Postpartum Intrauterine Contraceptive Device Research Articles

Awareness and utilization of postpartum intrauterine contraceptive device among postnatal women in Vijayapur

BACKGROUND: A fair proportion of women face an unmet need for family planning during the 1st year following childbirth. The postpartum period is an optimal time for effective contraception as the new mother is more receptive to accept family planning. OBJECTIVE: The objective of this study is to determine the awareness and utilization of postpartum intrauterine contraceptive device (PPIUCD) among postnatal women belonging to Vijayapur district in Northern Karnataka. MATERIALS AND METHODS: This was a cross-sectional study conducted over the duration of 1 month among postnatal women admitted at Vijayapur district hospital. RESULTS: Only 20% of the women were aware, 6% had accepted, and 17% were willing to accept. Most of the acceptors were younger in age, better educated, and primipara and had delivered male baby, although there was no statistical significance. A significant number of acceptors were from urban areas and had undergone cesarean section. CONCLUSION: Awareness and acceptance of PPIUCD are extremely low. Concerted effort is needed to be boost the utilization rates of this effective and safe contraceptive during the postpartum period.

Uptake of Long-Acting Reversible Contraceptive Methods in Enugu State University Teaching Hospital Enugu, South-East, Nigeria.

Background: Long Acting Reversible Contraceptive (LARC) methods provide very effective contraception for extended periods that do not depend on clients’ daily compliances or adherences. They are the ideal methods for the prevention of the harmful consequences of unintended pregnancies in most women including adolescents. Objectives: To determine the uptake rate of LARC in ESUTH Enugu, assess the characteristics of the acceptors, identify barriers, and make recommendations. Method: The new client register in ESUTH, Enugu was reviewed retrospectively from December 31, 2015 back to January 1, 2011. Data on clients’ characteristics, and uptakes of LARC and Non-LARC were extracted from the register, entered in Excel 2007 software, analyzed, and presented using percentages and graphs. Results: A total of 1737 clients accepted the available family planning methods during the five-year study period. One thousand five hundred and sixty seven (90.21%) accepted LARC while 170(9.79%) only accepted non-LARC. The LARC uptake rate was 90.21%. Majority of the clients were 30-39 years of age 1121(64.54%), 690 (39.72%) had secondary education, 821(47.27%) had tertiary education, and Christians were 1510 (86.93%). The acceptors increased as parity increased with a peak at Para 4 of 490(28.21%). Clients less than 20 years (0.06%), not educated (1.27%), and Para 0 (0.4%) rarely access the family planning clinic. The LARC acceptors opted for jadelle 526(30.28%) and implanon 465(26.77%) sub-dermal implants, depo-provera 276(15.89%), interval intrauterine contraceptive device 232(13.36%), noristerat 48(2.76%), and postpartum intrauterine contraceptive device 20(1.15%). Conclusion: There is a very high uptake of LARC in Enugu. Jadelle and implanon constitute over 50% of the LARC uptakes. Adolescents (< 20 years), less educated and low parity clients rarely access the family planning clinic.

Providers perceptions on postpartum IUCD as an option of postpartum family planning services in India

Background: With high unmet need for family planning in postpartum period new methods like postpartum intrauterine contraceptive device (PPIUCD) can reduce the gap between demand and supply. Role of providers is critical in facilitating a client’s decision to choose an appropriate contraceptive method during her postpartum status. Aims &amp; Objectives: To assess the role of providers in facilitating client’s decision to choose an appropriate contraceptive method during her postpartum status. Material &amp; Methods: This descriptive study was conducted as a multi-centric post-training PPIUCD follow up study of providers in eight states of India. From February 2012 to July 2012, 124 PPIUCD trained providers of sixteen hospitals were interviewed with a standardized questionnaire after informed consent. The providers were interviewed for their perceptions on timing and benefits of family planning counseling, procedure ease, side effects and complications of PPIUCD and their perception of client satisfaction of the method. Proportions and mean (SD) were calculated. Results: 66 doctors, 42 nurses and 16 counselors were interviewed. 95% providers felt IUCD is a suitable method for postpartum women. According to 94% doctors, 55% nurses and 88% counselors, antenatal period was the most preferred period for counselling clients. 89% doctors and 69% nurses felt that ideal time of insertion was immediately after delivery of placenta and most preferred Kelly’s placental forceps for insertion. Expulsion was the commonest perceived complication. More than 70% providers felt that clients were satisfied with their decision of choosing PPIUCD as a method with reasons. Conclusions: The results of this descriptive study on providers’ perceptions for IUCD use during the postpartum period showed a positive inclination of the interviewed PPIUCD trained doctors, nurses and counselors towards the method which will help improve access and availability to this service

