Postpartum Intrauterine Contraceptive Device Research Articles

Evaluation of Expulsion and Continuation Rate of Immediate Postpartum Intrauterine Contraceptive Devices: A Prospective Hospital-based Study

Introduction: 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. With increased institutional deliveries, Postpartum Intrauterine Contraceptive Devices (PPIUCD) can play an important role in addressing the unmet needs of spacing methods in India. Moreover, in this digital age, generalised awareness of the female population about contraception has increased considerably, so the acceptance and continuation rate might be high. Aim: To evaluate expulsion and continuation rate of immediate PPIUCDs at a tertiary care hospital in Haryana, India. Materials and Methods: The prospective, hospital-based study was conducted from October 2020 to September 2021 in the Department of Obstetrics and Gynaecology at Kalpana Chawla Government Medical College, Karnal, Haryana, India. Ninety women who underwent IUCD insertion within 10 minutes of delivery of the placenta were enrolled, irrespective of the mode of delivery. Patients were followed-up at six weeks, three months, and six months. The expulsion and continuation rate of immediate PPIUCD and reasons for removal were studied. Descriptive variables were expressed in percentages. The Chi-square test was used to determine the continuation rate and expulsion/ removal rates in vaginal versus cesarean deliveries and a p-value less than 0.05 was taken as statistically significant. Results: A continuation rate of 84.4% was observed at six months. A statistically significant difference was observed in the continuation rate of participants of vaginal delivery versus caesarean section (82.67% vs 93.33%, p-value <0.01). Overall, the expulsion rate was 6.66%. Conclusion: Immediate PPIUCD insertion has high continuation rates and can play an important role in family planning.

Comparative study to assess knowledge and attitude regarding post-partum intrauterine contraceptive devices among primigravida Mother and their life partners attending antenatal clinics

Comparative study to assess knowledge and attitude regarding post-partum intrauterine contraceptive devices among primigravida Mother and their life partners attending antenatal clinics

Immediate postpartum intrauterine contraceptive device utilization and associated factors among women who gave birth in public health facilities of Adama town, Ethiopia.

The evidence on utilization of immediate postpartum intrauterine contraceptive devices (IPPIUCDs) and its associated factors are limited in Ethiopia. Hence, this study intended to assess IPPIUCD utilization and related factors among women who gave birth in Adama town public hospitals, Ethiopia. A facility-based cross-sectional study was done among 493 postpartum mothers at selected government health facilities in Adama town from January 20 to February 20, 2021. All women who gave birth in selected government health facilities and within 48 h of postpartum were included in the study. Data were collected using an interviewer-administered questionnaire. Logistic regression models were used to identify the factors associated with IPPIUCD utilization. Adjusted odds ratios (AORs) with 95% confidence interval (CI) were calculated to measure the strength of association and statistical significance was declared at p < 0.05. In this study, 22.1% (95% CI: 17.3-25.2) of the mothers used IPPIUCDs within 48 h of giving birth. Having three or more children (AOR = 4.18, 95% CI: 1.79-9.79), having no desire to have another child (AOR = 3.9, 95% CI: 1.86-8.17), counseling after delivery (AOR = 3.1 95% CI: 1.52-6.34), and having good knowledge about PPIUCD (AOR = 3.82, 95% CI: 1.94-7.49) were significantly associated with IPPIUCD utilization. The utilization of IPPIUCD in this study was low. Strategies to raise pregnant mothers' awareness of IPPIUCD through mass media, and integrating standard counseling on immediate postpartum intrauterine device (IPPIUD) during antenatal care, and the immediate postpartum period are required to improve IPPIUD utilization.

