Analysis of awareness, acceptance, safety and continuation rate of post-placental and intra-caesarean insertion of intrauterine contraceptive device

Abstract

Background: Intrauterine contraceptive device (IUCD) is an effective form of long acting reversible contraception. This study was done to determine the level of acceptance among Indian women according to their socio-demographic profile and continuation rate of post-placental and intra-caesarean insertion of intrauterine contraceptive device (PPIUCD). Methods: A prospective longitudinal study was conducted in the Department of Obstetrics and Gynecology at RNT Medical College, Udaipur, Rajasthan, India from August 2014 to December 2014. CuT 380A was inserted within 10 minutes of delivery of placenta in 100 counseled women who fulfilled the Medical Eligibility Criteria. They were followed up for 6 months. Results: Total women counseled were 316, out of which 100 accepted and 216 declined the PPIUCD. Expulsion rate was 2%, bleeding (3%), missing strings (8%), pain abdomen (3%), removal rate (6%). Continuation rate was 92%. There was no case of pelvic infection,   perforation or pregnancy with the CuT in situ in the entire followed up period. Conclusions: PPIUCD was demonstrably safe, effective and high retention rate (92%).The expulsion rate was not very high (2%). Awareness of PPIUCD among Indian women was very poor. Myths and misconception among community, limited access to skilled service providers and poor awareness among people were the reasons for low acceptance levels. Increasing awareness of benefits of PPIUCD will surely ensure the change in the acceptance