Knowledge, attitude and practice study on immediate postpartum intrauterine contraceptive device method of family planning

Background: The objectives of the study were to assess knowledge, attitude and practice in post-partum intrauterine contraceptive device method of family planning and to know about willingness for post-partum intrauterine contraceptive device (PPIUCD) when knowledge is provided for the same.Methods: This is a cross sectional observational study including 1200 patients of immediate post-partum period (&lt;48 hrs of delivery), delivered at Safdarjung hospital. Women were evaluated with the help of a pre-designed and pre-tested questionnaire.Results: Out of 1200 women 864 (72%) were aware of some family planning method but only 672 (56%) had used some family planning method in the past. 108 (9%) women had knowledge regarding Post-partum intrauterine contraceptive device (PPIUCD). Among these, 72 (6%) women opted for PPIUCD. After knowledge regarding PPIUCD had been given, 80 more women adopted this as a method of contraception. So total 152 (12.67%) opted PPIUCD.Conclusions: This study highlights that awareness and knowledge does not always lead to use of contraceptives. A lot of educational and motivational activities are needed.

Efficacy and safety of Post-Partum Intrauterine Contraceptive device (PPIUCD) insertion-A prospective study

Introduction: Significantly increased institutional deliveries in India provide an opportune time for offering postpartum family planning services to the women. Although the available contraceptive methods are many, need of a single efficacious, feasible and cost effective method is desirable especially in a low resource country like India. This study was done to evaluate the acceptance, efficacy and safety of intrauterine contraceptive device as an immediate family planning method following delivery, and the complications associated with it. Materials and Method: A total of 115 women who underwent PPIUCD insertion were followed up at 1, 3 & 6 weeks and at 3 & 6 months post-partum. Outcome in terms of side effects, removal and expulsion was noted and compared in vaginal delivery and caesarean section insertions. Results: Out of 280 women who were counselled, only 115 women (41.07%) accepted the PPIUCD insertion. Insertion in literate women was high and extremely statistically significant (P

Comparative Study on Outcomes of Immediate Postpartum Intrauterine Contraceptive Device Insertions in Vaginal deliveries and Caesarean section

Comparative Study on Outcomes of Immediate Postpartum Intrauterine Contraceptive Device Insertions in Vaginal deliveries and Caesarean section

Family planning and Zika virus: need for renewed and cohesive efforts to ensure availability of intrauterine contraception in Latin America and the Caribbean

Objectives: The advantages of intrauterine contraception (IUC) are well established (highly effective, low discontinuation rate, easy to use, low cost, and suitable for immediate postpartum use), but low levels of use in many countries and declining use in others are causes for concern. Due to the ongoing Zika virus outbreak, public health officials are calling for the continued practice of safe sex and the delay of pregnancy. Our study was conducted to assess the current situation of IUC availability and provision in Latin America and to determine the role of national policies in meeting the contraceptive needs of the populations in these countries.Methods: A survey was conducted in Latin America and the Caribbean between December 2015 and January 2016 to assess national policies with regard to IUC provision, availability and accessibility. 18 countries participated.Results: All responding countries had national policies on IUC. Many in the public sector provided the intrauterine device (IUD) free of charge, but the levonorgestrel-releasing intrauterine system (LNG-IUS) was generally available in the private sector. Some countries had very restrictive policies on who was permitted to carry out IUC insertions, but most permitted a range of health professionals to do so. Immediate postpartum IUC insertion was uncommon. Some countries placed restrictions on IUC use in women who were nulliparous, young, at high risk of catching a sexually transmitted infection or who had multiple sexual partners.Conclusions: IUC is underused in Latin America. The study reveals policy level barriers that may impede access to IUC, one of the most effective, long-acting, non-hormonal, reversible contraceptive methods. Governments should consider reviewing and rethinking their policies on contraception to ensure IUC service provision among populations at high risk of unplanned pregnancy, especially those vulnerable to Zika virus.