Efficacy and Safety of Immediate Postpartum Intrauterine Contraceptive Devices in C-Section and Vaginal Deliveries

Aim: To determine the safety and efficacy of immediate postpartum intrauterine contraceptive devices insertion after vaginal and caesarean and vaginal deliveries. Study Design: Retrospective study Place &amp; Duration: Conducted at Gyne &amp; Obs Department, Shahida Islam Teaching Hospital Lodhran, during from 1-06-2020 to 30-06-2021. Methods: In this study 120 patients were included in this study. Patients’ ages were ranging from 20 to 45 years. Patients’ detailed medical history including age, residence and socioeconomic status were examined after taking written consent. All the patients divided into two groups, 60 caesarean, 60 vaginal. IPPIUCDs were inserted in all the patients. Outcomes were examined at follow-up and compared between both groups. Data was analyzed by SPSS 24.0. P-value &lt;0.05 was considered as significant. Results: 48 (40%) patients had ages between 20 to 30 years, 56 (46.7%) patients had ages 31 to 40 years and 16 (13.3%) patients had ages above 40 years. Complications rate was low. Perforation and pregnancy rate was 0%. Menstrual disturbance reported in 20 (16.7%) which was significantly higher in vaginal group. Expulsion rate was 9 (7.5%) and significant higher in vaginal group p&lt;0.05. Removal was done in 14 (11.7%) cases and rate of removal of IUCD was high in vaginal group. Continuation rate at follow-up was 106 (88.3%). Conclusion: It is concluded that the insertion of immediate postpartum intrauterine contraceptive devices was effective and safe method with low complications rate.

Prevalence of Complications after Interval Postpartum Intrauterine Device Insertion

Background and Aim: Postpartum intrauterine device (PPIUD) is a reversible, long-term and effective technique of contraception. The intrauterine device (IUD) is inserted within 48 hours of delivery. The immediate insertion of an intrauterine device causes certain complications. The present study aimed to assess the prevalence of complications after Interval Postpartum Intrauterine Device Insertion. Materials and Methods: This cross-sectional study was carried out on 147 women who underwent postpartum IUD (PPIUD) insertions during from January 2021 to June 2021 at Gynecology department, Mufti Mehmood Memorial Teaching Hospital (MMMTH), Dera Ismail Khan and Muhammad Teaching Hospital Peshawar. All the women who delivered and showed willingness for PPIUCD insertion were enrolled and continuously follow-up for 4 to 6 weeks after delivery. Demographic, obstetric, and clinical parameters were recorded on pre-designed medical proforma. PPIUCD insertion after 6 weeks of delivery were followed-up for the evaluation of complications. Uterine infection, medical removal of IUD, IUD expulsion, perforation, and method discontinuation were the outcome variables. SPSS version 20 was used for data analysis. Results: Of the total deliveries, 147 women inserted the postpartum intrauterine contraceptive device (PPIUCD). Of the total, about 122 (83%) women returned for follow-up after 6 weeks. All the women underwent transvaginal insertion of intrauterine contraceptive devices. The PPIUCD insertion related complications with prevalence were uterine infection 26 (21.3%), overall method suspension 17 (13.9%), perforation 20 (16.4%), interceptive uterine device expulsions 25 (20.5%), and intrauterine device removal 32 (26.2%). The severe uterine infection was in 2 (1.7%) cases who were hospitalized. Conclusion: The postpartum intrauterine device cumulative expulsion rate was higher among women compared to the expulsion rate of insertions. The longer duration of bloody lochia flow and delivery intrauterine device insertions were the key risk factors for expulsion of PPIUCD. Women can safely utilize intrauterine contraceptive devices with low complications beyond four week. Keywords: Postpartum intrauterine device; Complications; Intrauterine device expulsion

Utilization of Immediate Postpartum Intrauterine Contraceptive Device and Associated Factors among Women Who Gave Birth at Government Hospitals of Gamo Zone, Southern Ethiopia, 2019

