Acceptability and use of postplacental intrauterine contraceptive devices after antenatal counseling: An observational prospective cohort study
Jincy A. Iype, Tamma A. Reddy, Elza R. Kharsyntiew, Nitin A. Abraham, Swati Rathore, Bijesh Yadav
A
BSTRACT
Context:
India has a large unmet need of contraception. Long-acting reversible contraceptives such as intrauterine devices are the most effective along with the highest rate of continuation. Postpartum intrauterine contraceptive devices (PPIUCDs) have the advantage of high receptivity and easier access.
Aims:
To look at the acceptability and utilization of immediate PPIUCD along with factors associated with acceptance and whether different methods of counseling improved utilization.
Settings and Design:
It was an observational cohort among antenatal women who had care and delivery at a tertiary center in South India. The IUCD used was the CuT 380A.
Methods and Material:
Antenatal women, from 32 weeks of gestation, were assigned to six different counseling groups by randomization. At the time of delivery, all the study participants who accepted and gave documented consent had PPIUCD inserted and analysis was done on the data collected.
Results:
The acceptance rate of PPIUCD in this study was 9.5%. The acceptance after counseling was 9.0% in the consultant group and 10% in the registrar group. Among the participants who agreed to use PPIUCD antenatally, the acceptance was 14% in single counseling, 9.1% in group counseling, and 5.2% in multiple counseling.
Conclusions:
Our society’s awareness and acceptance of PPIUCD are still very low. Counseling antenatal women and their families are beneficial for PPIUCD acceptance. Even after effective counseling, the most common reason for the nonacceptance of PPIUCD is family refusal and apprehension about complications.