Utilization of Immediate Post-Partum Intra Uterine Contraceptive Device and Associated Factors: A Facility based Cross Sectional Study among Mothers Delivered at Public Health Facilities of Sidama Zone, South Ethiopia

Background: Insertion of an Intra Uterine device (IUD) immediately after delivery have a proven record of very high effectiveness, protection against unintended pregnancy, cost effectiveness, suitability and high user satisfaction. Despite these benefits, information on Post-Partum Intra Uterine device (PPIUD) acceptance and utilization was limited in Ethiopia. Therefore, this study was aimed to assess postpartum intra uterine contraceptive device utilization and its associated factors among mothers delivered in selected facilities found in South Ethiopia. Methods: A facility based cross-sectional study was conducted in two health facilities providing PPIUD insertion service (Yirgalem hospital and Bursa health center). Data were collected using structured questionnaire among 310 selected women. Frequency tables and graphs were used to describe the study variables. Bivariate and multivariate logistic regression analysis methods were used to identify factors associated with postpartum intrauterine device use. Variables with P-value of <0.05 with 95% CI were used to declare statistical significance. Results: Postpartum intra uterine contraceptive device use within 48 h of delivery was 21.6% while 38% of the respondents were interested in using PPIUD. Only 22.8% of participant mothers were counselled during ANC, labor and postpartum period. Mother who do not have a plan to have another child [AOR=2.36, 95% CI, (1.25, 4.47)], undecided plan to have another child [AOR=0.17, 95% CI, (0.05, 0.58)], mothers who did not heard [AOR=0.41, 95% CI: 0.41 (0.20, 0.83)] and not counselled about PPIUD [AOR=0.17, 95% CI: 0.17 (0.06, 0.52)] were associated with PPIUD utilization. Conclusion: Despite more than one-third of participants were accepted PPIUD, the actual utilization was low. Most mothers were not counselled during the important contact points through the whole cascade of pregnancy. Program managers need to develop strategies to raise pregnant mother awareness on PPIUCD through media sources. This study also highlights, the need to improve and integrate standard PPIUD counselling scheme during FANC, labor and postpartum period.

A Comparative Study of Manual vs Instrumental Intracesarean Postpartum Intrauterine Contraceptive Device

ABSTRACT Aims and objectives The main objective of the study was to compare the two different methods of intracesarean insertion of postpartum intrauterine contraceptive device (PPIUCD), i.e., manual vs instrumental, and to study the effectiveness, safety, and continuation rate of intracesarean PPIUCD as a contraceptive method. Materials and methods A total of 100 subjects undergoing lower (uterine) segment cesarean section (LSCS) were enrolled for the study. In group I (n = 50), Cu-T 380A was inserted manually and in group II (n = 50), Cu-T 380A was inserted with a PPIUCD forceps. After checking for the inclusion and exclusion criteria and proper counseling, written consent was obtained and subjects were enrolled for the study. All the subjects were followed up for 3 months either clinically or telephonically. All the complaints, side effects, complications, and findings of both the groups were compared and analyzed. Results The continuation rate after the period of follow-up was 94% in group I and 92% in group II. There was only one case (2%) of expulsion in group II. A total of 3 (6%) subjects in group I and 3 (6%) of the subjects in group II got PPIUCD removed for various reasons. There was no case of infection, perforation, or contraceptive failure. Conclusion Intracesarean PPIUCD is an effective method of postpartum contraception and both the methods (manual and instrumental) are equally effective with minimum side effects and complications and good acceptability by the clients. How to cite this article Chakheni N, Kaur P, Kaur K, Singh B, Mohi MK. A Comparative Study of Manual vs Instrumental Intracesarean Postpartum Intrauterine Contraceptive Device. J South Asian Feder Obst Gynae 2017;9(1):25-28.

Postpartum intrauterine contraceptive device: Knowledge and factors affecting acceptance among pregnant/parturient women attending a large tertiary health center in Puducherry, India