Background: An intrauterine contraceptive device is suitable for women of all reproductive age groups for preventing unwanted pregnancies. Immediate post partum family planning services need to be emphasized where in the woman leaves the hospital with safe and effective contraception in place. Despite the accepted demand for post partum family planning, many women do not access the services they need prevent unintended pregnancies. Objective: To assess utilization of immediate postpartum intrauterine contraceptive device and associated factors among women who gave birth at government hospitals of Gamo Zone, Southern Ethiopia. Method: Facility-based crosses sectional study was conducted from March 1 to 30 of 452 participants were studied using systematic random sampling technique. Data were entered into Epi-data v. 4.2.2.1 and exported to SPSS v.23 for analysis. Crude or adjusted odds ratio, and 95% confidence interval were used to assess the strength of association and statistical significance. Variables which had a p-value of ≤0.25 in bivariate analysis were considered as candidates for multivariate regression analysis; variables that had a p-value of ≤0.05 in the multivariate analysis were considered as independent factors associated with utilization of immediate postpartum intrauterine contraceptive device among parturients in the final multiple logistic regression analysis. Results: This finding revealed that about 161 (36%) of the respondents had showed willingness to use immediate PPIUD, however, only about 62 (14%) of study participants were utilized immediate PPIUCD. Mothers who did not plan to have another child (AOR = 2.84, 95% CI, (1.12, 7.21), undecided plan to have another child (AOR = 2.55, 95% CI, (1.21, 5.35), counselled about PPIUCD (AOR=4.35, 95% CI, (2.11, 8.96) and completed ANC follow up (AOR=2.43, 95% CI, (1.28, 4.60) were associated with immediate post partum contraceptive device utilization. Conclusion and Recommendation: Even though 58% and 53% of the mothers were counselled and completed antenatal service respectively but efforts need to improve antenatal care service and integrate counselling service through the whole cascade of pregnancy.

Effect of instructional guidelines on pregnant women's knowledge regarding immediate insertion of an intrauterine contraceptive device during cesarean section versus late insertion after the puerperium

Postpartum intrauterine contraception (PPIUC) should be made more widely available because it can decrease unplanned pregnancies and short inter-pregnancy intervals. The aim was to evaluate the effect of instructional guidelines on Pregnant Women's Knowledge regarding immediate insertion of an intrauterine contraceptive device during cesarean section versus late insertion after the puerperium. Subjects and method: Design: To accomplish the goal of this study, a quasi-experimental research design was used. Setting: the study was carried out antenatal clinic at Beni-Suef University Hospital. Subjects: A purposive sample of 100 pregnant women was included in this study. Tools for data collection: A structured interview questionnaire which consisted of three parts; part (I) pregnant women's personal data; part (II) pregnant women's current obstetric history, part (III) pregnant women's knowledge regarding immediate versus late insertion of the intrauterine contraceptive device (pre/post). Results: The study's findings showed that pregnant women's knowledge regarding early vs late placement of an intrauterine contraceptive device after cesarean section showed highly significant improvements post-instructional guidelines (P&lt;0.001). Conclusion: The results of the current study showed that the application of instructional guidelines improved pregnant women's knowledge of early vs late placement of an intrauterine contraceptive device during cesarean section.

STUDY OF KNOWLEDGE ATTITUDE AND ACCEPTANCE OF PPIUCD IN ANTENATAL PATIENTS

Objectives: To nd out the knowledge, attitude and acceptance of postpartum intrauterine contraceptive devices (PPIUCD) among antenatal mothers. Methodology: This is an observational study conducted in MMCH medical college Muzaffarnagar to assess knowledge, attitude and acceptance regarding PPIUCD by antenatal mothers with family members by pre counseling and post counseling questionnaire. Results: A total of 120 antenatal mothers were studied from September 2020 to December 2020. Number of primi and multigravida were almost same in the study. Prior acceptance regarding PPIUCD was only in 15.0%. About 44.16% accepted for PPIUCD after counseling. Most common reason in 50.74% for non acceptance was fear of complications. Conclusion: Knowledge on PPIUCD of our antenatal mothers is poor. Counseling of antenatal women and their families is helpful for high acceptance of PPIUCD.For these women, the only opportunity to receive information about contraceptives is during childbirth when they are in contact with medical personnel. Hence, it is suggested that family planning should be integrated with maternal and child-care services in order to effectively promote the use of contraceptive devices in these women who otherwise would not seek the use of such a device.

Increasing postpartum IUCD coverage through a QI initiative: a step towards reducing the unmet need of postpartum contraception

BackgroundUnintended pregnancies have a negative impact on the health and economy of a nation, which can be prevented by effective family planning (FP) services. Postpartum intrauterine device (PPIUCD) is a...

