Antenatal counselling as a tool to increase acceptability of postpartum intrauterine contraceptive device insertion in a tertiary care hospital

Abstract

Background: Acceptance of postpartum intrauterine device (IUD) insertions in women in Uttar Pradesh is low. In response to the concept that a good postpartum programme should begin prenatally, this study was designed to determine whether the provision of expert contraceptive counselling during the antenatal period would have an impact on its uptake as compared to women who were counselled in post partum period.Methods: Expert contraceptive counselling was given to 264 and154 women during their antenatal visits and postpartum hospitalization, respectively. Acceptors received IUCDs within 48 h of delivery in the case of vaginal delivery or transcesarean insertion in case of abdominal delivery. The acceptance rate of PPIUCD and the percentage of actual insertions were recorded. The causes of refusal were also recorded.Results: Among the 264 couples counselled in antenatal period 116 (43.9%) had PPIUCD insertion. Among the 154 unbooked women who were counselled postpartum only PPIUCD was inserted in 36 (23.4%) women. PPIUCD insertion was significantly high in women receiving expert counselling during antenatal period as compared to the women who were counselled in postnatal period (p< 0.001). Family refusal, No knowledge of PPIUCD and preference for another contraceptive methods were the most common reasons for refusing the use of PPIUCD.Conclusion: Acceptability of PPIUCD insertion was high in women counselled in antenatal period. Hence, it is suggested that counselling for PPIUCD should start in antenatal period.