further reduce maternal, perinatal, and neonatal morbidity and mortality in Nepal.

Highlights

For better maternal and child health outcomes, an interval of at least 24 months following birth is recommended before becoming pregnant again
One study based on Demographic Health Survey (DHS) data from 25 countries revealed that one-fifth of postpartum women who had resumed menstruation and were not abstaining from sexual intercourse were not using contraception, and among these women, two-thirds wanted to either space or limit their childbearing [3]
This paper looks at the interval between births and subsequent pregnancies, the risk of fertility return, and the level and determinants of unmet need in Nepal during the first two years postpartum using the data from Nepal Demographic and Health Survey (NDHS) 2011

Summary

Introduction

For better maternal and child health outcomes, an interval of at least 24 months following birth is recommended before becoming pregnant again. Postpartum family planning (PPFP) plays a vital role in preventing unintended pregnancies and reducing maternal and child mortality [4] It promotes the health of mothers and children by lengthening pregnancy interval and helps to avoid financial, psychological, and health costs due to unintended pregnancies. Following childbirth many families overlook contraception due to a poor perception of pregnancy risks, difficulty in accessing services, and sociocultural issues [5, 6]. Many factors such as geographical and financial access, provider bias, poor method choice, lower status of women, medicolegal restrictions, and fear of side effects act as a barrier to family planning use [7]

Methods

Results

Conclusion