Context: Intrauterine contraceptive device (IUCD) has been recommended for insertion within 10 min of placental delivery or within 48 h of delivery (postpartum IUCD [PPIUCD]) by the WHO. However, the acceptance across our country has been low. Aims: To determine the level of knowledge and the factors affecting it and the likely adoption of PPIUCD. Settings and Design: This cross-sectional study was carried out in the antenatal clinic and postnatal ward of a large tertiary care center in South India. Subjects and Methods: A total of 339 women were studied with the help of a validated structured pro forma. Proportions were expressed in percentage. Chi-square test was applied to compare proportions and univariate analysis for the factors affecting knowledge and likely acceptance. Results: Among the 339 women, 152 (44.8%) were aware of the method. Of the 152 women, 56 had a negative attitude about the method. Multiparity of the women was a significant factor affecting knowledge (χ2 = 8.068, P = 0.045). Women who were not exposed to formal health counseling were significantly associated with a lack of knowledge (χ2 = 23.332, P = 0.0001). Primiparity (χ2 = 14.683, P = 0.0001), husbands with skilled jobs (χ2 = 8.272, P = 0.0407), having shared information with their husband regarding the method (χ2 = 38.1, P

Contraceptive behavior of couples undergoing sterilization in an Eastern State of India.

Background:As a part of a larger study for evaluating the effectiveness of a community-based family welfare program, this study assessed the contraceptive behavior of couples preceding sterilization and termination of pregnancies, if any during the interim period.Methods:During May–June 2013, a cross-sectional study was undertaken in three districts of Odisha, an eastern state of India with poor maternal health indicators. Using a 15 × 14 cluster design with probability proportionate to size sampling 15 village clusters from each district were selected. Seven beneficiaries from the catchment area of two Accredited Social Health Activist of the selected villages were interviewed (14 respondents from each village) using a pretested predesigned questionnaire.Results:A total of 630 clients with either of the partner having undergone sterilization were interviewed. Male partner having undergone vasectomy was < 1% (n = 3). The mean age (standard error mean [SEM]) of the respondent women was 34.54 ± 0.26 years. The mean age of the women at the time of sterilization was 27.12 (standard deviation [SD], 3.8, SEM 0.15 and median 26.83 years) years. Women as young as 22 years had undergone sterilization. Average family size was 2.81 with about 29 respondents (4.5%) having 5 or more children. The average duration between the last childbirth (LCB) to the date of sterilization was 18.37 months (range: 1–142 months, SD: 24 months, SE: 10 months). Seventy-two percent of the respondents did not use any method of contraception during this period. Methods adopted for contraception among the users was pill (20%) followed by condom (7%), and intrauterine contraceptive device (IUCD) was least used (0.2%). Ten percent of the women had undergone abortion before sterilization either once (7.9%) or more than once (2.1%).Conclusion:There was a gross delay in sterilization after LCB. Postpartum sterilization or IUCD were also not used frequently.

To Study the Acceptance of Postpartum Intrauterine Contraceptive Device at Surat Municipal Institute of Medical Education and Research

To Study the Acceptance of Postpartum Intrauterine Contraceptive Device at Surat Municipal Institute of Medical Education and Research

Acceptance, perception, experience and satisfaction of the couple with postpartum intrauterine contraceptive devices (PPIUCD) insertion

