Postpartum Family Planning: Missed Opportunities across the Continuum of Care

Abstract

Introduction: Postpartum family planning is defined as the prevention of unintended pregnancies and closely spaced pregnancies during the first 12 months following childbirth. Objectives: To assess the practice of family planning (FP) by postpartum mothers in the Regional Director of Health Services (RDHS) division, Kalutara, Sri Lanka. Methods: A community-based, descriptive, cross sectional study was carried out among mothers, 8 to 12 weeks postpartum, in the RDHS division, Kalutara in 2014. Calculated sample size was 1200 and the participants were recruited using cluster sampling method. They were interviewed at their residence about their practice of FP methods using an interviewer administered questionnaire. Results: The response rate was 93.7% (n=1112) of which 730 (65.6%) were practicing a FP method at 8-12 weeks after delivery. Condoms were the most popular modern FP method (30.4%, n=222) followed by intrauterine device (26.7%, n=195) and depot medroxyprogesterone acetate (DMPA) injections (22.9%, n=167). Approximately 80% had utilized government sector FP services. Women with higher level of education (p< 0.05), lower family income (p< 0.01), parity more than 3 (p< 0.001) and more than three living children (p<0.01) were significantly more likely to use a FP method. Conclusions: Prevalence of postpartum FP is not satisfactory. Therefore, FP services should consider reaching postpartum mothers with unmet needs as a priority and ensure that a wide range of contraceptive options are available to them. Postpartum FP should be considered as a continuum of maternal care.