Where do we stand a Decade after Introduction of Ppiucd Program

Abstract

Introduction: At present one of the major challenges our country is facing is population explosion, unintended and unwanted pregnancies. This is in spite of being the first country in the world to launch a family planning program. Long-acting, reversible family planning methods, such as intrauterine contraceptive devices, have been reported to be very effective. This is usually inserted as an interval procedure but can be inserted post- delivery also which has many advantages. Study was undertaken to find out the present status of this programme ten years after its initiation by the government. Materials and Methods: This observational study was conducted for three months at three large medical institutes. The participants were all labour cases admitted for delivery. Only willing cases were included; they were interviewed to find out their awareness, acceptance and planning for future contraception. Results and Observations: 3453 were willing to be part of the study. The study showed that a large number of women (23.5%) relied upon breast feeding as a method of spacing. Almost half of them (47.5%) were undecided regarding methods to delay the next pregnancy. 81% had heard about the device. 5.9% had some information regarding insertion after delivery. Only 9.1% cases remembered being told something specifically about insertion after delivery. Insertion was done in 3.5% cases, mostly with cesarean section. Discussion: Contraception is an important part of population control and prevention of unwanted and unintended pregnancies. In India, as in many other countries, postpartum family planning is usually initiated after 6 weeks postpartum. The postpartum period is an optimal time for effective contraception as the new mother is more receptive to accept family planning and the couple is of proven fertility. Though insertion of contraceptive device immediately after delivery is a good method of contraception but its awareness, acceptance and insertion is extremely low hence there is a great need of making concerted efforts to improve its acceptance and insertion. Counseling during antenatal period is the ideal time.