Family planning can avert nearly one-third of maternal deaths and 10% of child mortality when couples space their pregnancies more than two years apart.In India 65% women in 1st year of postpartum period have unmet need for FP, but only 26% are using any contraceptive. Delivery may be the only time when they come into contact with health care providers; thereafter the chances of returning for contraceptive advice are uncertain. Insertion of intrauterine contraceptive device (IUCD) at 10 minutes after delivery is appealing. The Copper T 380A intra-uterine contraceptive device (IUCD) is a highly effective, non-hormonal method, long acting reversible and coitus independent contraceptive device that can be safely used by all women regardless of breastfeeding status during this interval. Thus increasing awareness and creating demand for postpartum intra-uterinecontraceptive devices (PPIUCD) is essential. Apart from the fact that its usage has to be increased, follow-up of the cases after insertion is an important factor since complications related to IUCD are extensive and vary with individuals. Thus routine followups and early measure is the base of PPIUCD insertion. Satisfaction related to IUCD insertion varies considerably. The studies also include the input of the husband’s opinion regarding the satisfaction related to IUCD as many problems related to interference in the sexual activity were recorded. We will conduct a study for acceptance, perception, experience and satisfaction of the couple with postpartum intrauterine contraceptive devices (PPIUCD) insertion at our institute.Objectives:1. Acceptability of postpartum intrauterine devices as a contraceptive method among women of reproductive age. 2. To record the experienceduring the procedure and first six weeks after insertion of IUCD. 3. To learn about satisfaction with PPIUCD among the couple. 4. Desire to continue the service in future. Methods: Study design- This will be an open prospective and longitudinal study toassess the acceptance, perception, experience and satisfaction of the 100 couples in the reproductive age group (19-49 years) who are willing for; with postpartum insertion of the Cu T 380 A within 10 minutes of placental expulsion. Couples will be recruited in this study after obtaining written informed consent. Institutional ethical committee clearance will be taken. Exclusion criteria will be severe anemia Hb 38°C during or after labor, and the patients with Postpartum Hemorrhage. Method of insertion: The Copper T model Cu T 380 A will be inserted with all asepticprecautions within 10 minutes of placental expulsion with a sponge holder and fundal placement will be ensured. String will be cut to the level of the cervix. The string will be visible at the cervix after the insertion. Participants will be interviewed prior and after insertion of PPIUCD and then six weeks later. Data collection: Data will be collected from participants using a structured questionnaire that includes basic demographic information, questions related to acceptance and perception of pain on insertion of PPIUCD. After six weeks, PPIUCD clients will again be interviewed using a structured follow-up questionnaire that will collect information about the clients overall satisfaction, problems or any complications, and retention /expulsion of the PPIUCD. In the cases where the client fails to return to the health facility for her follow-up visit, she will be contacted by telephone for the follow-up interview. Data analysis: Continuous variables will be reported using mean (standard deviation) and categorical variables will be reported using percentages. For two group comparisons, wherever applicable a student t-test will be used to compare means of continuous variables, and chi-square tests shall be used to compare categorical variables.Results:1.Acceptance of PPIUCD was 88% after counseling than 46% before counseling. 2. 79.54% did not have any pain during insertion. 3. 17.06% had mild discomfort while insertion and only 03.40% had painful insertion. 4. After 6 weeks 83% women followed-up. Rest 17% could not be contact even through telephones. 5. Major complications encountered were abdominal pain and expulsion 13.6% each than other complications. However 54.5% women had no complications. 6. 75.3% women were willing to continue the PPIUCD, rest demanded removal either due to complications or family opposes being the major reason. 7. Overall satisfaction rate was 78% in women and 73.9% in husbands Conclusions: The study thus concludes that acceptance rate was significantly improved after proper counseling and the complication rate of the PPIUCD were less as compared to the overall benefits.

Two-week postpartum intrauterine contraception insertion: a study of feasibility, patient acceptability and short-term outcomes

ObjectiveTo determine the feasibility and acceptability of inserting the levonorgestrel intrauterine system, LNG 52 mg IUS (LNG IUS), at 2 weeks postpartum. Study designThis prospective study of feasibility and patient acceptability recruited women interested in a postpartum LNG IUS and placed the LNG IUS under ultrasound guidance on days 14–20 postpartum. We determined feasibility by our ability to recruit and insert the LNG IUS in our predetermined sample size of 50 women. We measured our primary acceptability outcome at 6 months postpartum with the question: “Would you recommend Mirena placement at 2 weeks postpartum to a friend?” Other outcomes included expulsion and pain. The three study visits consisted of (1) insertion visit (14–20 days postpartum), (2) standard postpartum visit with a string check (6 weeks postpartum) and (3) research visit with sonography and assessment of the primary outcome (6 months postpartum). ResultsWe enrolled 50 women over 8 months, all of whom received LNG IUS. Forty-three of the 50 (86%) provided follow-up data for the primary outcome. Of those, 93% (40/43) would recommend 2-week LNG IUS insertion to a friend, and 86% (37/43) continued using their LNG IUS at the conclusion of the 6-month visit. There were two partial expulsions; one was symptomatic. There were no uterine perforations. ConclusionsLNG IUS inserted at 2 weeks postpartum is feasible and acceptable to patients. These results offer evidence to support intrauterine contraception insertion prior to the onset of ovulation and at a potentially more convenient time point in the postpartum period. ImplicationsThis study supports offering the LNG IUS beginning on the 14th postpartum day. The 4% expulsion rate is consistent with the rate of interval insertion and lower than immediate postplacental insertion. Additional research is needed to ensure a low risk of adverse events with other brands of intrauterine contraception.