ACCEPTANCE, COMPLICATION, EXPULSION AND FAILURE RATE OF POSTPARTUM IUCD IN A TERTIARY CARE HOSPITAL

Introduction: 1 India's population has crossed one billion in the year 2000. In recent censes of 2011 it has reached 121 crores and it is estimated to 2 reach a gure of1.53 billion by 2050, making it the most populous country in the world . India is the rst country in the world to adopt an ofcial population policy and launch ofcial family planning programme way back in 1952, which remains the mainstay of family planning efforts. Aims and objectives: 1. To nd out the proportion of accepting the Post-Partum Intrauterine Contraceptive Device (PPIUCD) insertion among eligible women delivering at SSKM hospital. 2. To assess the complications of post placental &amp;intra caesarean PPIUCD if any among these acceptors. 3. To determine the spontaneous expulsion rate of this contraceptive device. Materials and methods: All Adult ANC women attending SSKM hospital at Gynae OPD and as well as admitted in hospital wards or Labour Room who will full the inclusion criteria during data collection period. Conclusion: The study results, it can be concluded that PPIUCD in the eld of PPFP is a promising approach. Whatever may be the mode of delivery, PPIUCD is safe and efcacious in terms of safety and efcacy.

Outcome of Postpartum Intrauterine Contraceptive Device Insertion: Findings of an Institution Based Crosssectional Study

Background: To foster family planning activities by postpartum IUCD insertion, side effects and complications of PPIUCD insertion need to be characterized. The study was conducted to find out the outcomes of postpartum intrauterine contraceptive device insertion among women attending a tertiary level hospital.&#x0D; Methods: A cross sectional study was conducted among 130 women. Data were collected by face-to-face interview and reviewing medical records with semi- structured questionnaire and checklist. The subjects were purposively selected following specific selection criteria and maintaining ethical issues. The study was conducted during the period from October 2016- March 2017 in a tertiary hospital: Shaheed Suhrawardy Medical College Hospital (ShSMCH), Dhaka.&#x0D; Results: The study revealed that majority (53.1%) of women were 25-30 years and the mean (±SD) age was 26.40±4.273 years. Around 26.2% had secondary education and most of them i.e. 60.8% were housewife. Study revealed that average monthly family income was Tk. 20815.38 ± 9097.904. Majority (90%) of women choose PPIUD because it is convenient. Most of the respondents were inserted immediately after delivery within 10 minutes. Intracaesarean and manual insertion of PPIUCD was practiced in majority i.e. 79(60.8%) of the respondents. The study revealed that three fourth of the respondents had no side effect while common side effects of PPIUCD included vaginal discharge (12.3%), thread coming out (14.6%), missing thread (13.8%), lower abdominal pain (16.2%), expulsion (6.2%) and coital discomfort (10.8%). Only 18.5% respondents had abnormal uterine bleeding and 6.2% had PID. The results show expulsion rate was more in vaginal route (11.8%) than intra-caesarean route (2.5%) and this difference was statistically significant (p&lt;0.05). All complications like abnormal uterine bleeding (15.7%) and PID (20.3%) were seen more in vaginal insertions as compared to insertion during caesarean section and was statistically significant (p&lt;0.05).&#x0D; Conclusion: To reduce the unwanted pregnancy in postpartum period and maternal and child mortality and morbidity, PPIUCD insertion along its continuation by overcoming side effects and complications is an earnest need in a densely populated country like Bangladesh.&#x0D; JOPSOM 2020; 39(2): 1-7

Postpartum Intrauterine Contraceptive Device (PPIUCD) Versus Interval Intrauterine Contraceptive Device (IUCD) Complications: Which is better?

