Postpartum Modern Contraceptive Research Articles

Examining the linkages between maternity services and postpartum modern contraceptive adoption among young women in India: Insights from the 2015-16 and 2019-21 National Family Health Survey.

The adoption of maternity services and postpartum modern contraception are the two most crucial components that help in reducing maternal and infant mortality; still, India is consistently struggling with it. This paper, therefore, aimed to examine the linkages between use of maternity services and postpartum modern contraceptive adoption. The required reproductive calendar data were extracted from the 2015-16 and 2019-21 National Family Health Survey (NFHS) datasets. The assessment was made based on a sample of currently married women aged 15-24 years who had given most recent childbirth in five years preceding the survey. For the analysis, a time-to-event approach was applied using the Kaplan-Meier survival statistic, Log-Rank Chi-square test and Cox-Proportional Hazard (Cox-PH) models. The results revealed that the proportion of postpartum modern contraceptive uptake among young users increased by 9%, from 33% in 2015-16 to 42% in 2019-21. The Cox-PH models revealed that, in both NFHS waves, the associations between various components of maternity services and postpartum modern contraceptive uptake were strongly significant, even after controlling for selected socio-economic and demographic correlates. The findings of this study reinforced urgent need for implementing integrated maternal-child health and family planning programmes and for boosting effective family planning counselling by health professionals to promote and motivate young women with a desire to early adoption of modern contraception in subsequent months after a recent childbirth.

Time to initiate postpartum modern contraceptives among pregnant women in Ambo Town, Central Ethiopia; Cox-proportional hazard regression analysis

BackgroundTiming of postpartum family planning is crucial for maternal and child wellbeing by preventing unintended and closely spaced pregnancies. However, studies are limited on the time to use modern contraceptives in Ethiopia. Therefore, this study aimed to fill these gaps by assessing the time to initiate postpartum modern contraceptive and identifying its predictors among pregnant women in Ambo town, central Ethiopia.MethodsAn institution based cross-sectional study was conducted among 356 pregnant women in Ambo town, Central Ethiopia. The data were analysed using STATA-16 software. Kaplan–Meier estimates were performed to explain time-to- modern contraceptive use. A Cox-proportional hazard regression analysis was conducted to identify predictors. The adjusted hazard ratio (AHR) with a 95% confidence interval was considered to declare a statistically significant association.ResultsThis study showed that the median survival time to initiate postpartum modern contraceptives was 6 months. In this study, the risk of modern contraceptive use was 2.13 times higher (AHR = 2.13; 95% CI: 1.02–4.45) among younger women, 1.44 times higher (AHR = 1.44; 95% CI: 1.09–2.66) among women with no desire for more children, and 2.25 times higher (AHR = 2.25; 95% CI: 1.02–4.95) among nulliparous women. However, it is 57% times lower (AHR = 0.57; 95% CI: 0.32–0.94) among pregnant women with current unintended pregnancy.Conclusion and recommendationThe median survival time to initiate postpartum modern contraceptive was 6 months. Age of the women, desire for more children, parity and pregnancy status were found to be the significant predictors of time to initiate postpartum modern contraceptive. Therefore health care providers and concerned stakeholders should consider these factors to increase the uptake of the postpartum contraceptive methods.

Postpartum modern contraception utilization and its determinants in Ethiopia: A systematic review and meta-analysis.