Clinical Study of Acceptability And Safety of Postpartum Intrauterine Contraceptive Devices

Objective: India is first to introduce family planning services, Government of India revised its policy in 2013 to permit trained nurses and midwives to insert postpartum intrauterine contraceptive devices (PPIUCDs). To assess the acceptability and safety of Postpartum Intrauterine Contraceptive Device insertion among women on bases of two key outcomes of PPIUCD insertions — expulsion and infection,who delivered at Rajkiya Mahila Chikitsalya J.L.N. Medical College and Hospital. Method: this is a prospective interventional analytical study. The postpartum family planning services offered are in the form of health education in group counseling session at the postnatal ward. Results: Total women counseled 1000, accepted 312, declined 688, lost to follow up 56, followed up 256, complications 82 (Expulsion 8, Bleeding 21, String problem 32, Removal 8, continuation 231) Interpretation and conclusions: Immediate post-partum IUCD insertion provides highly effective contraception immediately after delivery. Although the expulsion rate for immediate post-partum is higher than for interval insertion particularly in country where women have limited access to medical care. The government needs to develop strategies to increase public awareness of the PPIUCD through different media sources. It is also important to arrange training on PPIUCD in order to increase knowledge and skills among health care providers. This will also further promote PPIUCD use and aid in reduction of expulsion rates. Case incentives to the acceptor, motivator and provider will bring about substantial progress in the PPIUCD use in developing countries like India.

Feasibility, acceptability, and uptake of postpartum intrauterine contraceptive devices in southern Nigeria

ObjectiveTo evaluate the effect of postpartum intrauterine contraceptive device (PPIUD) implantation on existing low contraceptive uptake and utilization in Nigeria. MethodsA prospective analytical cohort study was conducted at eight medical facilities in southern Nigeria between June 1, 2014 and May 31, 2015. Patients undergoing delivery during the study period were considered for eligibility and the exclusion criteria included any contraindications to PPIUD implantation. Following counselling, participants underwent PPIUD insertion within either 10minutes (post-placental) or 48hours (immediate) of delivery, or at cesarean delivery. All participants were scheduled to attend 14-day and 6-week follow-up. The primary outcome measure was the PPIUD-uptake rate and secondary outcome measures included patient satisfaction and complication rates. ResultsThere were 1061 deliveries recorded during the study period; 746 patients were offered PPIUDs, with 374 (50.1%) accepting and undergoing insertion. Immediate post-partum insertion was performed for 199 (53.2%) participants, with 169 (45.2%) and 6 (1.6%) undergoing post-placental and intra-cesarean insertion, respectively. ConclusionPPIUD was safe and acceptable to Nigerian women. Increasing the education of patients and training of healthcare providers is recommended to scale-up PPIUD use in Nigeria.

To study the acceptance of postpartum intrauterine contraceptive device, CU T 380 A, in a tertiary care hospital in India

IntroductionFamily planning allows people to attain their desired number of children and determine the spacing of pregnancies. Contraception plays a major role in women's health. Increased number of institutional deliveries allows us to offer family planning methods to couples. Postpartum intrauterine devices (PPIUCD) are the reversible long acting method. It does not interfere with breast feeding and can be provided before the woman leaves the hospital. This study of acceptance of postpartum intrauterine device was conducted in tertiary care hospital in India. Aim and objectivesTo find out the (1) acceptance of PPIUCD CU T 380 A, (2) retention rate of PPIUCD and (3) spontaneous expulsion rate at end of 6 months of delivery. Material and methodsPPIUCD was inserted in 680 women either after vaginal delivery or during caesarian section. Data analysis was done at the end of 6 months. Results(1) Insertion of PPIUCD amongst Para 2 was highest 375 (55.14%). (2) Retention rate was 86.33%. (3) Spontaneous expulsion was found in 55 (8.54%) women. (4) Bleeding was the main symptom perceived by 249 (88.71%) women followed by long thread 73 (26.02%) and pain in lower abdomen 45 (15.90%). (5) Total 361 (61.29%) women were satisfied and were continuing the method. ConclusionRetention rate of PPIUCD was high. Spontaneous expulsion in intra-caesarian IUCD was less as fundal placement was assured at the time of insertion. Bleeding problems were the major complaint and the main reason for removal of PPIUCD.

Acceptance rate, probability of follow-up, and expulsion of postpartum intrauterine contraceptive device offered at two primary health centers, North India.