Introduction: Intrauterine Contraceptive Device (IUCD) is an effective mode of contraception. But its timing of insertion remained debateable. Studies has shown that Postpartum Intrauterine Contraceptive Device (PPIUCD) is associated with less complications as compared to interval IUCD. But controversial results have been noted. This study aims to compare intricacy &amp; efficacy of PPIUCD Vs interval IUCD. &#x0D; Aims &amp; Objectives: To compare the complications of postpartum versus interval intrauterine device insertion (Copper T) in females seeking contraception in teaching hospital of Lahore.&#x0D; Place and duration of study: The six months study was conducted in Department of Obstetrics &amp; Gynecology, Shaikh Zayed Medical Complex, Lahore from 15-3-2018 to 15-9-2018.&#x0D; Material &amp; Methods: In this Randomized controlled trial 200 women were enrolled and divided into 2 groups. In group A, IUCD (Copper T) was implanted within 10 minutes of delivery of placenta (PPIUCD). In group B, IUCD (Copper T) was implanted after 6 weeks of delivery (Interval IUCD) and both groups were asked to follow up for 6 months and present in case of any complication. Data was analyzed using SPSS version 21.&#x0D; Results: In this study, the frequency of bleeding was (Group-A: 12% &amp; Group-B: 18%, p-value=0.235), per vaginal discharge (Group-A: 4% &amp; Group-B: 9%, p-value=0.152), abdominal pain (Group-A: 4% &amp; Group-B: 14%, p-value=0.013), pelvic inflammatory disease (Group-A: 5% &amp; Group-B: 11%, p-value=0.118) and IUCD removal (Group-A: 9% &amp; Group-B: 14%, p-value=0.268) was higher in Group-B patients. However, expulsion rate was observed to be higher in Group-A patients (8% Vs 3% in Group B).&#x0D; Conclusion: Based on this study, it can be analyzed that Postpartum Intrauterine Contraceptive Device (PPIUCD) is more effective than Interval IUCD in terms of lower bleeding, PV discharge, pelvic inflammatory disease, abdominal pain and IUCD removal.

Assessment of intention to use postpartum intrauterine contraceptive device and associated factors among pregnant women attending antenatal clinics in ambo town public health institutions, Ethiopia, 2018

BackgroundMaternal mortality tragedy is the issue of both developed and developing countries, especially sub-Saharan Africa including Ethiopia, which is due to poor quality of maternal health care services. Therefore family planning especially the use of Postpartum intrauterine contraceptive devices can tackle unintended pregnancy and maternal death. However,the intention to use PPIUCD and the use of IUCD in general is not well practiced in Ethiopia according to evidences of the literatures. For this reason, many mothers are exposed to unintended pregnancy and pregnancy related complications. The main purpose of the study was to assess the intention to use Post-partum intra uterine contraceptive devices and its associated factors among pregnant women attending Antenatal Clinics in Ambo Town Public Health Institutions, Ethiopia, 2018.MethodsA facility-based cross-sectional study design was conducted from March – April 2018 to assess the intention of pregnant women about Postpartum intrauterine contraceptive devices and associated factors in 422 pregnant women. Study subjects were selected using systematic random sampling. Data were collected by structured questionnaire, entered into a computer using Epi-info 3.5.4 statistical program, and exported to SPSS version 20 for analysis. A Logistic regression model was used to predict the intention of pregnant women about Postpartum intrauterine contraceptive devices and associated factors. Lastly, a significant statistical association was tested using 95% confidence interval (CI) and p value (p < 0.05).ResultsThe response rate was 417 (98.3%) and this study showed that 145(34.9%) of pregnant women intended to use Postpartum intrauterine contraceptive device. Age of pregnant women [AOR = 8.348(CI: 3.602–19.347], educational level [AOR = 3.249(1.057–9.985)], occupational status [AOR = 4.101(CI: 1.788–9.405)], monthly income [AOR = 3.175(CI: 1.423–7.082)] and knowledge [A0R = 5.408(2.994–9.767)] have shown significant associations with intention to use Postpartum intrauterine contraceptive devices.ConclusionsThe study found that 34.9% women intended to use PPIUCD. Maternal age, maternal educational level, occupational status, monthly income and knowledge were significantly associated with pregnant women intention to use PPIUCD.

A correlation study to assess the knowledge and attitude regarding postpartum intrauterine contraceptive device (PPIUCD) among women admitted in antenatal and postnatal wards