BackgroundContraceptive use is the best and most cost-effective strategy to reduce feto-maternal adverse effects of short birth intervals. More than two-thirds of women in developing countries who do not want to conceive are not using contraception methods. Although there were various primary studies in different parts of the country, there is no nationally representative evidence on postpartum modern contraception utilization and its determinants in Ethiopia.ObjectiveThis review was aimed to determine the best available pieces of evidence to pool the magnitude of postpartum modern contraception utilization and find out its determinants.MethodsPublished studies were extensively searched by using electronic databases and unpublished studies were identified from the digital library. All observational studies conducted on the magnitude of postpartum modern contraception utilization and its determinants in Ethiopia were included. Data were extracted on the Microsoft Excel spreadsheet and analyzed using STATA 14.1 version. A random-effects model was used to estimate the pooled magnitude of postpartum modern contraception utilization with a 95% confidence interval (CI). Inverse variance (I2) was used to identify the presence of heterogeneity and forest plot was used to estimate the pooled magnitude of postpartum contraception utilization. The presence of publication bias was assessed by funnel plots and Egger’s statistical tests. Sub-group analysis was computed to minimize underlying heterogeneity.FindingsIn this review, 19 primary studies were included. The pooled magnitude of postpartum modern contraception utilization in Ethiopia was 45.79% (95%CI 36.45%, 55.13%). The review found that having more than four Antenatal care visits(ANC), having postnatal care visit (PNC), having a formal education, history of family planning use, history of counseling on family planning, and having greater than four alive children as significant determinants of postpartum modern contraception utilization.ConclusionThe magnitude of postpartum modern contraception utilization in Ethiopia was low. ANC visit, PNC visit, maternal educational status, history of previous family planning use, counseling on family planning, and number of alive children were found to be significant determinants of postpartum modern contraception utilization. Therefore, strengthening focused ANC and PNC services to encourage women in utilizing modern contraception during the postnatal period is needed.

Postpartum Modern Contraceptive Utilization and Associated Factors Among Women Who Gave Birth in the Last 12 Months in Addis Zemen, South Gondar, Ethiopia: Community-Based Cross-Sectional Study.

IntroductionWhile family planning (FP) is important throughout an individual’s and couple’s reproductive life, postpartum family planning (PPFP) focuses on the prevention of unintended and closely spaced pregnancies through the first 12 months following childbirth. However, modern contraception utilization practice during the postpartum period is underemphasized in Ethiopia.ObjectiveThis study aimed to assess postpartum modern contraceptive utilization and associated factors among postpartum women in Addis Zemen, South Gondar, Ethiopia in 2019.MethodsCommunity-based cross-sectional study was conducted from January 1 to February 30, 2019 on 402 women. Study subjects were selected by simple random sampling technique. The data were collected by a structured and pretested, face-to-face, interviewer-administered questionnaire, entered into EpiData 4.2 and analyzed by using SPSS 23 software. Bivariate and multivariable analyses were used to examine the association. Odds ratio, 95% confidence interval (CI) and P-value <0.05 were used to determine the statistical association.ResultsThe prevalence of postpartum family planning utilization was 54.7%. Maternal educational status (adjusted odd ratio (AOR)=2.99, 95% CI (1.72, 5.19)), menses return (AOR=4.76, 95% CI (3.03, 7.48)), less than four alive children (AOR=3.61, 95% CI (1.51, 4.51)), postnatal care follow-up (AOR=2.96, 95% CI (1.57, 5.57)), length of time after delivery (AOR=1.80, 95% CI (1.16, 2.79)) and knowledge (AOR=1.69, 95% CI (1.07, 2.66)) were significantly associated with postpartum modern contraceptive utilization.ConclusionThe postpartum modern contraceptive utilization was low. Therefore, health care providers should strengthen the integration of family planning services with maternal and child health service, provide health information about timely use of contraceptives and improve postnatal care follow-up after giving birth.

Associated Factors of Postpartum Modern Contraceptive Use in Burie District, Amhara Region, Ethiopia.

