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Critical Factors Influencing the Acceptability of Post-placental Insertion of Intrauterine Contraceptive Device: A Study in Six Public/Private Institutes in India

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The Journal of Obstetrics and Gynecology of India Aims and scope Submit manuscript

Abstract

Objective

To determine critical factors and barriers to postpartum intrauterine contraceptive device (PPIUCD) use in India in order to guide programs aimed at reducing maternal and child mortality.

Methods

All pregnant women were enrolled for contraception counseling during their visit to the antenatal outpatient clinic. Women who opted for PPIUCDs were enrolled in the study and offered PPIUCD insertion, irrespective of mode of delivery. Those who withdrew consent when in labor or soon after delivery, experienced severe bleeding, or exhibited unstable vital signs were excluded, as were febrile women and those diagnosed with chorioamnionitis.

Results

A total of 66,508 women were enrolled in the study. 86.1% indicated they discussed family planning options with their partners/husbands before making a decision. 178 respondents (0.3%) could not mention one advantage of PPIUCDs, while 23.1% could not mention one disadvantage. 13.9% of the women withdrew consent. Family member objections (43.44%), husband/partner objection (27.94%), and deciding on another method (15.59%) were the main reasons for consent withdrawal.

Conclusions

Awareness of PPIUCDs is not a limiting factor in women’s consent to PPIUCD insertion. As a woman’s decision to use a PPIUCD is significantly influenced by family members and her partner/husband, awareness initiatives that target these populations should be considered.

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Acknowledgements

We would like to thank the Government of India, Ministry of Health and Family Welfare (Ms Vandana Gurnani, Joint Secretary, Dr Sikdar Commissioner Family Planning), FOGSI team (All Presidents, Vice Presidents, General Secretaries, Deputy Secretaries, Treasurers, Joint Treasurers, Joint Secretaries and Staff), Center Teams (Chief Coordinators, Deputy Coordinators, Nursing Staff, Advisors, Nodal Officers and Counsellors), and Avni Health Foundation team members who have all contributed to the successful program implementation. Additionally, the team thanks all the FIGO PPIUCD team members including Prof S Arulkumaran and Dr A Makins for the technical support, funding, and the ongoing partnership for the PPIUCD program implementation.

Funding

Anonymous Donors funded the program through FIGO.

Author information

Authors and Affiliations

  1. Federation of Obstetric and Gynaecological Societies of India, Mumbai, 400013, India

    Hema Divakar

  2. Avni Health Foundation, 2nd Floor, Amarsons Bhavan, 68 Misquitta St, Vile Parle East, Mumbai, 400057, India

    Ajey Bhardwaj, Thelma Sequeira & Pooja Sanghvi

  3. International Federation of Gynecology and Obstetrics, FIGO House, London, SE1 8ST, UK

    Chittaranjan Narhari Purandare

  4. Divakar’s Speciality Hospital, 220, 2nd Phase, JP Nagar, Bengaluru, 560078, India

    Hema Divakar

Authors
  1. Hema Divakar
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  2. Ajey Bhardwaj
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  3. Chittaranjan Narhari Purandare
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  4. Thelma Sequeira
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  5. Pooja Sanghvi
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Contributions

HD and AB were responsible for hypothesis formulation, data analysis, and initial drafting of the manuscript. AB, TS, and PS contributed to the development, implementation, and management of the training program described. CNP contributed to the development, partnerships with the government, administrative support for program implementation, and reviewing the manuscript.

Corresponding author

Correspondence to Ajey Bhardwaj.

Ethics declarations

Ethical Approval

PPIUCD program is implemented as per the approved guidelines “IUCD reference manual for medical officers and nursing personnel”—September 2013 issued by Government of India—Family Planning Division, Ministry of Health and Family Welfare (GOI).

Conflict of interest

The authors declare that they have no conflict of interest.

Informed Consent

Each and every subject was informed about the PPIUCD program, and consent was taken.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Dr. Hema Divakar is a Director of Divakar’s Specialty Hospital, Bengaluru, India. Ajey Bhardwaj is a Director of Avni Health Foundation. Chittaranjan Narhari Purandare is President FIGO during 2016–2018—The International Federation of Gynecology and Obstetrics (FIGO), Emeritus Dean—Indian College of Obstetricians and Gynaecologists and Consultant OBGYN—Purandare Hospital. Thelma Sequeira is a Project Director of Avni Health Foundation. Pooja Sanghvi is a Program Officer of Avni Health Foundation.

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Divakar, H., Bhardwaj, A., Purandare, C.N. et al. Critical Factors Influencing the Acceptability of Post-placental Insertion of Intrauterine Contraceptive Device: A Study in Six Public/Private Institutes in India. J Obstet Gynecol India 69, 344–349 (2019). https://doi.org/10.1007/s13224-019-01221-7

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  • DOI: https://doi.org/10.1007/s13224-019-01221-7

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