Introduction: India is the second most populous country in the world. Intrauterine contraceptive device (IUCD) is a very effective, reversible, and economical family planning method. In India, the acceptance rate of IUCD is very low, only 3% of the women in the reproductive age group are using IUCD. Aims: The study was conducted to assess the knowledge and attitude regarding the postpartum intrauterine contraceptive device (PPIUCD) among women. Materials and Methods: A descriptive approach with a non-experimental research design was used for the study. The subjects were 180 women selected by the non-probability convenience sampling technique. The study was conducted among the women admitted in antenatal and postnatal wards at Doon Medical College Female Hospital, Dehradun, Uttarakhand. Results: The study showed that 54.44% (98) of the women have average knowledge about PPIUCD, 21.11% (38) have poor knowledge, 23.33% (42) did not know, and only 1.11% (2) was having good knowledge about it. The study revealed that favorable and unfavorable attitudes toward PPIUCD of women were 43.33% and 56.67%, respectively. The present study communicated that there was no correlation (−0.113) between knowledge and attitude toward PPIUCD among women. The finding suggested that women had average knowledge and unfavorable attitude toward the PPIUCDs. The χ2 value showed that demographic variables such as age, family income, and education status were having an association with the level of knowledge regarding the PPIUCD. No association was found between attitude and selected demographic variables. Conclusion: Findings stress the need for teaching programs, which in turn may enhance the knowledge and attitude of women regarding the PPIUCD. It will also helpful in improving the health status of women. It may reduce maternal morbidity and mortality.

Acceptance Rate of Post-Partum Intra-Uterine Contraceptive Device and Factors Affecting its Uptake in a Tertiary Care Hospital in Pakistan

Objective: To determine the frequency of acceptance of Post-partum Intra-Uterine Contraceptive Device and the factors affecting its uptake in a tertiary care hospital in Karachi.Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynaecology of large public tertiary care centre in Karachi. 160 women in their immediate postpartum period were selected via consecutive non-probability sampling and counselled about the insertion of post-partum intra-uterine contraceptive device. Their willingness and the factors affecting their acceptance or refusal were documented. Women aged 20-40 years in their 36-40 weeks of gestation carrying a singleton foetus in-utero were included in the study. Past users of intrauterine devices, complicated pregnancies and emergency obstetric cases were excluded. Likewise, women carrying multiple foetuses or mal-positioned foetuses were not included. The study was carried out after due institutionalapproval.Results: The acceptance rate for postpartum intrauterine contraceptive devices was 23%. About 86.49% of the women acknowledged that thorough counselling made them opt for this method. Other factors that favoured its uptake were long action duration with one-time placement (70.27%), husband's approval (59.46%) and accessibility (56.76%). The majority that refused (76.9%) rejected the device due to religious beliefs (57.72%), fear of side effects (56.10%) and lack of knowledge about contraception (46.34%).Conclusion: The acceptance rate of postpartum intrauterine contraceptive devices remains low in our healthcare system. Healthcare workers and policy makers need to consider the factors responsible for its refusal for this means to be effectively utilized.

Acceptability and Factors Associated with Immediate Postpartum Intrauterine Contraceptive Device Use Among Women Who Gave Birth at Government Hospitals of Gamo Zone, Southern Ethiopia, 2019.

BackgroundAn intrauterine contraceptive device is suitable for women of all reproductive age groups for preventing unwanted pregnancies. Immediate postpartum family planning (PPFP) services need to be emphasized when the woman leaves the hospital. Despite the accepted demand for PPFP, many women do not access the services. Therefore, this study aimed to assess acceptability and factors associated with immediate postpartum intrauterine contraceptive device use among women who gave birth at government hospitals of Gamo Zone, Southern Ethiopia.MethodsA cross-sectional study was conducted from March 1 to 30, 2019 with 452 participants studied using systematic random sampling technique. Data was collected using a pretested interviewer-administered questionnaire from March 1 to 30, 2019. The data were coded, cleaned and entered into Epi-data manager version 4.2.2.1 and exported to SPSS version 23 for advanced analysis. Binary logistic regression was performed to identify associated factors of immediate PPIUCD acceptability.ResultsThis study revealed that about 161 (35.6%) in 95% CI (31.0, 39.6) of the study participants accepted immediate PPIUCD. Multiparty (AOR = 2.33, 95% CI, (1.29, 4.20)), completed antenatal follow up (AOR = 3.65, 95% CI, (2.22, 5.99)), counselling (AOR= 8.38, 95% CI, (4.85, 14.48)) and prior discussion (AOR=2.57, 95% CI, (1.51, 4.36)) were statistically significant.Conclusion and RecommendationEven though 58% of the mothers were counselled about PPIUCD during the important cascade of pregnancy and 53% of the mothers completed antenatal service, efforts need to improve antenatal care services and integrate counselling services through the whole cascade of pregnancy.