Methods A community-based cross-sectional study was employed among 686 mothers in Burie District from March 16 to March 25, 2017. A multistage sampling technique was used to select the study participants. Data were collected using face to face interviewer administered structured questionnaires. Then, the collected data was entered, coded, and cleaned into EPI Data version 3.1 and exported to SPSS version 20.0 for data analysis. Bivariate and multivariate logistic regression was done to assess the association of factors with postpartum modern contraceptive use. Adjusted odds ratios with 95% confidence intervals were calculated, and p values <0.05 were considered to indicate statistical significance. Result This study revealed that postpartum modern contraceptive use was found to be 20.7%. Postpartum modern contraceptive use was significantly associated with women's level of education (AOR = 0.15, 95% CI (0.03-0.71)), discussing FP methods with partner (AOR = 0.60, 95% CI (0.40-0.90)), knowing menses return after birth (AOR = 0.39, 95% CI (0.25-0.59)), ever heard about modern FP methods (AOR = 0.06, 95% CI (0.01-0.43)), and contacting health professionals (AOR = 1.85, 95% CI (1.19-2.88)). Conclusion and Recommendations. Postpartum modern contraceptive use was found to be low. Therefore, health professionals should work on improvements in women's educational status, making awareness of the women and counseling of their husbands about the use of postpartum contraception, when fertility returned and risky timing for becoming pregnant.

Awareness and Factors Associated with Postpartum Modern Contraceptives Use among Women of Reproductive Age in Bukombe District, Geita Region

Introduction: Pregnancies that occur during the first year postpartum are more likely to be unplanned. This leads to an increased risk of adverse maternal and perinatal outcomes. However, modern contraceptive use during this period helps to reduce unplanned pregnancies and its associated adverse outcomes. There is scant data on postpartum contraceptives in pastoral communities in Tanzania. This study aimed to assess awareness and factors associated with postpartum modern contraceptives use among women of reproductive age in Bukombe District, Geita Region. Method: A community based cross-sectional study was conducted in a predominant pastoral community of Bukombe district in Geita region in north-western Tanzania from May-June 2018. A total of 511 postpartum women who were in their first year after child birth were studied. A multistage sampling technique was used to select study participants. Data analysis was performed using SPSS version 21. Multivariable logistic regression analysis was used to determine independent predictors of postpartum modern contraceptive use. Results: Most (97.3%) of the participants were aware about modern contraceptives. The prevalence of postpartum modern contraceptive use was 11.9%. The most frequent used contraceptive method was Implant 6.5%. Majority (75%) of women started to use the contraceptive at the first three months after delivery. Living in urban (AOR = 1.84, 95% CI: 1.20 - 3.79), business women’s (AOR = 2.34, 95% CI: 1.31 - 2.28), having last born aged 3 - 4 months (AOR = 3.30, 95% CI: 1.11 - 9.85) and menses resumption (AOR = 9.23, 95% CI: 3.60 - 23.72) were associated with postpartum modern contraceptive use. Fear of side effects, poor knowledge about contraceptives, husband restrictions, distance to health facility and availability of contraceptive were the barriers for use of contraceptive use. Conclusion: We found low uptake of postpartum modern contraceptive use in this population. Numerous factors were associated with modern contraceptive use. Therefore, health communication targeting this group is warranted to improve modern contraceptive uptake.

Women’s Autonomy Decision Making Power on Postpartum Modern Contraceptive Use and Associated Factors in North West Ethiopia