Introduction:Acceptance rate of postpartum intrauterine contraceptive device (PPIUCD) offered through a public health approach is unknown. Our aim was to describe the acceptance rate, expulsion, and follow-up and factors associated with it when PPIUCD was offered to women delivering at two primary health centers (PHCs).Methods:We analyzed routine health data of deliveries at two PHCs in district Faridabad, India between May and December 2014, having sociodemographic variables, obstetric history, and during the follow-up check-up at 6-weeks postpartum for in situ status of intrauterine contraceptive device, side effects, and complications.Results:The overall acceptance rate among those eligible for PPIUCD was 39% (95% confidence interval [CI]: 35.1–42.9). Independent predictor of acceptance was a monthly family income of <USD75$ (odds ratio [O.R.]: 2.29, 95% CI: 1.58–3.31). The expulsion rate, and removal rate at 6 weeks postpartum was 18.0% and 13.0%, respectively. Expulsion by 6 weeks was associated with, age >25 years (O.R.: 2.21, 95% CI: 1.03–4.73), gravida ≥4 (O.R.: 4.01, 95% CI: 1.28–12.56), and a living previous-child (O.R.: 1.51, 95% CI: 1.04–2.19).Conclusion:Acceptance rate of PPIUCD was higher than that reported in literature. Women from lower income family, having at least one living child, and having attended antenatal care clinic were more likely to accept PPIUCD.

Effectiveness of Video Assisted Teaching Programme regarding Knowledge of Post Partum Intrauterine Contraceptive Devices among Antenatal Mothers in selected areas at Rajkot, Gujarat

Knowledge of post partum intra uterine contraceptive devices (PPIUCD) is important for antenatal mothers as an effective contraceptive and family planning method. Intrauterine contraceptive Device (IUCD) is one of the most commonly used reversible methods of contraception among women of reproductive age worldwide. The objective of the study is to assess the effectiveness of video assisted teaching programme regarding knowledge of post partum intrauterine contraceptive devices among antenatal mothers. Pre-experimental one group pre-test post-test design was selected for the present study and conceptual frame work for this study was based on General System Theory Modified Ludwig Von Bertalanffy's. The study had been conducted in selected areas at Rajkot district of Gujarat. Non probability purposive sampling techniques had been adopted to select the desired sample. The sample size was 60. The study design depicts that a pre-test was given in the form of structured knowledge questionnaire on selected antenatal mothers at selected rural areas at Rajkot, after that as an intervention video assisted teaching programme was administered in two sessions & a post-test was given after 7 days to assess gain in knowledge using the same structured knowledge questionnaire. Collected data was analyzed by using both descriptive and inferential statistical method. ‘t’ test and chi-square test was used to evaluate the effectiveness of video assisted teaching programme regarding knowledge of PPIUCD among antenatal mothers. The calculated ‘t’ value 43.89 is significantly higher than the table value 3.4632 at 0.05 level of significance. This indicates that there is significant difference between the pre test and post test knowledge score and video assisted teaching programme is effective in improving knowledge of PPIUCD among antenatal mothers. With regard to age, education, monthly income, obtain chi-square value were significant at 0.005 level and thus the hypothesis is accepted.

Immediate Postpartum Intrauterine Contraceptive Device Insertions in Caesarean and Vaginal Deliveries: A Comparative Study of Follow-Up Outcomes.

Background. Immediate postpartum intrauterine contraceptive device (IPPIUCD) is a lucrative postpartum family planning method which provides effective reversible contraception to women in the delivery setting. Our aim was to study the clinical outcomes of IPPIUCD insertions and compare them as a factor of route of insertion (vaginal versus caesarean). Methods. This is a retrospective analytical study done in a tertiary care teaching institute. A Cohort of 593 vaginal and caesarean deliveries with IPPIUCD insertions, over a two-year period, was studied and compared for follow-up results. Outcome measures were safety (perforation, irregular bleeding, unusual vaginal discharge, and infection), efficacy (pregnancy, expulsions, and discontinuations), and incidence of undescended IUCD strings. Descriptives were calculated for various outcomes and chi square tests were used for comparison in between categorical variables. Results. Overall complication rates were low. No case of perforation or pregnancy was reported. Spontaneous expulsions were present in 5.3% cases and were significantly higher in vaginal insertions (p = 0.042). The incidence of undescended strings was high (38%), with highly significant difference between both groups (p = 0.000). Conclusion. IPPIUCD is a strong weapon in the family planning armoury and should be encouraged in both vaginal and caesarean deliveries. Early follow-up should be encouraged to detect expulsions and tackle common problems.