Determinants of Postpartum Intrauterine Contraceptive Device Uptake among Women Delivering in Public Hospitals of South Gondar Zone, Northwest Ethiopia, 2019: An Unmatched Case-Control Study.

Introduction Integrated use of postpartum intrauterine contraceptive devices with delivery service during the immediate postpartum period is ideal for both women and health-care providers. However, utilization of intrauterine contraceptive devices during the postpartum period was rare and in Ethiopia, with information regarding uptake of postpartum intrauterine contraceptive devices limited. Objective Identify determinants of postpartum intrauterine contraceptive devices uptake among women delivering in public hospitals of South Gondar zone, Northwest Ethiopia, 2019. Methods An unmatched case-control study was conducted in public hospitals of South Gondar, Ethiopia, from August 1, 2019, to November 10, 2019. A total of 140 cases and 280 controls have actively participated in the study. Five hospitals were selected by simple random sampling. Cases were selected consecutively, whereas two controls for each case were recruited by the lottery method. Pretested questionnaires were used to collect data and it was entered into Epidata version 4.4.2. Logistic regression analysis was used to identify variables associated with the use of outcome and adjusted odds ratio with a 95% confidence interval was used to determine the association between independent and outcome variables. Results Completing secondary education (AOR = 4.5, 95%CI 2.3–8.85), having a total number of children of 3–4 (AOR = 3.6, 95%CI 1.25–10.2), having ≥ 5 (AOR = 4.7, 95%CI 1.5–15.3), attending 3 antenatal care (AOR = 2.8, 95%CI 1.44–5.6), ever hearing about postpartum IUCD (AOR = 6.6, 95%CI 2.7–16.1), and having counseling from health-care provider about a postpartum intrauterine contraceptive device (AOR = 6.2, 95%CI 2.99–12.8) were significantly associated with uptake of the postpartum intrauterine contraceptive. Conclusion and Recommendation. Completing secondary education, having 3–4 and ≥5 children, attending three antenatal care, ever hearing about postpartum IUCD, and having counseling from health-care providers about the postpartum intrauterine contraceptive device among women were significantly associated with uptake of an intrauterine contraceptive device after birth. Therefore, it is better to advise women to strictly follow their antenatal care, access to information, and provide counseling.

Immediate postpartum intrauterine contraceptive device utilization and influencing factors in Addis Ababa public hospitals: a cross-sectional study

BackgroundPostpartum intrauterine device (PPIUCD) utilization remains very low in Ethiopia beside high levels of unmet need for postpartum family planning even if nongovernmental organizations efforts to promote its use. This study investigates immediate PPIUCD utilization and influencing factors.MethodsInstitution based cross-sectional study was conducted on public hospitals of Addis Ababa city. All public hospitals which have PPIUCD service were included and systematic random sampling technique was used to select 286 participants. Data were entered using Epi Data and exported to SPSS for analysis. Bivariate and multivariate logistic regression analysis was used to determine the effect of independent variables on immediate PPIUCD utilization. Variables which have P-value< 0.2 on bivariate analysis were candidate for multivariate analysis. Variables which have P-value ≤0.05 on multivariate analysis was considered as statistically significant.ResultsUtilization of immediate PPIUCD among participants who gave birth in Addis Ababa public hospitals was 26.6% (95%CI: 21.3, 31.8). Eighty one percent respondents occupation was housewife were (AOR = 0.19, 95%CI: 0.06, 0.67) less likely to utilize PPIUCD compared to those who have personal job. In the other hand respondents who have discuss about PPFP with their partner were 1.21times (AOR = 1.21, 95%CI: 1.14, 25.67) more likely to utilize PPIUCD compared to those who never discuss. Contrarily 81% of respondents who need partner approval were (AOR = 0.19, 95%CI: 0.05, 0.79) less likely to utilize PPIUCD compared to those who doesn’t need approval. Respondents who have been counseled about PPIUCD were 1.13 times (AOR = 1.13, 95%CI: 1.10, 2.21) more likely to utilize PPIUCD compared to those who were not counseled. Similarly respondents who have good knowledge about PPIUCD were 7.50 times (AOR = 7.50, 95%CI: 4.06, 9.31) more likely to utilize PPIUCD compared to those who have poor knowledge.ConclusionThis study verifies that immediate PPIUCD utilization is high compared to other studies. Having a housewife occupation and necessity of partner approval to utilize PPIUCD have negative influences, whereas spousal discussion about PPIUCD, counseled during pregnancy and having good knowledge have positive influences on PPIUCD utilization. Therefor empowering women by the government and other organizations working on maternal health will advance immediate PPIUCD utilization.