Background. Most postpartum women (95%) do not want pregnancy within 24 months after birth, however, 70% of them do not use modern contraceptives. In Ethiopia postpartum modern contraceptive use is low. Evidences show that women’s autonomy within the household is the most important thing in modern contraceptive use. Yet, there is dearth of information in Ethiopian context. Therefore, this study was aimed to assess women’s autonomy on modern contraceptive use and its associated factors among women who attended their children immunization service. Methods. Facility-based cross-sectional study was carried out from May 5 to Jone15, 2017 in sekota town and its surroundings among 415 women who attended immunization service for their children. Participants were selected by using a systematic sampling technique. The data were collected through face-to-face interviews using pre-tested structured questionnaires. The data were entered into epi.info version7 and analyzed using SPSS version 23. Both descriptive and logistic regression analyses were performed. A P-value less than or equal to 0.05 at 95% confidence interval was set to test statistical significance. Result. The proportion of women’s decision making power on postpartum modern contraceptive use was 77.3%. Being counseled on postpartum family planning (2.29, 95% CI: 1.27, 5.71), discussed on postpartum family planning with their husbands (AOR = 14.62, 95% CI: 6.52, 32.75), and had the index child within one year after previous birth (AOR = 7.98, 95% CI: 2.52, 30.65) were found positively associated with women’s autonomous decision making power on postpartum modern contraceptive use. In addition, those women who knew that pregnancy could happen during the postpartum period (AOR = 6.53, 95% CI: 3.2, 14.12) were more autonomous in decision to use postpartum contraception. Conclusion. The proportion of women’s autonomous decision making power on postpartum modern contraceptive use was low. Those women who were counseled on postpartum family planning, discussed with partners, and those who knew that pregnancy could happen during the postpartum period had higher odds of autonomous decision making power. Therefore, strengthening counseling, educating on postpartum family planning, and encouraging women to discuss postpartum family planning with their husbands may improve women’s power.

Postpartum modern contraceptive use and associated factors in Hossana town.

BackgroundPostpartum family planning is the initiation and use of family planning services within the first 12 months following childbirth to impede closely spaced and unintended pregnancies. Globally, spacing pregnancies at least 2 years apart can prevent an estimated 10% of infant deaths and 21% of deaths in children 1–4 years of age. The main purpose of this study was to determine postpartum modern contraceptive use and associated factors in Hossana town, Hadiya zone, Southern nation nationalities peoples region, Ethiopia.MethodsFacility based cross-sectional study was conducted from June 03 to July 03, 2018, in Hossana town, Hadiya zone. Data was collected by structured questionnaires using face-to-face interview on 368 women. Systematic random sampling technique was employed to approach the study participants. SPSS version 20 software was used for data analysis. Both bivariate and multiple variable logistic regression analysis were computed. Odds ratio with their 95% confidence intervals were calculated and statistical significance was decided if p < 0.05.ResultTwo hundred seventy one (72.9%) women used postpartum modern contraception. Educational status of mothers [AOR = 0.26; 95% Cl; 0.09–0.744], resumption of sex [AOR = 4.20; 95% Cl; 1.533–11.517], menses resumption [AOR = 8.48; 95% Cl; 3.072–23.228] and duration postpartum period [AOR = 0.26; 95% Cl; 0.107–0.644] had significant association with postpartum modern contraceptive use.ConclusionsThe prevalence of postpartum modern contraception use is relatively high. Educational status of mothers, resumption of sex, menses resumption and duration of postpartum period were factors significantly associated with postpartum modern contraceptive use. Improving women education & delivering messages for couples on the risk of getting pregnant prior to menses is crucial.

The Effect of Combined Antenatal and Postnatal Counselling on Postpartum Modern Contraceptive Use: Prospective Case-Control Study in Kocaeli, Turkey.

The integration of family planning education into obstetric care has been suggested to increase postpartum contraception use. However, ideal time and type of counseling is controversial. There is no prospective study about combining prenatal and postnatal education on the postpartum modern contraceptive use (PPMC). This study was aimed to explore the effects of the addition of postpartum contraceptive counselling to antenatal education on PPMC. Family planning counselling was given to all participating patients throughout antenatal care (ANC) via brief communications. After delivery, the women were categorised into two age-matched groups with a 1:1 allocation ratio in the order of the birth date. No further intervention was performed for Group I (n: 98). Women in Group II (n: 102) received further contraceptive education at six weeks after hospital discharge. Six months after delivery, PPMC was compared between the two groups. PPMC was similar between Group I and II (p>0.05). Previous contraceptive experiences, obstetric care service intensity and partner's support were the factors related to postnatal contraceptive use. Logistic regression analysis showed that PPMC was independent of confounding factors in each group. The addition of postnatal counseling to antenatal one did not further increase PPMC. The results of this study suggested that family planning counseling should be provided antenatally.