A study to assess the effectiveness of video assisted teaching programme on knowledge regarding post-partum intra uterine contraceptive devices (PPIUCD) among antenatal mothers in selected rural areas at Udaipur, Rajasthan

A Pre-experimental study to evaluate the effectiveness of Video assisted teaching programmeon knowledge regarding PPIUCD among antenatal mothers in selected rural areas at Udaipur,Rajasthan. The sample consisting of 150antenatal mothers in selected rural areas by using non-probability convenientsampling method. The tool comprised of structured self-administered questionnaire. The pre-test was conducted and the Video assisted teaching programmewas administered. The post-test was conducted after one week. The data obtained were analyzed by using descriptive and inferential statistics. The mean post-test knowledge score 23.04 was higher than mean Pre-test knowledge score i.e. 11.30 (p=0.05, significant). This indicated that there was a significant difference between pre-test and post-test knowledge score of antenatal mothers regarding PPIUCD. Hence, the research hypothesis H was accepted. The Chi-square test was carried out to determine the association between the posttest knowledge and demographic variables such asAge in years, Religion , Education, Occupation, Income, type of family, Aware about PPIUCD, Source of information. Out of which age in years (χ = 16.97*) education (χ = 13.51*) awareness (χ = 8.77*) source of information (χ = 8.56*) were found to be significantly associated with posttest knowledge at .05% level Hence, research hypothesis Hwas accepted.

Evaluation of Acceptability, Safety, Efficacy and Outcome of Postplacental IUCD Insertion in Women Undergoing both Vaginal Delivery and Caesarean Section- A Cohort Study

Introduction: Prevention of unplanned and unwanted pregnancies could help avert 20-35% of maternal deaths and as many as 20% of infant death. Despite many advantages of, mothers of India are reluctant for IUCD use. Aim: To determine the acceptability, safety, efficacy and outcome of Postpartum Intrauterine Contraceptive Device (PPIUCD) following both vaginal delivery and caesarean section. Materials and Methods: A descriptive prospective cohort study conducted in the Department of Obstetrics and Gynaecology in a tertiary care institute in Eastern India from August 2019 to July 2020. Among the women delivered almost all mothers were counseled about postplacental IUCD insertion and the first 100 mother who satisfy inclusion criteria were incorporated in the present study. Out of 100 mothers, six mother refused and 94 mothers accepted PPIUCD. Only three mothers were lost to follow-up. Ninety-one mothers were followed-up in postnatal clinic after 6 weeks, 12 weeks, 24 weeks and 48 weeks. Primary parameter was to assess acceptance rate and reason for acceptance. Secondary variables were refusal rate and reason for refusal, reason for removal, failure rate and complications. Collected data were then analysed by SPSS (version 27.0; SPSS Inc., Chicago, IL, USA) and GraphPad Prism version 5. Results: Majority of mothers were in the 21-25 years age group and completed secondary school education. A very high rate of acceptance of about 94% was found. The most common reason for acceptance was its long-term effect of contraception (40.4%) followed by reversible nature (27.7%). This study showed that refusal rate was 6%, majority due to fear of complications. Among 91 mothers followed-up for safety profile of PPIUCD, majority (81.3%) had no complication which was statistically significant (p&lt;0.0001). Out of 91 women, 80 mothers (87.9%) continued PPIUCD, three mothers had abdominal discomfort, 10 had abnormal bleeding P/V, and 67 mothers (90.4%) had no complications and failure rate was 2.2%. Only two mothers conceived with PPIUCD in-situ. Expulsion rate was 4.4%. Out of 91 mothers followed-up, only four had expulsion. Conclusion: PPIUCD is widely accepted, efficacious, safe method of family planning, that can reduce maternal morbidity and mortality